Bone Disease

Arthritis

Arthritis is a term that covers a wide number of diseases that are often characterized by inflammation in the joints. Inflammation can lead to redness and swelling, which can cause pain and joint stiffness often reported in arthritis. Common sites affected are the hip, knee, spine, and fingers, but arthritis can affect almost any part of the body.

Some of the most common types of arthritis include osteoarthritis, gout, and rheumatoid arthritis. Different types of arthritis can cause different symptoms and require different treatment. Currently, there is no cure for arthritis, but it may be managed with diet, exercise, and medications.

Osteoarthritis

Osteoarthritis (OA) is a progressive disease that occurs due to damage in the joints to the cartilage and bone. Cartilage, a tough elastic material, protects bones at joints from rubbing against each other. Contact between the bones can cause pain, stiffness, and swelling. The most common symptoms of OA include joint pain, morning stiffness for less than 30 minutes, and decreased range of motion in the affected joints.

Gout

Gouty arthritis, also known as gout, occurs due to high levels of uric acid in the blood. Uric acid is a normally occurring waste product that is usually removed in urine. High levels of uric acid are not always harmful, but for some people, uric acid can form crystals in the joint. This can cause symptoms of pain and swelling.

A gout attack is characterized by pain and swelling that usually gets worse over 8-12 hours. The attack commonly happens at night. Symptoms usually improve over the next few days and are gone within a couple weeks. Even though there is no pain, high uric acid levels can still be causing damage, so it is a good idea to see your doctor after a gout attack.

Chronic gout can develop if there are high uric acid levels for many years. In chronic gout, gout attacks can become more common, the pain may not go away, and there may be more permanent joint damage. Treatment of gout often involves taking medications to reduce uric acid levels to prevent gout attacks and the development of chronic gout.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that can result in joint inflammation, damage and pain. In an autoimmune disease, the immune system – which normally protects the body from things like infection – mistakenly targets a part of the own body. RA will often affect the body symmetrically. That means if your right knee is affected, your left knee will also likely be affected. Treatment of RA often involves taking medications to help with pain, reduce inflammation and prevent permanent damage.

Osteoporosis

Osteoporosis is a disease where bone becomes thinner and weaker than normal. This results in a greater risk of breaking your bones (fractures) in areas that normally wouldn’t break easily, such as the spine and hip. There may not be any signs of osteoporosis until the disease is quite far along. The first sign may be a bone fracture after a bump or fall. Other signs can include back pain and abnormal height loss.

Risk Factors

Bone loss happens normally as we get older. In osteoporosis, there is a greater loss and weakening of bone than normal. While it is not possible to predict who will get osteoporosis, there are some factors that put you at greater risk of developing the disease. These include:

• Older age
• Female who has gone through menopause
• Family background of osteoporosis
• Smoking
• Drinking alcohol
• Reduced weight-bearing exercises
• Lack of calcium or vitamin D
• Taking certain medications that may affect bone, such as glucocorticoids
• Having certain diseases, such as rheumatoid arthritis

Treatment

Treatment of osteoporosis includes improving lifestyle factors, such as exercising and maintaining a good diet. Medications can help slow down bone loss or help with bone production. It is also important to reduce the risk of falling. This can include making changes in your home to make it safer.

10 Tips For Healthy Bones

As we age, our bones and joints can become weaker which can affect our ability to move like we once used to. Issues with movement and bone strength can be caused by underlying conditions such as osteoporosis and arthritis. This handout provides information about what we can do to keep our bones healthy:

1. Calcium and Vitamin D supplements may be useful above the age of 50 years old, especially for women. In general,1000-1200mg of elemental Calcium if you have osteoporosis and 800-1000 International Units of Vitamin D are recommended on a daily basis for bone health. You can find both of these elements in certain foods you eat but in order to assess your daily intake and the safety of these for your specific health conditions, please talk to your pharmacist or doctor.
2. Regular weight bearing and muscle strengthening exercise can help reduce the risk of falls and fractures while improving the mobility of our joints.
3. Aerobic (water) exercises are easier on the joints and are effective in relieving joint pain too. Tai chi is another exercise that has shown promise in helping with knee pain.
4. If you are overweight or obese, weight loss through healthy diet and exercise can decrease the amount of stress placed on your joints, and improve your mobility.
5. You can protect your bones and joints by using walkers, canes, braces or tape to provide them with more support. Consult a healthcare provider to ensure these assistive devices are fitted for you. In addition to this, wearing shock absorbing, comfortable footwear in the right size and with proper arch support can also help reduce the impact on your joints.
6. If you are a current smoker, consider quitting smoking to reduce your chance of developing bone health issues. If you are a BC resident, the government has a program that can help you on this journey. Talk to your healthcare provider to learn information about this program or visit https://www2.gov.bc.ca/gov/content/health/managing-your-health/mental-health-substance-use/quitting-smoking-tobacco-use
7. Decrease your alcohol intake to 2 drinks/day or less as it can increase your risk of falling. Increased falls have been linked to fractures and loss of bone.
8. To prevent falls, minimize any hazards around your house such as loose rugs and also ensure adequate lighting, especially if you need to walk around your house at night.
9. Certain medications (such a blood pressure medications, sleep medications) can also cause dizziness and increase your risk of falling. Talk to your doctor or pharmacist about your medications, as well as any natural or non prescription products you are using.
10. Talk to your doctor about your fracture risk or a bone mineral density scan as this can help detect osteoporosis and inform you about your risk factors for fractures. It is also important that you talk to a physiotherapist or occupational therapist before starting a new exercise regimen to make sure it is safe for you.