You first notice swelling in a finger or a stiff knee when you get up in the morning. In the moment, you brush it off as normal aches and pains of aging. But, it could signal arthritis.
The joint disease osteoarthritis is thought to be on the rise, partly because of active baby boomers and higher U.S. obesity rates. It occurs from the wearing down of protective joint cartilage, leaving bones rubbing together.
People at younger ages might have this type of arthritis but not know it. A recent study published in Arthritis & Rheumatology, a journal focused on the rheumatic diseases, suggests such cases among U.S. residents ages 18 to 64 have been underestimated.
“The pain got pretty bad about a year ago,” said Joanna Cable, 52, a South Hill, Washington, resident who experienced early arthritis in her lower back, hips and knees.
Cable considers herself very active, including skiing, yoga, gardening, cycling and her family’s passion — playing tennis. In November, she had surgery on both hips. Her regimen has included physical therapy, stretching and better nutrition.
“I have zero pain now,” she said. “I’m basically moving all the time.”
It’s good to notice such patterns and ask a doctor about early remedies, said Cable’s physician, Dr. Christopher Dewing, orthopedic surgeon at MultiCare Rockwood Clinic Integrated Sports Medicine. Exercise, physical therapy and weight loss often can ease symptoms, he said.
“We have an aging population that remains very active into their later years; with that comes some wear and tear, aches and pains of arthritis, which is a normal aging process in the body,” Dewing said. “But I think there are many people who probably ignore some of the early signs — just chalk it up to aging or sort of the aches and pains from life.”
He listed possible signs to bring up to a physician: Specific joints feel stiffer or more achy, especially while resting or after sleeping. Occasionally, there’s swelling of the joint area. Someone notices you’re limping.
“Sometimes, people don’t even realize they’re limping,” Dewing said. “The onset is very gradual and subtle, so people are slowly modifying what they’re doing, including the way they walk or the way they’re moving their shoulder or neck.”
Many people pursued athletics through high school, college and beyond. Others continue with triathlons, Spartan races, skiing and tennis. It’s good to be active, Dewing said, but it takes a toll.
“Cumulative minor injuries do add up to an increased risk for arthritis,” he said.
More sedentary people might have issues controlling weight, predisposing them to arthritic problems, Dewing said. People need to keep moving, even if it’s with low-impact activities, he said.
“Motion is life,” Dewing said. “Keeping your joints in motion through stretching, walking and participating in regular fitness activities is a great way to combat some of the stiffness and loss of motion that can come with early arthritis.”
As it advances, osteoarthritis can affect quality of life or become a disability. More people are getting joint replacement surgeries. But Dewing said doctors often work with patients to lessen symptoms before resorting to invasive procedures.
Dewing agrees even a small weight loss can go far toward controlling pain and arthritis symptoms. The U.S. population generally has a higher rate of obesity or borderline cases than elsewhere.
“It’s hard to face when your doctor sits down with you and says, ‘Hey, the best thing for you would be to lose 20 pounds,’ " Dewing says. “I have that conversation frequently with my patients; it’s not an easy conversation but I usually tell them, ‘I could stand to lose 20 pounds too, and I’m working on it.’ ”
Nutrition is important, Dewing said, based on research in the past decade: “A low-sugar diet has been shown to be extremely beneficial for arthritic symptoms because high sugar intake has been associated with bursts of inflammation in the body.”
People also can benefit from cross-training, low-impact water workouts, stretching and muscle-strengthening. Yoga or Pilates can help joint mobility and motion.
Genetics is mainly a factor in such inflammatory types of arthritis as rheumatoid arthritis, Dewing said. “That type of arthritis does require good medical management with immunological modifying-type drugs.”
Dewing said osteoarthritis is more common. “That’s the type of arthritis that can happen after injuries, trauma or just part of the aging process.”
“My goal is as an orthopedic surgeon to keep them as pain free, and as mobile and fit as I can, with the use of all sorts of modalities: Therapy, nutrition, and when appropriate, surgery or injections.”
Joint replacement surgery can be the best option if arthritis causes disability and other remedies don’t help, he said. “How can we find ways to really enjoy being outdoors and playing the sports we’ve loved all our lives without paying a huge price afterward and limping around or lying in bed at night with pain? I really care a lot about that," Dewing said.