One of the greatest blessings of practicing medicine in Tahoe is working with a wonderful population far healthier in body and mind than many and highly motivated to keep it that way. Most people are conscious of what they eat and active, enjoying hiking, biking, kayaking and skiing year-round. As a result, one of the greatest concerns I hear patients express is how to deal with joints that no longer behave as they once did. Although there are a range of exciting new therapies now available that make use of regenerative factors including stem cells, platelets and growth factors readily available in your own body, the best plan is always, when possible, to prevent the damage and associated pain rather than deal with the problem later.
Unfortunately, that’s not easy. By the age of sixty, half of us will suffer some degree of osteoarthritis, the most common degenerative joint condition today. This is the most common ‘wear and tear’ arthritis resulting from years of accumulated overuse and minor injuries.
The good news is that although genetics plays a minor role, most of the issues contributing to this condition can be mitigated by lifestyle changes, potentially preventing years of pain and disability.
The most important of these factors is weight. Our joints are designed to carry our ideal body weight and no more. Over years, the additional stress of carrying even ten extra pounds adds up, especially to weight-bearing joints in the knees, hips and back. Obesity results in at least a three-fold increase in severe osteoarthritis. Although achieving and maintaining a healthy weight can be a challenge, those who do usually note improvement in pain and decrease their risk of future problems.
An easier battle for many is to improve your posture, both at rest and while exercising. As we spend increasing hours hunched over keyboards and folded into car seats, our joints pay the price. Consider where you spend your time and try to optimize your seating, desk and keyboard height to promote a tall, evenly balanced posture. When standing and walking, become more conscious of holding your head high, shoulders back and pelvis slightly tucked beneath you. You may find you breathe more deeply and see the sights better on your next hike or stroll. Over time, you’ll likely feel better as well. Exercises focused on improving posture such as pilates and yoga can make a real difference as well.
What you put in your body can greatly promote inflammation or minimize it. Avoiding foods to which you have sensitivities and balancing lean proteins, complex carbohydrates and beneficial fats have been shown to decrease production of arthritis-promoting inflammatory mediators. Supplements such as fish oil, calcium, vitamin D, glucosamine, chondriotin, and MSM offer assistance to many. Other natural anti-inflammatories include turmeric, ginger, boswellin, and devil’s claw.
Although it seems counter-intuitive, some of the prescription steroids often used to decrease inflammation can worsen the condition of joints when used chronically. Medications such as prednisone and Decadron belong to a class of steroids know as catabolic or ‘breaking down’ steroids (as opposed to ‘anabolic’ or ‘building up’ steroid hormones such as naturally-occurring testosterone). By all means, if you need medication such as prednisone for asthma or COPD, autoimmune or other diseases where your doctor has found no alternative, do not quit them, however if you and your doctor are able to minimize their use, you will suffer less long term joint damage.
Most of us love our joints and the myriad activities they allow us to enjoy. If small lifestyle changes can add up over the years to allow us to function well and pain-free, it seems like a worthwhile investment to me.