Q: Four years ago, I was diagnosed with osteoarthritis (OA) in my right ankle. Now X-rays show OA in my spine, neck, knuckles, wrists and knees. Can you tell me what caused OA to spread this way, and is there anything I can do to stop it?
A: OA is a degenerative disease of cartilage and results in overgrowth of bone underneath the cartilage. In some people, a traumatic joint injury can lead to OA, while in others genetics may play a role. The disease usually begins with a single large joint, such as a hip or knee. But it is not uncommon for a smaller joint, such as an ankle, to be affected initially – particularly if that joint has had a significant injury, such as a sprain or cartilage tear.
While OA can be limited to a single joint, in many cases it progresses to involve other joints, often in a sequential fashion as you describe. In some cases, pain from OA in one joint (such as an ankle or knee) can prompt you to walk, stand or move differently, which can, in turn, force other joints (such as the hip or joints of the spine) out of alignment and predispose them to OA as well.
Unfortunately, we don't fully understand the reasons OA progresses or have therapies to effectively stop the progression. For OA in general, the most helpful advice is to maintain an ideal weight, avoid overusing joints that are damaged and follow a plan of exercise that strengthens the muscles supporting the joint. Your doctor or physical therapist should be able to help you with any of these.
Grant W. Cannon, MD, Rheumatologist
































I live in the UK and wondered if anyone else has had problems getting useful help from the Doctor. They have no problem giving me modified release and immediate release morphine at what im sure are quite high doses, very strong NSAIDs (also now have ulcer symptoms so taking medication for medication), and other pain meds (up to about 20 pills morn and night). What the Docs dont seem to want to do is help me. I loved my career had a great social life but in the last ten years have lost all my friends cos I cant go out and live as somewhat of a recluse because I cant walk, cant sit, cant sleep due to crippling pain.
I have XRays and MRIs in my notes along with letters from consultants confirming OA yet the Docs (GPs not consultants) seem almost dismissive with me as if im wasting their time. I know it must be difficult to see a patient like me for whom not much can be done but just a sympathetic ear would be nice. The last consultant i saw nearly 10 yrs ago told me surgery wasnt an option for someone as riddled with OA as me and I havent been back since.
I dont bother going to the GP anymore either. My last visit to the Docs I saw the head of the practice. She barked "YES" as I walked in. I told her that it was 10 yrs since I had seen anyone about my OA and wondered if it was worth revisiting a consultant. She didnt bother reading my notes, and said "It cant be that bad at your age, id get down the gym". I must add that I had drugged myself to the eyeballs just to get to see her yet still took 15 minutes to walk the few feet from the waiting room to her office all while she huffed and looked at her watch not offering me any help. This was the last in a reasnably ling line of equally depressing doctor visits.
I know my notes show the extent of my OA, and I am being prescribed many strong drugs so I just cant understand why Im being dismissed. I dont go regularly nagging or complaining, in fact other than medication reviews (which I do over the phone or just have blood pressure done from home) I have barely been in ten years, and not been at all in the last three because I cant take it any more,
Am I alone in this? I kinda hope I am because I wouldnt wish it on my worst enemy, but at the same time just dont understand it. I find myself wishing I paid the Dr. So I could demand a decent service!!
So I started researching into treatments. Reluctant to use long-term painkilling and anti-inflammatory medication (and worried about its side-effects), I focused on the efficacy of natural approaches.
I was astonished to find a substantial and well established literature, from a variety of perspectives, all pointing to the impact of grain proteins (gluten and lectin) and dairy (casein) proteins on a wide variety of diseases - including degenerative diseases such as osteoarthritis.
Gluten, lectin and casein damage the gut. The intestines contain 60% of the body's immune system, thus any damage to the intestines can cause immune changes that can affect joints.
After further research and correspondence with respected doctors and practitioners in their field, I have decided to embark on the GAPS diet. However, there are a number of others options - all of them based on "food as medicine".
