Understanding arthritis

Pulling up your socks, rising from a chair, opening a jar — the one in 10 Canadians with arthritis knows just how taxing these simple actions can be. And finding the right treatment can make a dramatic difference in how you feel every day.

Experts still aren't sure why cartilage, the shock-absorbing tissue that normally coats the ends of bones, sometimes breaks down, causing the typical arthritis symptoms of stiffness and pain. Once the cartilage has worn down, however, your bones start to grate against each other. The roughened ends thicken and may develop knobby outgrowths called "spurs." Bits of cartilage break off in the joint space.

At later stages, the joint can look as if a dog has been gnawing at it. The breakdown of cartilage induces inflammation, which alone can make your joint hurt; often it’s associated with warmth, swelling and stiffness that make symptoms worse. At first, pain may appear only when you move the joint, but later it may hurt even when you're still. Some people notice cracking sounds of broken cartilage, so-called "joint mice," when they move a stiff joint.

Arthritis is a degenerative disease, and its causes are varied. Your family history may bear some responsibility: your genes set the stage for a defect in the production of collagen, a protein crucial to cartilage. Or perhaps you were injured (even decades ago), you're overweight or you use a certain joint repetitively (maybe on the job).

Most people develop pain in just one or two joints, but any joint is vulnerable. Trouble spots include knees, hips, spine and fingers. More than 100 conditions cause joint pain, so get a firm diagnosis before you label yours "arthritis."

• Acetaminophen for discomfort, over-the-counter or prescription NSAIDs (including COX-2 inhibitors) for inflammation or opiates for pain.
• Application of topical liniments and heat or cold for immediate relief.
• Strengthening exercises to enhance recovery.
• Physical aids such as shoe wedges, canes and joint protectors (splints, braces) to ease joint stress.
• Eventually injections or surgery, even a joint replacement, may be necessary.

1. Go to class. Studies show that being actively involved in managing your own osteoarthritis (OA) can dramatically lessen your pain.
2. Toss the heels. Twice as many women as men suffer from knee OA, and Harvard researchers have a clue as to why. When walking in heels higher than five centimetres (two inches), the torque — the rotational force — applied around the ­inside of the knee is 23 percent greater than when barefoot. This is enough torque to destroy cartilage and cause arthritis. So opt for low-heeled or flat shoes, and keep the high heels for (brief!) special occasions.
3. Get on the ball. Try squeezing a tennis ball to relieve stiffness and strengthen your forearms and hands. Make a five-centimetre (two-inch) cut in the ball for light resistance, and a 2.5-centimetre (one-inch) cut to create moderate resistance.
4. Be hip on hips. Don't just settle for a standard replacement hip. Ask your doctor about different options. Many people go overseas for variations such as the Birmingham, England, hip resurfacing procedure.