Ask the Doctor: Keeping joints healthy into your 50s and beyond

October 23, 2018
Keeping joints healthy into your 50s and beyond
Dr Nishiyama

Oh, those aching joints. You may think that arthritis is just something you’ll have to bear as you age, but non-surgical interventions and surgical treatments can help keep you functional and pain-free into retirement and beyond. Here, Steven Nishiyama, DO, PhD of Desert Orthopaedic Center shares tips for keeping hips and knees mobile.

What is the most common knee or hip issue for adults older than 50?

The most common hip and knee disorder in adults 50 or older is osteoarthritis. It is the most common form of arthritis, affecting more than 27 million adults in the United States alone. Osteoarthritis is a progressive loss of joint cartilage and often results in pain, deformity, and stiffness.

How is osteoarthritis treated?

A typical course of treatment starts with non-surgical management including pain medicines like Tylenol® or nonsteroidal anti-inflammatories (NSAIDS) to help reduce pain and swelling in the joint. Exercise and physical therapy can be helpful to increase range of motion and flexibility and strengthen muscles, decreasing joint pain.

If these interventions aren’t making a significant benefit, cortisone or other injections can relieve pain and reduce inflammation, but their effectiveness varies by patient. In some situations of joint deformity, braces can provide stability and pain relief.

If these nonoperative treatment options are unsuccessful, the next best step is to pursue hip or knee replacement.

How is weight related to osteoarthritis?

Every ten pounds of extra weight that you carry can result in fifty pounds of weight-bearing pressure across your hips and knees, so losing weight can greatly reduce stress on your weight-bearing joints. Losing weight can also significantly improve recreational activities and exercise by reducing pain, increasing energy, improving stamina and increasing function.

With hip or knee issues, are there benefits to doing physical therapy before and after surgery?

There is significant benefit to doing physical therapy (PT) before and particularly after surgery. Before surgery, PT will help strengthen muscles and increase flexibility, which significantly aids in recovery. After surgery, PT is absolutely necessary to help maintain range of motion and flexibility, strengthen muscles, and help develop confidence, ultimately leading to a faster recovery and improved outcomes.

What is the effect of osteoporosis on hips and knees?

Osteoporosis, commonly confused with osteoarthritis, is a condition where bones become less dense and more likely to fracture. This is particularly important to hips, as common fractures in the hip are a result of weak bones. Other common locations for osteoporosis-related fractures are the spine and wrist.

How does chemotherapy or other medical treatments affect joints and bones?

Chemotherapy and other medical treatments like extended courses of steroids can have a lasting effect on joints and bones. Some common side effects of these drugs include joint pain, peripheral neuropathy (a persistent feeling of pins and needles or numbness in the fingers or toes), muscle pain, stiffness, osteoporosis, osteonecrosis (bone tissue death) and a higher risk of fractures. However, not all medical treatments have these side effects, so it’s best to speak to your care team about specific side effects from any medications you take.

What can I do to keep knees and hips in good shape?

The keys to keeping your knees and hips in good health include weight reduction, regular physical activity and low impact exercises. Keeping a healthy diet and controlling blood sugar are also vital. Some evidence suggests that glucosamine and chondroitin supplements may help, but this is not a definitive recommendation — talk to your doctor about what’s right for you.

Are there exercise tips to keep in mind?

Three kinds of exercise are important for people with hip and knee pain: range of motion, aerobic and strengthening. Range of motion exercises like yoga or Pilates include gentle stretching and movements that take joints through their full arc of motion. Aerobic exercises strengthen your heart and lungs and reduce fatigue. Low-impact aerobic exercises like walking, cycling or swimming can provide benefits in as little as 30 minutes of activity, four to five times per week. Additional benefits of aerobic exercise include helping reduce weight and improved mood and sleep. Finally, strengthening exercises like weight training or resistance training can support and protect your joints.

How does shoe wear affect hips or knees?

Shoe wear can have a significant impact on your hips and knees, particularly if you have “knocked knee” or “bow legged” knee deformities, which can lead to deterioration of not only your hips and knees, but along your feet, ankle and spine. When determining a treatment plan, I’d assess your gait, shoe wear, work ergonomics, and lifestyle along with the condition of your joints.

What else should patients know before pursuing treatment for joint problems?

Although I am a surgeon by calling, I stress to my patients to do everything possible to prevent surgery. Hip and knee problems often cause quality of life issues and my objective is to provide you the best opportunity to achieve your best quality of life. Although surgery is sometimes unavoidable, my focus is on treating the problem as a whole, encouraging patients to pursue lifestyle changes that can improve outcomes before and after surgery. If surgery is necessary, I will do my best to make the experience as pleasant and painless as possible.

If you’re dealing with chronic knee or hip pain, call 702-388-4888 to schedule a meeting with an orthopedic surgeon.

Learn more about orthopedic care in the Valley Health System >