I urge all of you who are suffering pain, distress and declining health (particularly from arthritis, aching joints, eczema, "brain-fog", fibromyalgia, fatigue, sleep problems) to consider the possibility that your diet is likely to be responsible for your declining health.
Put any combination of these search terms into Google and you too will be astonished: Grains, lectins, casein, proteins, arthritis, GAPS.
Finally, have a look at a video on UTube for an inspiring story of how Dr Terry Wahls, an eminent medical research professor, having failed to benefit from the best medical treatment and drug therapy, reversed her crippling multiple sclerosis through designing a specific diet:
http://www.youtube.com/watch?v=KLjgBLwH3Wc
Good luck to you all xx
2)keep moving as well as I can, don't do the things that hurt, I love to garden but now am going to container gardening and exercises are best done in a salt water pool - I love natural mineral pools when can get to one also
3)take supplements (as many as I can afford)a multivitamin, calcium (it was hard to find one that did not increase joint pain), vitamin D, and vitamin K, CoQ10, plus others.
4)use essential oils - I am careful to use therapeutic grade ones - they have helped both joint and muscle pain.
5) Laughter helps keep me happy, helps with pain, makes the days brighter. I have learned to laugh for no reason other than all the benefits it brings. I just decide to laugh! "Laughter is the best medicine"- is more than a saying!
6)Read the scriptures and PRAY
I am still active, look forward to tomorrow, and don't give an inch until I have no choice, so far I am on no medications (I have tried some but get to many side effects.) Hope this helps someone!
Sarah
I am 56 years old and have OA from my cervical to my lumbar and both hips. As Richard said my neck sounds like it's breaking apart when I turn my head. I have a lot of instability with all areas affected. The diagnosis of OA was about 5yrs ago. What has me concerned is how rapidly the deterioration has been in the last year. I have actually felt it progress from one hip to the other and now over the last couple of weeks my left shoulder has the same pain as my hips did when they started. I woke up one morning and felt that twinge and just knew what was going on. I'm waiting for the right to do the same. All the major joints pop now with normal movement and that is a recent change also. Nobody likes surgery and having one or both hips replaced is bad enough to accept but in my mind where/when will surgery stop? I don't really think it is worth all that trouble to face an unknown future with this disease. I have lost weight, take supplements and I'm working with PT to help. There is a possible answer in stem cell research but this country will not allow it. It's a shame that a host of ailments can be treated with this technology and suffering of millions can be reduced. But the greed of surgeons, hospitals, drug company's and politicians is a blockade that will never be broken...just our bodies!!
I only wish there would be more research into our debilitating illness. I'd rather find a cure than do what I'm doing now.
I am 51 and I was recently diagnosed with advanced end stage osteoarthritis and osteonecrosis in my right hip.
What seems to be working now is the spin class at my gym as well as supplementations of H.A., Tumaric, Amino Acids, Celadrin and fish oils.
Wishing everyone strength for all you face today.
Debi,
Beaverton OR
As of about two weeks ago, I can now workout without taking ibuprofen. I have been taking glucosamine /Chondroitin for a year. I started taking omega 3 and D3 two months ago. I exercise and stretch the muscles around the joint on a regular basis.I have been gradually moving to a more anti-inflamatory diet. Again, I saw reasonable improvement about two weeks ago. The puzzle is that I don't know what caused the improvement. Possibly it was a combonation of all of the above.
I wish both you and Valerie some peace in your upcoming days and offer support in any way possible.
I had a previous cervical surgery (ACDF w/fusion)on C-3 thru C-5 and just found out that after 4 years the bottom portion of the fusion didn't take. So I'm headed back to surgery for a Posterior Cervical Laminectomy w/ Fusion....
I've been dealing with this for 10 years now. It does get very depressing since I'm only 52. I'm on permanent disability( due to a host of additional med issues) and although I don't look like I'm in pain people have no idea what I go through on a daily basis.
So Nancy, I do know how you feel and believe me you're not alone.
I wish you the best and God Bless!
