Foundation Good afternoon everyone! Thanks for joining our
osteoarthritis chat with Dr. Patience White, MD, MA and Arthritis Foundation
Vice President of Public Health and Dr. Shreyasee Amin, MD and Mayo Clinic
Today’s chat will last an hour. In that time, Dr. White and Dr. Amin will
respond to as many questions and comments as they can. If you’d like to submit
a question... for Dr’s through the Arthritis Foundation inbox, please feel free
to message us and we’ll post anonymously for you. Please note, this chat is
intended to be an informative dialogue about osteoarthritis, and no part of the
chat should be considered medical advice from the Arthritis Foundation, Mayo
Clinic or Dr. White and Dr. Amin. Dr. White and Dr. Amin cannot analyze tests
or diagnose patients during the chat. For specific medical advice or opinion
about rheumatic diseases, please consult your rheumatologist.
Archer Malone I have osteo arthrits and it is severe in my knees.
I've been told that it is bone on bone from the xrays. My only choice now is
knee replacements. I am 49 and my Dr. said I should wait as long as possible
due to the longevity of the replacements. He said I would need them again after
so many years and the 2nd ones are not as successful. However, my pain is nearly
unendurable. In addition, I am very overweight. I feel like if I had it done
now, I could then be more active to lose weight. What would you suggest?
I have Osteoarthritis in my knees.My left knee is the worst.It will not even straighten
out anymore.I have Kidney Disease ,which now limits what medications I can
take. Do you have any suggestions.I cannot climb stairs of any kind for the
most part. I swim,but it does not help.I used to ride my bike and walk, and
even these tasks are almost impossible. I take Tramadol ,but it does not seem
to help much. Then,my Kidney Disease has made the Arthritis worse.
Patience White This is Dr. Patience White. Hello
and thank you very much for the introduction. It is great to have the
opportunity to have a conversation with you about important issues to people
Shreyasee Amin Good afternoon to all! This is Dr.
Amin, and I am a rheumatologist at the Mayo Clinic. I look forward to answering
your questions today.
Fesler Is running really bad for Arthritis? I am 32 and have
rheumatoid arthritis. I also suspect that I have some osteoarthritis in my
knees as a result of a lifetime (since the age of 9) of obesity. I have lost
over 100# with diet and exercise and have found a passion for running. I am
training for a marathon, but I wonder am I doing more harm to my body than
Coleman Shirley My dad had a knee replacement surgery on his right
knee 5 years ago… It felt better for a while, but the pain is starting to come
back in that knee. Now his pain is even worse because his left knee has really
started bothering him also. I told him he should exercise his knees, but he
tells me his knees are so bad that he doesn’t think exercise will help. What
advice would you give him?
Lang -jarvis is there any chance of remission for osteo arthritis,i
have it in my ankle,and have been told i have no ankle joint left,i am too
young for a replacement and dond want to have it fused,is there any other
solutions as i am tired of taking tramadol,which is what my doctor has
Kronkaitis what are the long term side effects on orthrovisc
injection and how many years can you take them before you should have a knee
Patience White @Janice. It's important that you
keep moving to keep your muscles strong. If you decide to have surgery, you
will recover more easily. Using drugs in the short term could be beneficial.
Shreyasee Amin @Venne I usually recommend
surgery when it is affecting lifestyle and we aren’t able to control pain or
improve function by medications and lifestyle changes, regardless of xray
changes. Other than Tylenol, there are other medications that could be used to
help pain from osteoarthritis, such as NSAIDs (eg ibuprofen, etc) if they can
be used safely given other medical conditions, or tramadol. There are a number
of non-medication options, such as using canes or other assistive devices to
help unload the hip when walking to help with pain. Talking with your health
care provider about the different options, other than Tylenol, would be
Patience White @Diana. Thanks for your question.
OA in your hands is often genetic. Keeping your hands moving and strong is
important. We suggest you might ask your doctor about topical pain medications
and visiting an occupational therapist for strengthening exercises.
Guinn Ford Is there anything that can done about the fingers being
disfigured? Besides being unsightly, it is very painful.
Riley Gasior @Patience. I tried topicals and found they burned too
much. I do workout a lot, but gripping has become a bit challenging. Thank You
for your response.
Lori TMJ shows up on x-rays/tommograms as arthritis of the jaw. Why
isn't the AF more vocal about what TMJ actually is? What is the AF's position
on treatment for TMJ? - thanks, in advance.
