Arthritis treatment Scottsdale: start with steady, gentle movement

Lower the strain without stopping

Cut back the task that first made it hurt, but don't stop all activity. Shorten a walk and stay on level ground when a knee or hip hurts. For a sore hand, loosen your grip and pause between repeated tasks; make a single change, then wait.

Mild soreness during movement may be all right if it settles soon. Stop when the ache keeps building, and check the joint later that night and after waking.

Let the soreness afterward guide tomorrow's amount.

Write down when the joint hurts

Arthritis often brings tightness after sitting and an ache during use. Stairs can bother a knee, while a hip may ache in the groin or thigh. A hand may feel weak when you open a jar, and mild swelling can come and go.

Write down what you were doing, where it hurt, and the time it took to ease. A few days of notes can show whether the same task keeps causing trouble.

Get prompt help for a hot, red, or quickly swollen joint. Recent injury, fever, weakness, or trouble standing on the leg also needs a timely exam.

Arrange an exam when life gets harder

See a doctor when the joint aches again and again, disturbs sleep, or prevents usual tasks. Take your scan reports, a list of medicines, and a short record of the joint pain. Tell the doctor which task you most want back.

The doctor will ask about the ache and examine the joint. An X-ray may clearly show joint wear or only suggest a cause, but it cannot measure how sore you feel.

Before leaving, ask what to try and when to check the joint again.

Sources

1. The Lancet Seminar on osteoarthritis states that diagnosis is clinically based despite widespread OVERUSE of imaging, that management should focus on core treatments - self-management and education, exercise, and weight loss where relevant - and that surgery should be reserved for people who have not responded appropriately to less invasive methods.

   Hunter DJ, et al. — Osteoarthritis.. Lancet, 2019. DOI: 10.1016/S0140-6736(19)30417-9.

2. In the Framingham Osteoarthritis Study, 710 people over 50 with NO radiographic evidence of knee osteoarthritis underwent knee MRI: 89% had 'any abnormality'. Osteophytes appeared in 74%, cartilage damage in 69% and bone marrow lesions in 52%. Prevalence of at least one abnormality was 90-97% in painful knees and 86-88% in painLESS knees.

   Guermazi A, et al. — Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study).. BMJ, 2012. DOI: 10.1136/bmj.e5339.

3. A systematic review found the proportion of people with knee pain who have radiographic osteoarthritis ranges from 15% to 76%, and the proportion of people with radiographic knee OA who have pain ranges from 15% to 81%. The authors conclude X-ray results should not be used in isolation when assessing an individual patient with knee pain.

   Bedson J, et al. — The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature.. BMC Musculoskelet Disord, 2008. DOI: 10.1186/1471-2474-9-116.

4. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-efficacy and self-management programmes, tai chi, cane use, hand orthoses for first-CMC joint OA, tibiofemoral bracing, topical NSAIDs for the knee, oral NSAIDs and intra-articular glucocorticoid injections for the knee; acupuncture, thermal modalities, radiofrequency ablation, acetaminophen, duloxetine and tramadol are only conditional.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020. DOI: 10.1002/art.41142.

5. The Cochrane review of land-based therapeutic exercise for knee osteoarthritis extracted data from 54 studies, with high-quality evidence from 44 trials (3,537 participants) that exercise reduces pain immediately after treatment, and further high-quality evidence that it improves physical function. Benefit attenuates but persists for at least two to six months after the programme ends.

   Fransen M, et al. — Exercise for osteoarthritis of the knee.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD004376.pub3.