After MRI’s and X-rays I went on to arthroscopic surgery, my recovery wasn’t good at all; another MRI was performed 45 days after the surgery… Surprisingly the knee exhibits degenerative changes… The Orthopedic MD was in disbelief since when he performed the surgery and the pre op. MRI’s have not shown anything more than a mild meniscus common tear.
Immediately I was referred to a rheumatologist and infectologist, several labs and imagery procedures took place, everything was normal except for a slightly high sed rate for my age stage of 25. Several drugs mostly NSAID’s were prescribed, days were so and so, some days good some of them traumatic.
With an infant at home was very difficult for me to keep up with the status quo. After 6 months of the knee surgery, my left knee started hitting me bad; Osteochondritis dissecans, chondromalaccia patellar and a mild tear of the meniscus were also diagnosed. Optimist I decided to take another arthroscopic procedure, even though I did follow all the doctor recommendations for a fast, strong recuperation, it took the same amount of time to recover, 6 months. My life from there was tear apart I have never imagined, not even on my worst nightmares that I was going to be at home, disabled from a Sunday softball minor injury.
To make the story shorter since 2000 I have been on treatment… bone scans, MRI’s, labs, etc. have been ordered, the results are no good, OA have invaded knees, ankles, hip, lumbar, cervical, jaw, wrists and some fingers since 2000.
Nevertheless since 2002, I woke up from my depression caused from this disorder and I have left behind all the pains and regrets caused by it. I enjoy an active life, along with my family, kids and friends.
Fortunately the pain on the knees isn’t as sharp as of 9 years ago due to a synvisc treatment; synvisc did change the whole completion of the game for me and my knees, it really worked.
Unfortunately the OA keep on rocking my joints on a fast pace, the degenerative changes on my joints represents a 10 year progress in only 2. I have try several remedies for the past 8 years to slow it down with no noticeable results, my main concern is… What I’m going to expect in the next 10 years? Why my OA is in such of a broadening hurry?
Johnny
What is an appropriate dosis for an adult male?
In early 2005, I had a laminectomy for back pain which was unsuccessful. Through the year I had 3 procedures of injections in my spine and around my spine, all to no avail. I got a second opinion from a neurosurgeon who said I had multiple issues in my back and he would not operate as he couldn't eliminate the pain with certainty.
In 2006, I studied and read 6 books on mind/body functioning. I became a vegetarian for that year. My big take-away from all of that self-learning was one simple thing: take your power back and live the life you want to live. Don't let your pain stand in front of you but put it behind you and focus on your life, not your pain. I have tried to keep this in mind as I live with pain daily. It doesn't overwhelm me so much anymore. I have pain in my back, knees, wrists, neck, and now my left big toe joint at the base of the toe is starting to swell and is painful.
I take an NSAID twice a day but no pain medications, don't want to do that. I took fish oil but saw no noticeable difference but will try this again. I began juicing last year with spinach, lettuce, apple, carrot, cucumber, parsley and lemon. This has to help, just make sure you buy organic or wash veggies well before juicing.
One last thing, I have always been athletic and while running a daily 4 mile run 15 years ago, my back went into spasm. That was the beginning. I then walked 2 miles a day, to and from work, did gym workouts from time to time, I now play golf but not regularly. I need to get back to walking and I have a pilates machine that I think really helps my back to stretch. I think exercise is really one of the big keys to pain relief. Hope this helps.
I have learned a great deal from reading you guys inputs. Thank you very much. Princess
I think the people who took the Vioxx would have had a heart attack even if they didn't take the Vioxx. It's a shame that the only drug I've taken in 15 years that took away the pain and slowed the progression of the disease is not available to me. I wish someone would make the drug again, I'd buy it in a second!
forgot to say all my pain is mostly in my trochanter(outside leg bone at top of thigh) and am just beginning to get lumbar pain. if i stay active that goes away. the right hip tries to keep me inactive. i dont know which thing is causing which pain and i agree that drs. sometimes just want to keep you coming because we are their paychecks.
