USA Today
Dolores "Jeanne" Streightiff, right, of Hollidaysburg, Pa., works with physical therapist Tim Parnell after her second knee surgery. She has osteoarthritis. By Kalim A. Bhatti, for USA TODAY
Dolores "Jeanne" Streightiff asks if she can talk after she wraps up her physical therapy session.
"I'm allergic to painkillers, so there can be a lot of screaming," the retired ski instructor, 67, half-jokes during a phone interview.
Streightiff recently had knee replacement surgery because of painful, activity-inhibiting osteoarthritis and is in the middle of one of her weekly in-home sessions.
"I'm still young. Now I'll be able to do everything I did before," says Streightiff, who lives in Hollidaysburg, Pa., with her husband.
Though Streightiff decided surgery was the way to go, some, such as baseball Hall of Famer Hank Aaron, 76, sought a less invasive route for relief. Aaron says he saw numerous doctors and tried a variety of arthritis medications before injections reduced his knee pain.
It can be difficult to determine how best to achieve arthritis pain relief, says Vonda Wright, assistant professor of orthopedic surgery at the University of Pittsburgh Medical Center for Sports Medicine, who is also Streightiff's knee surgeon.
Tough choices for patients
"People with OA (osteoarthritis) have to find the balance between rusting out — sitting around and getting stiffer and stiffer — and wearing out, pushing through the pain until you can't move anymore. It's a fine line," says Wright, author of Fitness After 40.
Wright says there is a wide range of options including inflammation- and pain-reducing medications, physical therapy to help strengthen muscles that support a joint, joint-relieving injections, joint care supplements and surgery. She says the key is to sit down with your orthopedist, determine your life and activity goals and develop a treatment plan from there.
A chronic degenerative joint disease, osteoarthritis afflicts almost 27 million Americans and is the most common type of arthritis, the Arthritis Foundation says. It occurs as a result of wear and tear on a joint's cartilage, which causes bones to rub against each other. Stiffness, pain and loss of movement in the joint can result, says Patience White, the Arthritis Foundation's chief public health officer.
The condition can begin as early as in a person's 40s, sometimes younger, but in that group it's usually the result of an old injury, says Reuben Gobezie, an orthopedic surgeon at University Hospitals Case Medical in Cleveland. Genes, overuse and weight influence osteoarthritis' onset, he says.
The hand is the most commonly affected area, but knee and hip arthritis can be the most debilitating because they interfere with mobility, White says.
Gobezie says that when patients come to him, he typically prescribes oral anti-inflammatory arthritis medication and then steroid shots if pain persists. Arthroscopic debridement or resurfacing — where he goes in surgically and "cleans up" a joint — may come next.
White says weight loss can make a difference, too. "Every pound you gain is like 4 pounds across your knees," she says.
Physical therapy is often recommended as well. It can build up muscles that surround a joint, which offers more support, says Chavone Johnson, a physical therapist with Integrity Regional Rehab Group in Vienna, Va.
"It's not changing the state of the bone, but you're re-educating the muscles that are going to stabilize the bones that are arthritic," Johnson says.
Though he was practically injury-free during his 23-year career, Aaron says his years as a professional baseball player caught up with him in his right knee about five years ago.
"You take a lot of beatings. You slide, you run. Eventually it tells on you," Aaron says.
A grandfather of seven and an executive with the Atlanta Braves, Aaron says he was frustrated that he couldn't play golf or shoot hoops with his 11-year-old grandson.
"I knew I couldn't do what I did at 20 years old, but I wanted to have fun with my grandkids. But all that was snatched away from me because of the pain I had in my right knee."
When other treatments failed, he opted for injections of hyaluronic acid, a gel-like substance that helps create a padding between the bones in the worn joint. He says he has been pain-free since last June and is back on the golf course.
Many options for surgery
Surgery is the last resort, says Mathias Bostrom, professor of orthopedic surgery at Weill Medical College and the Hospital for Special Surgery in New York.
"The general consensus is that you avoid orthopedic surgery as much as you can until it's as far gone as it can be," Bostrom says.
Gobezie says hip and knee replacements, which were performed only on the most debilitated, older patients several decades ago, are much more common now: About 700,000 are performed annually in the USA.
Surgeries are more complex now, too, and use a variety of materials, says Rick Schultz, director of the orthopedic division at Scott and White Healthcare, in Round Rock, Texas.
In one recently retired man, Schultz says, "we put in a high-tech combo of ceramics, plastics and metal to give him a very durable, flexible, stable hip, because he's hoping to play highly competitive racquetball like he did in his 20s."
As for Streightiff, she is looking forward to hitting the slopes again next winter:
"I've already bought my season's pass."
The condition can begin as early as in a person's 40s, sometimes younger, but in that group it's usually the result of an old injury, says Reuben Gobezie, an orthopedic surgeon at University Hospitals Case Medical in Cleveland. Genes, overuse and weight influence osteoarthritis' onset, he says.
The hand is the most commonly affected area, but knee and hip arthritis can be the most debilitating because they interfere with mobility, White says.
Gobezie says that when patients come to him, he typically prescribes oral anti-inflammatory arthritis medication and then steroid shots if pain persists. Arthroscopic debridement or resurfacing — where he goes in surgically and "cleans up" a joint — may come next.
White says weight loss can make a difference, too. "Every pound you gain is like 4 pounds across your knees," she says.
Physical therapy is often recommended as well. It can build up muscles that surround a joint, which offers more support, says Chavone Johnson, a physical therapist with Integrity Regional Rehab Group in Vienna, Va.
"It's not changing the state of the bone, but you're re-educating the muscles that are going to stabilize the bones that are arthritic," Johnson says.
Though he was practically injury-free during his 23-year career, Aaron says his years as a professional baseball player caught up with him in his right knee about five years ago.
"You take a lot of beatings. You slide, you run. Eventually it tells on you," Aaron says.
A grandfather of seven and an executive with the Atlanta Braves, Aaron says he was frustrated that he couldn't play golf or shoot hoops with his 11-year-old grandson.
"I knew I couldn't do what I did at 20 years old, but I wanted to have fun with my grandkids. But all that was snatched away from me because of the pain I had in my right knee."
When other treatments failed, he opted for injections of hyaluronic acid, a gel-like substance that helps create a padding between the bones in the worn joint. He says he has been pain-free since last June and is back on the golf course.
Many options for surgery
Surgery is the last resort, says Mathias Bostrom, professor of orthopedic surgery at Weill Medical College and the Hospital for Special Surgery in New York.
"The general consensus is that you avoid orthopedic surgery as much as you can until it's as far gone as it can be," Bostrom says.
Gobezie says hip and knee replacements, which were performed only on the most debilitated, older patients several decades ago, are much more common now: About 700,000 are performed annually in the USA.
Surgeries are more complex now, too, and use a variety of materials, says Rick Schultz, director of the orthopedic division at Scott and White Healthcare, in Round Rock, Texas.
In one recently retired man, Schultz says, "we put in a high-tech combo of ceramics, plastics and metal to give him a very durable, flexible, stable hip, because he's hoping to play highly competitive racquetball like he did in his 20s."
As for Streightiff, she is looking forward to hitting the slopes again next winter:
"I've already bought my season's pass."
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