Carolyn Cooper, M.D. Internal Medicine Dr Carolyn Cooper joined On Call Medical Group in 2007. She is a Board Certified Internal Medicine physician, and has been practicing in San Francisco for over seven years. She received a BS from the University of St. Andrews in Scotland, and completed her medical education at the Welsh National School of Medicine in Cardiff, Wales. Dr Cooper completed her internship and residency at California Pacific Medical Center in San Francisco. She has previously worked as a Clinical Investigator at Stanford University School of Medicine, and in private practice in San Francisco. Dr Cooper has participated in many research studies, and is also widely published.
CAROLYN COOPER, MD: Today, I will be talking about osteoarthritis. There are many, many different types of arthritides; osteoarthritis is the most common, affecting about 1/6 of the American population. It is also known as degenerative joint disease and is named such due to the process by which the cartilage, which forms a protective cushion on the ends of bones, becomes degenerate, it wears down, it flakes off, and it may even wear away causing bone-on-bone, causing more symptoms. The process of degeneration of this cartilage results in inflammation, which causes joint pain and joint swelling. Any joint can be affected by osteoarthritis, the most common being the weightbearing joints, hips, knees, spine, and also hands. The symptoms of osteoarthritis can be extremely mild and as the process progresses, it can result in pain which progresses during the day or with use, stiffness of the joints affected, which is worse in the morning and in fact gets better during the day, tenderness to touch, redness, and swelling may also occur. The treatment of arthritis, there's no actual cure but the aim of treatment is to reduce pain and improve mobility and function of the joints. Some people, in fact, need no treatment whatsoever, and can function perfectly normally. Some people need medications or treatment for pain relief. Conservative measures for osteoarthritis start with weight loss, gentle exercise, may be physical therapy, and these types of measures. If these measures fail, then medications would be the next treatment for osteoarthritis. Aspirin and common over-the-counter medications like ibuprofen and Advil, those types of medications may be of benefit to reduce the inflammation and pain. Other pain killers may be required if these measures do not reduce the pain. If medications just described do not reduced inflammation, injection of steroid or hyaluronic acid into the joint space may indeed reduce inflammation and relieve symptoms. If all conservative measures fail, then surgery would be the next treatment for whichever joint is affected and may include arthroscopic debridement which is cleaning out of the joint space in trying to reduce the inflammation within there. Osteotomy is done to realign the bones to realign the forces that are causing the pain within the joint, and also joint replacement, be it the total joint or unijoint, which is half of a joint, may also be required. So prevention of osteoarthritis is not completely possible. Osteoarthritis is directly related to age, genetics, also weight, repetitive injury, and repetitive stress to joints. Avoiding these is obviously difficult to do completely, but weight loss is extremely important in maintaining joint health. Dietarily, glucosamine, which is a food supplement, has been shown to improve cartilage health and may be used in people who have been diagnosed with osteoarthritis but do not need any specific treatment. If an individual has a painful joint, which does not settle down after rest and simple pain relievers, should see their doctor to assess whether they do indeed have osteoarthritis, which is usually diagnosed clinically or maybe an x-ray may help that diagnosis. There are no blood tests for osteoarthritis and usually the diagnosis is made clinically.
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