Presentation is loading. Please wait.

Presentation is loading. Please wait.

HealthPartners Medical Group

Similar presentations

Presentation on theme: "HealthPartners Medical Group"— Presentation transcript:

1 HealthPartners Medical Group
Arthritis 101 Kenneth D. Kleist, M.D. HealthPartners Medical Group Regions Hospital St. Paul, MN Introduce yourself and the plan or plans available to the members. Let members know that you are happy to answer their questions.

2 The Key Players Orthopaedic Surgeon
The expert in the musculoskeletal system Diagnose Treat Medication Physical Therapy Exercise Brace Surgery Prevent Physician Assistant Primary Care Sports Medicine Physician Physical Therapist

3 Arthritis—Background
Arthritis is the second most common chronic condition in the US (sinusitis is first) Most common among elderly Arthritis affects over 20 million people in the US 76 million by 2030 Leading cause of disability in people > 65 yo Total costs associated with arthritis are over $82B/year, including hospital and drug costs, nursing home costs, and lost productivity and work

4 Synovial Joints Fibrous capsule Bone Synovial membrane
Joint space filled with synovial fluid Articular cartilage To understand osteoarthritis, it is helpful to first look at a joint and understand how it works. A joint is the place where the ends of two or more bones meet. These bone ends of the joint are covered with a smooth material called cartilage. Cartilage cushions bone and allows your joints to move smoothly and without pain. The synovium is a fibrous envelope that encloses the joint and produces fluid that helps reduce the friction and wear on that joint. Ligaments connect bones and keep your joints stable. Finally, muscles and tendons power your joints and allow them to move.

5 There are two general types of arthritis
Osteoarthritis: By far the most common “Garden Variety” or “wear and tear” Caused by the breakdown of cartilage Remainder of the talk will focus here Rheumatoid Arthritis and related diseases: These involve not only the joints but other organs like skin, tissues, eyes, and blood vessels Immune system attacks the tissues of the joint

6 Osteoarthritis (Inflammation of Joints)
Pain Loss of Motion Avoidance of Motion Arthritis is, simply put, inflammation of the joints. Inflammation is one of our bodies’ normal reactions to injury or disease. Inflammation in turn results in visible swelling, pain, and stiffness, because as the joint becomes painful, the individual avoids moving it, which causes the muscles to tighten, making it harder to use that joint. This results in more pain. Usually this inflammation is temporary. But in an arthritic joint it may cause long-lasting and sometimes permanent disability. Osteoarthritis is a particular type of arthritis which affects the cartilage in the joints, causing it to break down and eventually be lost altogether. Increased Muscle Tightness

7 What does arthritis look like
Arthritic Knee X-Ray Normal Knee X-Ray

8 Diagnosis: History Symptoms Pain in affected joints
Pain worse with prolonged overuse Pain better with rest and exercise Stiffness relieved by flexing Unlike other systemic forms of arthritis, osteoarthritis does not affect the other organs of the body. Symptoms vary greatly from patient to patient, but the most common early symptom is pain in the affected joint or joints. This pain gets worse with prolonged overuse and is relieved by rest and moderate exercise. In addition to pain, many osteoarthritis sufferers experience a stiffness that is relieved by flexing the joint a few times. This stiffness, called gelling, is generally most pronounced first thing in the morning.

9 Diagnosis Physical exam X-rays Blood test to rule out other diseases
The effects of osteoarthritis can be fairly significant, but with proper treatment, we can get you back into the game, living your life to the fullest. Your orthopaedic surgeon will use a combination of an evaluation of your symptoms, a physical examination, and x-rays to make an arthritis diagnosis. Your physician will likely also order a blood test, to rule out other forms of arthritis as well as other ailments that could be causing your symptoms.

10 Treatment: Non-operative
Activity modification Avoid painful activities Low impact exercise Decreases pain Improves flexibility Improves joint nutrition Physical Therapy Cane or other assistive device

11 Treatment: Non-operative
Weight Control Maintain current weight or lose weight 10 lbs of weight loss 30-50 lbs less weight on your hips and knees Heat/Cold – Both Can be effective

12 Treatment: Medication
Acetaminophen – Pain control (Tylenol) NSAIDs – Pain and inflammation Standard Ibuprofen, naproxen, piroxicam Cox-2 Celecoxib Ultram – Non-narcotic, addiction potential Mild Narcotics Not recommended except short term

13 Treatment: Injection Corticosteroids (Cortisone) Injection
Anti-inflammatory placed into the joint Temporary pain relief Temporary swelling improvement Does not change the arthritis Limited number per year Blood sugar elevation in diabetes

14 Treatment: Injection Hyaluronic Acid Injections (knee only)
A series of 3 – 5 injections Much more costly than steroids May last longer than steroids No one knows exactly how they work May increase lubrication May soothe the nerve endings May have anti-inflammatory effect

15 Treatment: Alternative Approaches
No Scientific Evidence to Recommend Glucosamine/Chondroitin Sulfate Acupuncture Green tea Grape seed extract Tart cherry concentrate

16 Treatment Summary Activity Modification Weight Management Medications
Injections Alternative Treatments

17 Questions??

Download ppt "HealthPartners Medical Group"

Similar presentations

Ads by Google