Readers’ Corner | How to avoid osteoarthritis?

Twice a month, our journalist answers readers’ questions about health and well-being.

Osteoarthritis is characterized by degenerative changes in the joint. It is the most common joint disease: in patients aged 60 and over, about 60% will have changes consistent with osteoarthritis on X-rays, says Dr.^D Evelyne Vinet, rheumatologist and assistant professor at McGill University.

However, with equal X-rays, the intensity of symptoms varies from one person to another. There are genetic predispositions for certain types of osteoarthritis, such as that of the hands, but there is a form of osteoarthritis that is more preventable, indicates Dr.^D Vinet: “Why are some people more symptomatic than others? There are three things that can change the symptoms, and also make it less significant over the years,” she says.

The first? Exercise. Obviously, it’s better to have been active all your life. That said, even if you were rather sedentary and you start to have joint pain, exercise is still beneficial, says Dr.^D Vinet.

The recommendation is 150 minutes per week of moderate-intensity aerobic activity, such as brisk walking, cycling or aquafitness. Two strength training sessions per week are also recommended. Muscles, explains Dr.^D Vinet, help protect the joints. “When you start doing physical activity, you have pain, precisely because you are not used to it,” explains Dr.^D Vinet, who advises perseverance. It takes a certain amount of time, weeks and months, before you see the effect,” she says. People who already have a lot of degenerative changes or who have had serious injuries to their joints should first consult a physiotherapist, who will guide them in their exercise sessions.

The second effective way to prevent osteoarthritis is to lose weight if you are overweight, and to maintain a healthy weight. Extra weight means more stress on your joints, especially your knees and hips, says Dr.^D Vinet.

And the third thing is to avoid injuries to the joints when you are younger: ligament injuries, meniscus injuries and intra-articular fractures. Surgery does not completely restore the integrity of the joints, emphasizes Dr.^D Vinet: “In a group of people who will have osteoarthritis later, there is about 1 person in 10 for whom it is perhaps linked to a trauma in a joint that they had when they were younger,” she indicates.

What treatments are effective?

As for supplements, such as glucosamine and chondroitin, D^D Vinet points out that there are no good studies demonstrating their effectiveness. “And it costs a lot,” stresses the rheumatologist, who advises investing this money instead in a gym membership.

Several researchers are looking into the issue, but at present, there is no medication that can reverse or stop the progression of osteoarthritis. The only treatment proven effective, notes Évelyne Vinet, is physiotherapy, which helps reduce symptoms in many patients. Analgesics and joint injections help reduce pain, but do not change the course of osteoarthritis.

For inflammatory arthritis—a different problem—there are medications that can stop the disease from progressing. “You need to see a doctor and get diagnosed early,” advises Dr.^D Vinet. Inflammatory arthritis is associated with stiffness in the morning lasting more than an hour, and pain that can wake you up at night. As for osteoarthritis, the pain increases with use of the joint, and morning stiffness usually lasts no more than half an hour.