September 23, 2021 by John Fernandez and Bethany Rundell
Here’s How Arthritis is Diagnosed and Treated to Keep You Active
Arthritis affects roughly 55 million U.S. adults — about 1 in 4 — and it’s one of the most common chronic conditions in the nation. It is also a frequent cause of chronic pain and work disability.
Most types of arthritis cause pain and stiffness in and around the affected joint. Arthritis is a general term encompassing more than 100 types of chronic conditions, with the most common being osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia.
“I’m very surprised that a lot of people in our population don’t understand what arthritis is,” says Francisco Garcia, PA-C, a physician assistant with Miami Orthopedics & Sports Medicine Institute’s arthritis clinic. “They think it’s just pain or crepitus or noises that their joint makes, and they have to live with it. That’s not necessarily true.”
People don’t necessarily have to live with arthritis, he adds.
The Arthritis Clinic
“We can tailor the treatment based on the patient’s symptoms and how much this condition is affecting their quality of life,” says Mr. Garcia. “Not everybody that has arthritis needs to have surgery. And not everybody that has arthritis is required to have an injection.”
The goal at the Institute’s arthritis clinic is to help patients with arthritis return to their daily activities by using non-surgical techniques — and educate them on their condition, he says.
Osteoarthritis (OA), which affects more than 30 million U.S. adults, is the most common form of arthritis, also referred to as degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, and knees.
With OA, the wearing down of the protective tissue at the ends of bones (cartilage) occurs gradually and worsens over time. It’s a slow process that can cause pain, stiffness and swelling. In some cases, OA can cause reduce quality of life and prevent an individual from going to work and taking part in physical activity.
Luis Rodriguez, M.D., a primary care sports medicine physician with Miami Orthopedics & Sports Medicine Institute, says that arthritis is one of the most common complaints from his patients. But there is a process for diagnosis the chronic disease and following up by fully educating the patient about the condition and providing the framework for a rehabilitation or exercise program to improve functionality and reduce pain.
“Most patients will come to us because they’re having symptoms,” explains Dr. Rodriguez. “They may be having knee pain or perhaps they hear increased cracking in the knees. About 80 to 90 percent they come to see me because of pain in the joint.”
Imaging tests usually follow, depending on results from the initial exam and patient interview.
Sometimes, with just an X-ray or radiograph and obtaining some history, we can have at least a good idea of what’s going on … a strong presumptive diagnosis which can then be confirmed by the physical exam and perhaps some additional work-up,” says Dr. Rodriguez. “Some patients may need some advanced imaging, but that’s not always necessary.”
Treatment for the most common cases of arthritis may involve over-the-counter analgesic or prescribed anti-inflammatory to reduce pain. A “self-management program” is going to be very important to feel better and stay active and “to retain or improve quality of life,” he says.
A physical rehabilitation program will be prescribed as well if needed. Most significantly, the patient will be educated on starting and maintaining a regular exercise program that will improve the strength and flexibility of the affected joint.
“It all starts with patient education and providing them with the tools to better understand and manage the disease,” says Dr. Rodriguez. “Physical activity is going to be very important. Very often, we will recommend an exercise program to keep the muscles around that joint strong and keep the joint flexible and moving.”
Risk Factors for Osteoarthritis
The U.S. Centers for Disease Control and Prevention lists the following risk factors for osteoarthritis (OA), the most common type of arthritis:
- Joint injury or overuse—Injury or overuse, such as knee bending and repetitive stress on a joint, can damage a joint and increase the risk of OA in that joint.
- Age—The risk of developing OA increases with age.
- Gender—Women are more likely to develop OA than men, especially after age 50.
- Obesity—Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. This stress increases the risk of OA in that joint. Obesity may also have metabolic effects that increase the risk of OA.
- Genetics—People who have family members with OA are more likely to develop OA. People who have hand OA are more likely to develop knee OA.
- Race— Some Asian populations have lower risk for OA.