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October 10, 2008  
REFERENCE: Frequently Asked Questions
Osteoarthritis
Q: I am having severe joint pain that my doctor diagnosed as osteoarthritis. I have not experienced any traumatic situations. What could possibly have caused this condition?
Answered by Ken Alleyne M.D.
A: Osteoarthritis (OA) has many causes, some which are well understood and others that remain a quandary. Osteoarthritis comes in two varieties: primary and secondary. Primary OA appears to be related to a genetic predisposition to cartilage breakdown for no known reason. This arthritis can strike people at any age and many have no specific history that can be related to the arthritis. An inciting agent causes secondary OA, whether it is trauma, medication or an issue of how we were born. They are both usually treated similarly, beginning with conservative treatments such as exercise, anti-inflammatory medications, weight loss (if applicable to the joint), ice, well cushioned shoes (if applicable), etc. Obviously, the more involved management requires surgical interventions from alignment procedures and/or arthroscopic procedures to total joint replacement.
 
Q: I have been suffering from knee pain and symptoms that resemble arthritis, yet I am only 35 years old. Could it be another condition that I am unfamiliar with or is it possible to have arthritis at such a young age?
Answered by Ken Alleyne M.D.
A: It is possible to have arthritis at your age. It can sometimes be the manifestation of other diseases or osteoarthritis that is usually not related to other disease states. You should undergo evaluation by your primary care physician or orthopaedic surgeon to develop a treatment plan for your concerns.
 
Q: What surgical options do I have to relieve the symptoms of my osteoarthritis before I have to consider a total knee replacement?
Answered by Ken Alleyne M.D.
A: Options range from weight loss (which, if applicable can be very helpful), exercise (such as swimming to stay active with minimal trauma to the joints), to arthroscopic procedures and realignment procedures. These are very dependent on the severity of the arthritis in your knee and may or may not be a reasonable option for you. You should consult with your orthopedic surgeon to review all of the options available to you.
 
Q: I have heard of several different drugs used to relieve symptoms of osteoarthritis, but all the different names confuse me. Could you explain what medications are useful to treat osteoarthritis?
Answered by Ken Alleyne M.D.
A: There are many medications that are useful in treating osteoarthritis, but they largely fall into three categories: pain relievers, anti-inflammatory medications, and natural remedies. Pain relievers are medications like Tylenol (acetaminophen) they focus on relieving pain and do not treat inflammation. Anti-inflammatories comprise the majority of arthritis medications and ibuprofen is a frequently utilized representative from this category. There are many prescription strength variants on this theme, including the newer cox-2 inhibitors that have less stomach side effects than some of the other anti-inflammatory medications. Natural remedies are represented by the likes of glucosamine and chondroitin sulfate. There is very little hard evidence regarding their efficacy but some patients do gain relief with their use. The FDA does not regulate these medications and therefore there is little "official" information regarding their use and efficacy. As with any medication caution should be utilized with their use as well as consultation with your physician.
 
Q: Are there any alternative therapies that are successful in relieving the pain of osteoarthritis?
Answered by Ken Alleyne M.D.
A: Alternative therapies can range from exercise, weight loss, improved cushioning of shoes or utilizing a cane, to glucosamine, chondroitin and ginger derivatives. These medications are frequently viewed as "alternative," because the FDA does not regulate them, because they are thought to be "natural," and because they can be purchased over the counter. As with any medication, caution should be utilized with their use as well as consultation with your physician.
 
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