But I am 21 and live in the UK. At 19 I was told I have OA in my hips. then at 20 I was told I have Facet Joint Hypathropy (athritis of the facet joint). I am also training to become a Mental Health Nurse, and this is a challenge as I have to hide my pain from my colleagues as they would stop me from continuing in the enviorment I love so much. I see a chiropractor twice a week and I believe I have OA developing in my neck, ankle, and knees. I have found that simple stretching 4 times a day relieves a part of my pain. I also suffer now with depression, as it seems I have went from a being a top athelete running and weightlifting, to someone who cannot walk to get the bread without pain and I know its a matter of time till I have to give up my Nursing training. I am hoping I can find some comfort in knowing I am not the only one in a similar circumstance.
Here in Central India Arthritis is very common disease . I am also one of these .
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I was told that 2 years ago I have osteoarthritis, started in right knee and now get to the left knee, the pain it not too bad so far I can cope, can someone tell me how long ostearthritis take to develop at a point that the pain it not bearable, I 47 and went to the gym for 8 years doing weight, runing and cyling a lot, other question can someone tell if runing and cycling cause ostearthritis.
Also try dance for fun, socializing and exercise. Playing the piano daily (I teach piano) is also helpful for finger arthritis, as long as you warm hands first, do gentle piano warm-ups, use good technique and take breaks as needed.
I am going to try harder to limit sugar and gluten.
I endured flares with pregnancy at 32 and hysterectomy at 42. I became anemic after surgery then developed FM. No more surgeries! Family history of OA/RA.
I have had OA in both my hands for about 15 years. I only take Diclofenac 100 mg. per day which takes care of the pain. My kidneys etc., are monitored since I have been taking it so long but so far, so good. I also take alot of vitamins which include MSM, chondrotin, botswania for the OA. I find keeping active with my gardening and working three days a week help.I also use magnetic (NIKKAN) therapy if I have pain in my back or shoulders. It helps too. Wish the powers that be would find a cure.
I'd like to know what a Gazelle is as mentioned in one of the e-mails. I've had both knees replaced and have OA in the big toes which are too fr damaged to have an implant. have a hard time walking and need to do more exercising.
Rheumatica (spelling?) and gave me prednisone for 3 months and I got better but since then I am in constant pain in my lower back, hips and legs and most days I am very weak. I am on Hydrocodone for the pain but it doesn't help much. What could possibly be wrong?
It is comforting to me to hear other people's stories regarding OA. I had my right knee replaced almost 6 years ago now, when I was 43 yrs old. Wish I NEVER would've had that done!! My Ortho doctor was also quick to tell me I needed a replacement and who was I to argue, he's the doctor after all. My left knee is so bad now there are days when I can barely get out of bed. I've had 2 scopes done and am just biding my time until this one needs to be replaced. Am no where near retirement yet and my job requires walking, alot of walking, on a daily basis. I wear an "Unloader Brace" on by left knee but my most of the time I don't even know if I have it on correctly. It's big and bulky. Can't take prescription pain killers because of my job and most OTC medicines don't to the trick. Have been getting some good tips from reading everyone else's comments. Hopefully I'll try some of them and get some relief from my pain.
Since I wnat to stay away from HARD drugs as long as possible I decided to experiment with diet, herbs, vitamins.
Diet- no coffee, chicken, meat,sugar (only on very rare occacions)
Whats in: to keep my pH under control, 8 oz water with 1 oz honey and 1 oz organic vinegar. Lots of vegetables and fruits.
vitamine: e/d/calcium/fish oil/and part of a multiple
for inflammation: cayenne pepper, ginger root,garlic and 3 times a day 10 Arnica drops
in an 8 oz glass of water.
Hot bath in the morning
Exercise class 3 times a week
Pain: constantly
I am looking forward to find the right combination to put this illness into remission.
I am 67, and have never had a weight problem.
Thank you for all the tips, especially the stinging nettle tea. I will add it to my diet
I, too show dogs. Over the past15 years I've been disabled from degenerative disk disease and severe osteoarthritis I have had to take many breaks from the sport due to surgeries-about 20 so far. I love the dogs and the sport too much to quit, however.
