“Bodies don’t age on a precise schedule,” my doctor said, my hands still in hers. She had just finished examining my knuckles to confirm a diagnosis of osteoarthritis, the wear and tear type of the condition. I was 36, and it hadn’t occurred to me that the relatively sudden and severe stiffness and aching in my hands could be age-related degeneration; that in my mid-30s I’d be fighting a case of early-onset arthritis.
What is osteoarthritis?
Like many people, I had put off seeing the doctor for my pain. I popped Tylenol (acetaminophen) and continued on with my activities. But when the brisk temperatures of winter blew in, I began to have difficulty buttoning my coat, gripping door knobs, and holding my coffee mug in the mornings. I knew it was time to seek medical help.
Osteoarthritis involves the breakdown of cartilage, the tough, yet flexible tissue in our joints that allows smooth movement. The breakdown of the cartilage can make bones susceptible to degeneration as well as cause an inflammatory response that further causes joint breakdown, swelling, and pain. It can develop in one or multiple joints. Typically, it develops slowly, causing pain, stiffness, and restricted movement.
Signs of osteoarthritis
Since we all develop aches and pains as we age, how can we distinguish osteoarthritis from other painful conditions? According to Diana Girnita MD, Ph.D., Founder & CEO of Rheumatologist OnCall, the most common signs are:
- Tenderness of the joints
- Joint swelling
- Limited motion, or joint stiffness
In more advanced cases, there can also be joint deformity, bony deformity, or instability of the joint.
Magdalena Cadet, MD, a New York City–based clinical rheumatologist and associate attending at NYU Langone adds that joint stiffness may especially occur in the mornings, and there may be “crunchy, crackling noises” when the joint moves. Whatever your symptoms, a medical professional can diagnose osteoarthritis by combining your self-report, a physical examination, and sometimes X-rays to view changes in the affected joints.
How is osteoarthritis diagnosed?
Osteoarthritis is typically diagnosed through comprehensive medical and family history and physical examination. X-rays may show bony or joint changes and some lab tests can help with the diagnosis. If you are concerned about joint pain or swelling, start by visiting your primary care provider for an evaluation.
Arthritis is one of the most widespread health conditions in the United States, affecting more than 32 million adults. Even so, I was surprised to be diagnosed with it so young…so I thought. “Contrary to popular belief, [osteoarthritis] is not a form of arthritis limited to the elderly population,” explains Dr. Cadet. “Genetics, activity, weight, sex, can all play a role in development.” As it turns out, I had most of the risk factors associated with the condition without even knowing it.
Even though people don’t actually inherit arthritis itself, certain genetic components do put one at increased risk. And I had other risk factors, too. I was female, overweight, and had performed rigorous, repetitive movements of the knuckle joints during 12 years as a competitive violinist. It all added up. It would be surprising for me not to have arthritis.
Finding the right treatment
Though there is no cure for osteoarthritis aside from a total replacement of the affected joint, there are many ways to seek relief from the pain and stiffness. Treatments can include medications like pain relievers and anti-inflammatories, either oral or topical. Analgesics like Tylenol and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are the most common arthritis medications, according to a recent SingleCare survey. NSAIDS are actually first-line treatment since they treat both the pain and inflammation.
Heat and ice can help, as can low-impact physical activity like swimming, yoga, and tai chi. Staying active and maintaining a healthy weight are very helpful for minimizing pain and disability associated with osteoarthritis. Additionally, working with a physical or occupational therapist to improve overall strength, flexibility, and balance can be very beneficial. There are assistive devices like canes and walkers and lifestyle accommodations that can make mobility easier. There is even some evidence that acupuncture, certain foods, and other alternative treatments can relieve symptoms.
Each body (and even each joint) reacts to treatments differently, so not every treatment option will work for every person. It is important to try different protocols to arrive at a plan that works for you. For example, I am not able to take anti-inflammatories due to another medical condition, so that option is not available to me; however, I found that moving my finger joints by doing needlework and keeping my hands warm in the winter are the keys to overcoming my pain and stiffness. I have also used acupuncture and Tylenol (acetaminophen) during particularly difficult flares.
Moving forward: Living with osteoarthritis
“Osteoarthritis is a chronic condition, but not a life-threatening condition,” Dr. Girnita emphasizes. Some risk factors, like obesity or inactivity, can be alleviated to help reduce symptoms and the rate of degeneration. Thankfully, my arthritis has progressed quite slowly so far, and I can still do all daily activities with minimal pain.
“Patients who are actively involved in the management of their disease will be able, with guidance, to have good outcomes,” Dr. Girnita says. By educating themselves and combining the treatment options above, she adds, “these patients can have a good life.”