Burzlaff I am 62 YO and have OA in my left knee. What is the best
exercise? I walk 1.5 to 2 miles a day now plus 30 minutes of circuit training
in a gym daily. I want to increase the range of motion in my knee as much as
possible as it is very difficult to get up and down off of the floor and I have
grandkids that like to play.
Shreyasee Amin @Kim If you take care of your
knee replacements after surgery, you may do well for a long while. Every effort
to lose weight before surgery will also help the longevity and success of your
artificial knee. Water-based exercises may be one option to consider, since
there is less loading on the knee.
Patience White @Kathy. Thank you for your
question. Have you considered a referral to physical therapy for pain relief
modalities such as ultrasound and to increase the range of motion of your joint
and strengthen the muscles. If medical therapy fails, perhaps consulting an
orthopaedic surgeon to see if any joiny procedure can improve your situation.
See the OA disease center at arthritis.org to review other options.
I have OA and Fibromylgia - I have already had joint replacements in both
thumbs. The OA is now in all major joints - I am 55. Do you believe there may
be a connection between the OA and the Fibromylgia?
Hi! I am 48 yo due for a knee replacement due to OA, which I have in both knees
and both feet. I have 2 ?s. 1- should I get surgery on my feet before or after
my knee? 2-will the pain & tightness in my knee go away after replacement?
Thank you so much!
Noelle McCartney What do you recommend for lower
back pain from arthritis?
Shreyasee Amin @Beth For people with arthritis,
running may put extra loading on the knee, and put them at a higher risk for
injury and wearing out the joint faster. I usually don’t recommend running for
people with knee arthritis. If you do want to run, it should be with good
footwear and proper training.
Blust Pillarelli I am 60yrs old and have OA, Fibro, and Scleroderma.
I feel lousy and always in pain. Some days are better then others. My question
is what are the ulcers on my fingers and why they cause so much pain?
Patience White @Taten. Thank you for your
question. You are correct. Physical activity is important to strengthen the
muscles around his knees to make his knees function better mechanically. Also
consider returning to the orthopaedist to understand why the knee with the
replacement has recurring pain. For exercise, swimming is particularly helpful.
For a list of physical activity and self-management programs proven to decrease
pain and improve function, see Arthritis Foundation Programs for Better Living
Shreyasee Amin @ Tracy Unfortunately once the
joint is this far damaged, our options other than surgery are to consider ways
to help with pain and function. Splints or bracing to help support the ankle
may be other ways to help with pain and with maintaining function.
Patience White @Audrey. Thank you for your
question. The major issue with joint injections is the increased risk of
infections as the number of joint injections goes up. We suggest you ask your
orthopaedist how long it has to be between your last injection and joint
Patience White @ Piper. Thank you for your
question and for alerting us that the AF needs to have more information for the
public about TMJ and its treatment. We do not have a formal position on
treatment for TMJ at this time.
Shreyasee Amin @Sherrie That’s a good question,
and one I am often asked…Unfortunately, there is little that can be done about
the fingers becoming disfigured. Other than pain medication, paraffin wax
sometimes can be soothing. Another medication that has been tried for this type
of arthritis in the hands is one called hydroxychloroquine. While it is a
medication often used for rheumatoid arthritis, some people have found it
helpful for the pain from hand osteoarthritis.
Patience White @Steve. Thank you for your
question. Congratulations, walking is a great exercise for your knees.. It is
important to not only do strengthening, but also stretching exercises for joint
OA. If your gym professional cannont assist you with particular exercises with
OA, consider getting a refferal for a physical therapist to show you the best
exercises to increase your range of motion.
Kronkaitis thanks for your answer to my questions about joint
injection. i have been having the injection every 6month for the last 2yrs now.
Theisen DeMorett Hello, I have OA in my hands and I think now my
hips. I'm 34 years old and have been going through treatment for brain cancer
for 7 years including mostly oral chemo plus one cycle of raditiation and
several of intra-arterial chemo. Could my historical and current treatment
initiate and expedite the progression of OA?
Patience White @Julie Boyd. Thank you for your
question. On your first question, it depends on the amount of surgery needed on
your feet, but in general orthopaedists suggest getting your feet problem
settled before other lower extremity joint surgery. On your second question, in
general, knee replacements improve pain and tightness if they are due to
structural abnormalities of the joint surface.