I have an implanted pain pump and take oral painkilers as well. I realize this is not the choice for everyone, but it gives me the opportunity to enjoy some things that I enjoyed most in life-taking hikes, showing and training my dogs, etc. on occassion.
I am also more sociable and better company to my husband when I'm not in intolerable pain and corresponding despression.
Water therapy is most helpful.
I now preparing for my second knee replacement and surgery on the opposite foot, so I will be recovering for some time. I've also had two neck fusions and lumbar fusions and numerous foot surgeries that ruined my gait and cause additional pain. I can't take any nsaids as my stomach can no longer tolerate them.
After reading this article, I do plan on trying acupuncture-past back massages are now too painful.
I'd be happy to correspond with Chris if there's any way possible.
have been on many drugs that did not help until I was put on the biologic drugs. Remicade , and then Embrel gave me excellent results for about a year each. I have now been on Orencia for 1&1/2 years.It is not working as well. My hands &
wrists become very painful,swollen,inflamed and just about useless frequently. I have taken prednisone off and on for 4 years ,when i have a flare of my RA.(prescribed by my
rheumatologist ) I was told i could take 5 mg. a day without
harming my body. MY Question IS--IS THIS TRUE?
With the Orencia, 5mg. prednisone and water aerobics 3 times a week I almost have a normal live.
I am 79 and normal wt.
Thank You, Barb
I am a pharmacist and take one Lortab 7.5/500 and one tylenol 500 in the am and then sit for 30 min so I can get moving then take 1 more of each in the afternoon so I can get through the day. I too have been diagnosed with fibromyalgia although I am not sure it is just not muscle involvement from the joint damage...I take Cymbalta 60 and Lyrica 75...that is all I can tolerate but it does help with muscle pain and neuropathy. I take Glucosamine and MSM and anything I think might help...avoid red meat except for an occasional exception. My finger joints are getting knots and hurt so I am not sure anything helps. I swim in the summer and do better, but most exercise hurts. 58 and trying to wait for a breakthrough....anyone got any good news?
One thing that has helped a lot is the therapy hot wax unit , it was expensive but worth it. I would not be surprised that some of you also have fibromyalgia as I do. There are several pills out now for that and if you can take them, they work..when I took viox it was a miracle pill and then they took it away. I blame most of my oa from a lot of prednisone I had over a period of 5 years for my back and neck. all in all, we have to live with some pain but no one should have to be in as much pain as I had and have to feel like an addict addressing a dr. the issue of needing pain relief. I can also say for sure that when all else fails then try marjuana, it is the best and it will some day be legal, at least it is a natural product NOT a man made chemical and if you just use when needed for severe pain you will not get addicted
Methotrexate is NOT therapy for Osteoarthritis. If you do have osteoarthritis, you must also have another type of arthritis, such as Rheumatoid arthritis, to have had such a good response to Methotrexate.
While side effects are frequent with Methotrexate, they are usually mild and manageable. Nonetheless, no one should take Methotrexate on a "what have you got to lose" premise for any form of arthritis since fatalities from the use of Methotrexate have occurred.
I haven't seen any comments about this, does anyone else have this problem too?? Physical Therapy was no help for me. Aqua exercise is great, its the one time I'm pain free. I do gentle yoga twice a week, & am trying the elliptical machine at the gym. Great suggestions from everyone. Please let me know if anyone else has this posture problem. Thanks to you all.
My first real flare up was in a knee which was helped with a steroid shot and then more as it moved to the neck, etc. I also take glucosamine-chrondoiton. I am on coumadin and Mobic put me in the hospital with a bleeding ulcer. Out of desperation, I tried accupuncture that has no side effects and now go monthly for maintenance. Most days, at 82, I do not even need the Tylenol Arthritis,
Having it in my thumbs and wrists makes it very difficult to do any strength exercises.
Any suggestions?
Second, I have found that my nutrition affects the inflammation in by body--to much sugar, wrong kinds of protein, etc. Anyone interested in this approach should check with their doctor, a nutritionist or a local health food store for more information. Good luck.
