Myth Buster: The Truth About Arthritis Causes and Treatments

Arthritis affects millions of people and is the most common cause of disability in the U.S., but myths about its causes and treatments persist. UR Medicine Sports Medicine's Dr. Maria Karipidis Pouria helps clear up confusion about arthritis and offers advice on effective strategies for treating it.

Myth: Arthritis is an old-age disease.

Fact: Arthritis affects 54 million Americans of all ages, even children. I see patients as young as their early 20s who have arthritis as a result of prior injury, patients in their 30s up to middle age, and many patients as old as 100 who are coping with it. And to clarify, arthritis isn’t “one” disease; it’s a term we use to describe many different health problems that cause joint pain or joint disease. The most common form is osteoarthritis, which wears down the cartilage that cushions joints.

Myth: There’s nothing you can do for arthritis, short of surgery.

Fact: Osteoarthritis is a progressive disease and, in the early stages, there are many things you and your health care provider can do to manage the symptoms and prolong your joint health. Approaches that work include:

• Hot and cold therapies: Use heat to ease pain and stiffness; cold to reduce swelling. 
• Assistive devices: Braces and orthotics may help support a joint that’s not functioning properly to give you better mobility with less pain.
• Over-the-counter anti-inflammatory medicines (non-steroidal anti-inflammatory drugs, or NSAIDS): These can help with pain and inflammation, but they’re not right for everyone. People with heart disease, chronic kidney and liver issues, reflux, ulcers, hypertension and other conditions should avoid NSAIDs. Acetaminophen (Tylenol) is not an NSAID; it won’t reduce swelling but can be effective in reducing pain. It also has side effects, so ask your doctor if it’s safe for you.
• Avoiding injury and excessive repetitive movements: If you are having difficulty with arthritis, you may need to adjust your daily routines. This is especially true if your job is physically demanding: kneeling or squatting can put tremendous pressure on knees and hips. An occupational therapist can help you find new ways to complete your tasks with less long-term risk of injury.

Myth: Cortisone or hyaluronic acid injections wear out the joint cartilage.

Fact: Cortisone, a steroid with anti-inflammatory properties, is used for moderate to severe arthritis. Hyaluronic acid is one of the components of the fluid in our joints. Hyaluronic acid injections help to replace some of the fluid lost to arthritis and help nourish and cushion the joint. Both types of injections are safe if used as intended; cortisone injections should be given only as needed, with at least three months between treatments; hyaluronic acid injections can be given every six months. Both are effective in reducing pain and improving mobility.

Myth: You shouldn’t exercise if you have arthritis; it wears out the joints quicker.

Fact: Exercise can be the best “medicine” for arthritis because it develops the muscles that support your joints and improves your flexibility and range of motion. You just need to be sure your workout isn’t overstressing your joints. A physical therapist can help you adapt your exercise routine, from high-impact sports and running, to lower-impact options such as hiking, swimming, or using an elliptical machine. A physical therapist can also recommend exercises to ensure that the muscles supporting a joint are in balance. This is crucial because if some muscles are overdeveloped and others are underdeveloped, it affects your body’s alignment and movement, putting excess pressure on affected joints.

Myth: Dietary changes can reverse or lessen the effect of arthritis.

Fact: Many people ask about “anti-inflammatory” gluten-free/dairy-free diets or taking certain supplements, such as tart cherry juice or glucosamine chondroitin. Unless someone has celiac disease or sensitivity to lactose, restricting the diet isn’t going to make a difference. As for supplements, we don’t know how much of the anti-inflammatory substance in these products is bio-available to reach the joint.  While there is no known harm in taking these, we do not yet have research-based evidence that they offer benefit. I advise patients to focus on the remedies that we know work well: weight management, appropriate exercise, medications and/or injections tailored to your unique needs.

Myth: If you have osteoarthritis, the only real treatment is surgery to remove the bad joint.

Fact: Arthritis is a progressive disease that begins with relatively mild soreness and swelling; symptoms can change and worsen over time but not all patients will require joint-replacement surgery. With the right care, many people can manage their symptoms non-surgically for years after their initial diagnosis and some are able to do it the rest of their lives.

If you are having symptoms like pain, stiffness and swelling, at least have this evaluated to confirm that it is arthritis, and to start treatment that can make a big difference in your quality of life. I have many patients who have come in depressed about the way arthritis is affecting their everyday tasks, and are pleasantly surprised at how effective non-surgical treatments can be. They’re back exercising, playing with their grandkids and doing the things they love to do.

Maria Karipidis Pouria, M.D., is an assistant professor of Orthopaedics, specializing in non-operative sports medicine for all ages. Her practice includes treatment of osteoarthritis, tendonitis, acute and chronic musculoskeletal injuries, sport-related spine injuries and the medical management of athletes.