Galliers Mclaughlin Hi, i am a 48 year old woman and suffer from OA
mainly in my Hips/knees, feet and wrists, i know my weight does not hellp and i
am currently attending a weight management course in plymouth devon and they
will not refer me for surgery until i lose some weight myself (which i am
trying to do but finding hard) i do have a very good gp but i know this surgery
will help. I really am getting fed up with the daily pain and also dont like
taking so many tablets.
Burzlaff Patience - Thank you. I try to stretch, but probably do not
devote enough time to it. I have had sessions with a PT, but found the trainer
at the gym works better in my case. He is only 21, right out of school and
really pushes me, but at the same time his training is still fresh in his mind
so he has me doing some exercises that really help. BTW, I have lost 45 lbs in
the last year and now have a BMI of 24.
Shreyasee Amin @Janie Although chronic pain from
other medical conditions can be aggravated in people with fibromyalgia,
fibromyalgia does not cause osteoarthritis. Keeping physically active with low
impact activities is still be good for both osteoarthritis and fibromyalgia.
Patience White @Noelle. Thank you for your
question. In general, it's important to strengthen your core back and abdominal
muscles. Lose weight if you are above your ideal weight and be careful how you
lift heavy objects.
Spelman I have severe tinnitus in my right ear, due to displacement
of the Tm discs. I have generalised osteo arthritis in neck, fingers hips etc.
I am wondering if there is any surgery that is not too invasive, which would
replace the disc in the correct posiiton. The tinnitus started at the time it
moved out of place. Nobody seems able to treat this in Ireland. I am willing to
travel for a cure - I would do anything to be able to sleep without sleeping
Sharon Theimer My mother has hand OA, as did her
mother. Are there hand exercises I can do to fend it off? Re OA generally,
would yoga help me avoid it?
Patience White @Tracy. Thank you for your question.
Drugs, such as cortisone, can cause arthritis. Being overweight and not
physically active to keep the muscles strong around your hip joints can worsen
osteoarthritis of the hips. Please see www.arthritis.org disease
center to learn more about what you can do to improve osteoarthritis pain. We
wish you luck with your cancer therapy.
Foundation We have a question from our inbox: I’m 32 and have had
JRA for 25 years. I have seen wonderful results from Enbrel and most of my
joints feel so much better. I have had neck pain and stiffness for years and
its is still bothering me every day. Could it be osteoarthritis if the Enbrel
isn’t helping? I had a negative MRI last month and am trying to figure out why
I have so much pain in my neck.
Shreyasee Amin @Pat Ulcers on fingers are not
usually from osteoarthritis. Ulcers on fingers can be from scleroderma, which
are usually caused by decreased blood flow to the fingers. Pain is often
associated with this problem.
Noelle McCartney Thank you!
Patience White @Katherine. Thank you for your
question. You can improve pain from OA through a small amount of weight loss.
For every pound you lose, that's the equivalent of decreasing four pounds of
pressure across each knee. Also, strengthening and stretching the joints can
improve pain and function. We suggest you consider swimming as an exercise. For
other suggestions, see the OA disease center and Programs for Better Living
offered by the Arthritis Foundation at www.arthritis.org.
Shreyasee Amin @Sharon OA is often genetic, so
it is sometimes hard to prevent. But it is a good idea to think of ways to help
decrease this risk. Yoga is a great way to help maintain strength and
flexibility of joints. For hand exercises I suggest going to the following
Patience White @Arthritis Foundation. Thank you
for your question. Given you have a normal MRI, your pain could be due to
muscle tightening and/or spasm. We suggest asking for a referral to a physical
therapist for guidance on range of motion exercises, pain relief and better
support while sleeping to improve your neck pain.
Foundation That’s all the time we have for questions today. Thanks
to Dr. Patience White and Dr. Shreyasee Amin for taking time out of their day
to answer many of these questions. Their expertise is certainly appreciated.
And, thank you to everyone who posted questions and participated.
Patience White Thanks for your questions today.
If you would like more information, please visit www.arthritis.org
Shreyasee Amin There were many great questions! I
have enjoyed answering them. For more information on osteoarthritis, feel free
to visit this site as well: http://www.mayoclinic.com/health/osteoarthritis/DS00019
Thanks to the Arthritis Foundation for hosting this chat.