During a recent presentation on shoulder pain, a participant asked me what the difference was between osteoarthritis and osteoporosis. Although they may sound and spelled similar, they are two very different diagnoses. Each is treated with different medications and sometimes surgery is needed.
Bone meets bone at a joint. There are lots of ways this can happen. The most common issue with people is where bones meet to form joints like in fingers, knees, hips and shoulders. These joints are called synovial joints. Synovial joints are held together by ligaments, tendons and a capsule that is lined with synovial cells that lubricate the ends of the bone. Additionally, the ends of the bone are coated with a super slick and durable surface called cartilage. Cartilage allows the ends of the bone to glide against each other.
To recap, joint capsule holds the joint stable, synovial lining lubricates the joint and cartilage allows smooth gliding motion. Damage to these structures can result in the loss or wearing away of the cartilage. When the cartilage wears away, the joint doesn’t move smoothly anymore. This causes popping, swelling, loss of motion, deformity and PAIN. This is osteoarthritis.
Osteoarthritis is an unfortunate disease which can lead to severe disability and pain. Osteoarthritis affects billions of people. Osteoarthritis can lead to early death if not treated appropriately due to decrease in heart and lung function from lack of mobility. Treatment for osteoarthritis begins with an accurate diagnosis. It is best to see either your family physician or an orthopedist. The history and exam can point to the cause of joint pain; usually a simple x-ray can confirm osteoarthritis. Osteoarthritis can also be confirmed through blood tests or even an MRI.
Initial treatment for osteoarthritis is to alter activities (it hurts when I do this, Doc! Well, stop doing it!!). Low impact activities such as swimming, walking, yoga and elliptical rider are best for maintaining joint mobility and strength. Ice can be used on the joint to control swelling. Over the counter anti-inflammatories such as Ibuprofen (Advil or Motrin) or Aleve can be effective when taken as directed. When these methods cease to work, more aggressive measures are needed such as cortisone injections. Lubricant injections can be given to supplement the normal joint fluid produced by the synovial lining of the joint mentioned earlier. Physical therapy and even chiropractic care can also help.
These therapies all treat the symptoms and there is no effective way to stop or reverse osteoarthritis. If symptoms become intolerable, surgery can help. Arthroscopy surgery can “clean out” the joint relieving some of the symptoms. Joint replacement is very effective to permanently remove the disease joint surface, correct deformities, relieve pain and restore motion.