I am not in the Tampa area but the Middle TN area. I do have psoriatic arthritis and was diagnosed approx. 7 or 8 years ago and probably had it before I was diagnosed. It hits hard and fast and the sooner you get meds, the sooner you can feel some relief and possibly slow future damage.
I have found that the best solution - aside from discontinuing running and any high-impact activity 20 years ago - is, indeed, exercising/strengthening the muscles of the leg that lift and separate the knee bones and staying slim and toned overall. I also take glucosamine sulfate daily, per my doctor's suggestion - to help maintain healthy joint tissue as much as possible. All of this seems to work well for me.
I am 70. It has been in my lumbar spine which I injured lifting patients years ago.
Sometimes it moves to my knees and cervical spine (auto accident whiplash). My knuckles of both hands are beginning to have pain occasionally now too. I sew, knit and use a computer so I think that has helped a lot. The above otc meds seem to be the best for now. But I am surely not pain free and expect that will not change. I feel that perhaps there are calcium deposits between the vertebrae of my lumbar spine, but do not know.
I am too surprised that doctor's don't suggest more alternative therapies. It is definitely not a cure, but some of them out there, do help you to cope with the daily uncomforable feeling and pain OA creates.
I used to go to a chiropractor - went to him for 4 years before the diagnosis. Then postdiagnosis I went to a rheumatologist who put me on Mobic daily with a muscle relaxant that I take at night only as needed (suffered occasionally from muscles spasms in my upper back). They along with moderate exercise at the YMCA seem to help.
But I started out with pain in my spine not in another joint and now the back of my right knee hurts and I have to stretch that leg to be able to alleviate the pain and walk more freely.
I do sometimes have pain in my finger joints especially on the right side of my body but that doesn't happen too often yet.
So prescription meds plus mild to moderate exercise several times a week seem to work for me... I'm never painfree but they help.
I am intrigued by several who said acupuncture has helped them with pain. I may give that a try too.
I can't walk for exercise because of still recovering from the bone fusion. However I ride my bike regularly and enjoy that exercise.
At this point frustration set in and I told myself there must be a better way so I tried some natural supplements and started an exercise program of swimming, rebounding and using a Gazelle......
Well, I don't know which of the above was the answer but I have not taken a drug in about a year now and the knee has not flared up in 15 months so my opinion is that the
doctors are trained to use prescription drugs and don't want you to get any better.
It's really a sorry situation that there are better ways to improve your condition but they don't want you to know about them.
Bottom line number one: PT has been great, along with injections into the piriformis muscle.I'm walking without the cane and the pain has reduced considerably. Bottom line number two: when the pain subsides further, I will be referred to a "gate" clinic for analysis of and help with walking. EVERYONE who has knee or hip replacements should, in my view, be recommended immediately for such analysis. It's not enough for doctors to say "you may walk differently" We need help learning what that means so as to avoid further pain!!!!
Sue
I really don't have a medicine to take for this without it making me feel crazy. What would you suggest? Every now and then I will take Aleive, Excedrin or Tylenol but, this may not help depending on the severness of my pain that day. FYI...I believe I was diagnosed with OA and Rheumatoid as well.
I feel helpless.
Alice Y. Spinner
Your body is worse when you stop moving. I went into the foot Dr. for a bone spur (heel) problem ( also have arthritis in my big toes, and he gave me a new product called Limbrel. I am going to try it for 3 weeks. He is excited about it. Eve
When I spoke with my daughters doctor about vitamin D she told me she takes 50,000 IU once a week. Because we live in the north we don't get enough sun which is one way we get vitamin D.
I saw an article about vitamin D on the program "The Doctors" and also on a news program one evening, which is why I tried it in the first place. Good Luck.
I go to an acupuncturist, do Yoga daily, walk, ride a recumbent bike.
Why don't you tell about all of these good thngs?
Sue
pills are Celebrez and Tylenol artritis, at least the celebrex helps the inflamtion in the fingers.
I am on arthritis medication and have tried most of them on the market but nothing helps or keep the pain down much. Even my pain medican darvocet does not help much.
My arthritis just seems to be attacking all the joints in my body, why?
What can be done to stop the progression?
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