Keeping your joints healthy as you age

When joints start to creak or hurt, it's usually because our cartilage has worn out due to overuse and/or ageing. — TNS

For joints to work well, they need cartilage – a slippery tissue that covers the ends of bones, acts like a shock absorber, and helps joints move smoothly.

Mayo Clinic orthopaedic surgeon Dr Joaquin Sanchez-Sotelo says that many people lose cartilage as they age, but it does not mean that joint replacement is inevitable.

Here are some tips for keeping joints healthy.

Cartilage degenerates for various reasons, Dr Sanchez-Sotelo says.

People may be born with abnormally-shaped bones or a tendency toward weaker cartilage.

Obesity, overuse or injuries from accidents can also damage joints and cartilage.

"When cartilage degenerates, the body forms bone spurs," he says.

"This is a reaction to the main underlying problem – cartilage degeneration.

"Bone spurs can hit each other and become painful.

"Many patients get obsessed with bone spurs, but just taking them out won't cure the problem, except in very rare circumstances."

Loss of articular cartilage is the essence of what is called osteoarthritis – a common joint disorder.

Dr Sanchez-Sotelo says that most of his osteoarthritis patients are in their 60s when they go to see a healthcare professional with symptoms – achy and painful joints, stiffness, and loss of movement – that developed over time.

However, according to him, you can take steps when you are younger to protect your joints as you age.

Having strong muscles around the joints can help take the load off the joints.

However, people who exercise at high levels in sports, like football and bodybuilding, have higher risks of developing arthritis.

"You have to exercise within reason," Dr. Sanchez-Sotelo says.

"Find that point where your muscles are healthy, flexible, strong and will protect the joints, but don't overdo it."

Maintaining a healthy weight is important, as obesity is hard on the joints.

Glucosamine and chondroitin are popular supplements for joint pain, but lack convincing evidence that they work, he says.

He offers these suggestions for managing arthritic pain:

• Modify your activities

  If you have an arthritic hip or knee, instead of running, which results in the pounding of the joints, maybe you can try bicycling.

• Take the load off the joints with gait aids

  Using a cane can help lighten the load on your hip, knee and ankle joints, and decrease the pain.

  A knee brace – worn outside the clothes – shifts the load to the healthier side of the knee joint.

• Over-the-counter medications

  If the pain persists, you may want to consider such medications, like acetaminophen and ibuprofen.

  However, be aware of the side effects, such as ulcers, kidney or heart issues.

  In general, narcotics should not be used for osteoarthritis.

• Prescribed medications

  If the pain continues, you may also consider injections with medications such as cortisone or toradol, which, when injected into the joint, can help relieve pain.

  Again, these medications have side effects, so be sure to speak with your healthcare professional.

• Hyaluronic acid

  This uses components similar to those of the joint-lubricating fluid to try to replenish it.

  It is also injected, and has been more successful with the knee joint than hip and shoulder joints.

• Regenerative medicine

  These therapies include stem cells and platelet-rich plasma, which are injected.

  At this point, many consider their use as experimental as there is no firm evidence about their efficacy.

"In the past, older people just accepted joint pain," Dr. Sanchez-Sotelo says.

"Now people are living longer and want to remain active as they age.

"We are not all destined for joint replacement. There are some people in their 80s and 90s who have great joints." – By Rhoda Madson/Mayo Clinic News Network/Tribune News Service