Practical Prevention: Osteoarthritis
By age 65, more than half of us will have x-ray evidence of osteoarthritis in at least one joint. That's the bad news.
The good news is there's a lot you can do to prevent the disorder—or at least delay its impact—according to the National Institutes of Health (NIH). Here's a rundown of risk factors and arthritis prevention tips.
View of Osteoarthritis
For years, scientists envisioned osteoarthritis as a disease caused by gradual wear and tear on the joints. In the last decade, however, research has shown there is a lot more to the disorder than simple aging changes. Osteoarthritis is now seen as a cascade of events that eventually leads to thinning of the cartilage that cushions the ends of bones in your joints.
At the crux of these detrimental changes are the enzymes that normally regulate cartilage repair. An imbalance of these enzymes can cause joint cartilage to break down faster than it's rebuilt, resulting in osteoarthritis. Though the exact cause of this enzyme imbalance is not known, scientists have some hunches.
Risks for Joint Deterioration
According to the NIH, several factors linked to cartilage destruction may increase your chances of developing osteoarthritis. These include:
Older Age—Being 45 or older raises your risk of degenerative arthritis.
Female Gender—For unclear reasons, about 16 million women have osteoarthritis, out of a total of 21 million Americans who suffer from the disease. And though more men than women develop it before age 45, after that, degenerative joint disease becomes far more common in women.
Heredity—Genetic factors account for at least 50% of osteoarthritis of the hands and hips, and a smaller percentage in the knees. Certain inherited conditions—such as being born with defective cartilage or malformed joints—can also contribute to degenerative arthritis.
Obesity—People who are more than 10 pounds overweight have a higher risk for osteoarthritis, especially in weight-bearing joints like the knees. Pressure on joints from the excess weight causes cartilage to break down faster than usual.
Joint Injuries—A severe injury in the past can damage cartilage and lead to quicker joint deterioration. Research has found that young adults with knee injuries have six times the risk of developing osteoarthritis by age 65 compared to adults without knee injuries. For those with hip injuries, the arthritis risk is three times greater.
Risk factors or not, you can still take steps to stave off degenerative joint disease. Here are some osteoarthritis prevention tips from the NIH:
- Keep your weight down. In a study reviewed by the NIH, people who lost 11 pounds cut their risk of osteoarthritis in half.
- Get enough vitamins C and D. Onset or progression of arthritis is less in people who consume adequate amounts. Eat fresh fruits and vegetables for vitamin C. Good sources of D include sunlight, fortified milk or margarine, and supplements with 400 international units (IU) a day. This dose should be increased to 600 IU after age 70.
- Make sure your diet contains sufficient amounts of calcium. Most adults need to take between 1000-1500 mg per day.
- Strengthen your thigh muscles. Doing moderate conditioning exercises for your quadriceps muscles can reduce the risk of degenerative arthritis in the knees by up to 30%.
- Take precautions at work. Researchers have linked osteoarthritis with repetitive tasks and with jobs that involve kneeling or squatting, especially when doing heavy lifting.
- Avoid sports injuries.
NIH advice for reducing your risk of injury while exercising includes:
- Use proper equipment and protective gear.
- Cross train, or vary your activities.
- Take a break if something hurts.
- Get prompt care for injuries so they heal properly.
Where We Go From Here
In the future, doctors may use biomarkers—substances in joint fluid, blood, or urine that indicate changes in bone or cartilage—to detect degenerative arthritis or its risk factors much earlier. Hopefully researchers' growing understanding of the disorder will bring new options for averting osteoarthritis.
American College of Rheumatology
National Institute of Arthritis and Musculoskeletal and Skin Diseases
The Arthritis Society
Canadian Orthopaedic Association
The NIH Consensus Development Program website. Available at:. http://consensus.nih.gov/1994/1994OptimalCalcium097html.htm. Accessed June 14, 2008.
Osteoarthritis: new insights, part 1: the disease and its risk factors. Ann Intern Med. 2000 Oct 17.
Last reviewed June 2008 by Robert E. Leach, MD
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