AF, Mayo Clinic Web Chat on Osteoarthritis

Arthritis Foundation and Mayo Clinic Facebook chat on osteoarthritis for Arthritis Action Month, featuring Patience White, M.D., the Arthritis Foundation's vice president of public health, and Mayo Clinic rheumatologist Shreyasee Amin, M.D., 5/16/2012

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  1. Arthritis 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 rheumatologist.


    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.

    Kim 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?

    Kathy Tucker 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 with OA.

     

    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.

    Beth 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 good?

    Taten 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?

    Tracey 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 prescribed me/

    Audrey 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 replacement surgery?

    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 recommended.

    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.

    Sherrie Guinn Ford Is there anything that can done about the fingers being disfigured? Besides being unsightly, it is very painful.

    Diana 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.

    Piper 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.

    Steve 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.

    Janie Nutter 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?

    Julie Boyd 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.

    Pat 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 at arthritis.org.

    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 replacement surgery.

    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.

    Audrey Kronkaitis thanks for your answer to my questions about joint injection. i have been having the injection every 6month for the last 2yrs now.

    Tracy 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.

    Katherine 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.

    Steve 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.

    Patricia 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 tablets!

    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 arthritis.org disease center to learn more about what you can do to improve osteoarthritis pain. We wish you luck with your cancer therapy.

    Arthritis 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 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 link:  http://www.mayoclinic.com/health/arthritis/AR00030 

    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.

    Arthritis 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 arthritis.org and fightarthritispain.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.

     

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