As a rheumatologist, I am fortunate to have the opportunity to meet with people of all ages. Regardless of their age, one of the most frequent concerns that comes up in our conversations is what exactly is "normal or abnormal" as we all get older.
This certainly applies to common symptoms - such as joint stiffness - as well as disturbing sounds (pops and cracks) that our joints can make. It also applies to more indefinite symptoms such as fatigue, or joint or muscle weakness.
Unfortunately, there really are no clear guidelines as to how our muscles and joints should feel when we’re 40, 60 or 80 years of age. After many years of learning about joint conditions and spending time with patients, I have noted several recurring themes. Some of these are highlighted here, with the hope that they may help in trying to answer that often elusive question as to what’s normal and what’s not.
What are the most common joint conditions of which to be aware?
- Rheumatoid arthritis: This inflammatory type of arthritis can strike at any age. It is characterized by widespread joint pain, swelling and stiffness in multiple areas such as the hands, wrists and feet. If diagnosed at an early stage and treated adequately, it can frequently go into remission, with little or no subsequent joint damage.
- Polymyalgia rheumatica (PMR): When joint aches become widespread and prolonged, and especially when associated with severe stiffness in areas like the shoulders and hips, a potential cause could be a condition known as polymyalgia rheumatica or PMR. This inflammatory condition becomes more prevalent after the age of 50 and typically resolves completely with relatively low doses of prednisone.
- Psoriasis: Psoriasis can be associated with joint or tendon pain and inflammation, even when the skin condition is relatively mild or limited to small areas. Pain and swelling in a single finger or toe is a classic feature of this type of arthritis, though inflammation may also be confined to an isolated joint, such as the knee.
- Sjogren's syndrome: Chronic and severe dryness involving the eyes and mouth can be a common side effect of allergies or certain medications. It can also be a feature of an autoimmune condition known as Sjogren’s (pronounced Showgruns) syndrome, which is also frequently associated with diffuse joint pain and fatigue.
- Temporal arteritis: The new or sudden onset of jaw pain, especially involving the temporomandibular joints (TMJ) in an older individual, can be a feature of a serious condition known as temporal or giant cell arteritis. Unfortunately, this inflammatory condition can cause permanent blindness if not treated promptly with a sufficient dose of corticosteroid, such as prednisone. The new onset of headaches, scalp pain or the sudden development of double vision are all symptoms that can herald the onset of this disease.
- Fibromyalgia: Fibromyalgia is a poorly understood chronic condition characterized by widespread pain that typically involves most of the body. It is frequently associated with severe sleep disturbances, as well as post-traumatic stress disorder (PTSD) and depression. Unfortunately there is no diagnostic test that can confirm fibromyalgia. Treatment is also often inadequate. An appropriate diet and exercise program can help immeasurably.
- Gout: Gout is a common type of arthritis that becomes more frequent with age and is commonly associated with obesity, as well as dietary factors such as alcohol intake, especially beer. Refined sugars, especially high fructose corn syrup, have been linked to the development of this painful condition. When gout is seen in younger individuals, however, it is frequently hereditary in nature. Fortunately it can usually be treated very successfully with medication. Weight reduction and dietary modifications can also be very beneficial.
- Osteoarthritis: This "wear and tear" type of arthritis involves the knees, hips and hands, as well as the neck and lower back and is due to the deterioration of cartilage. None of the joint supplements and injections really do anything to restore or rebuild the joint itself. Exercise and modest weight loss can make a significant difference, in reducing joint pain and stiffness, and protecting the joint from further deterioration. If weight-bearing exercise becomes too painful, using a stationary bike or participating in aquatic exercises can be helpful.
Regular movement is the key to reducing future joint problems
Perhaps the last point highlights the simplest, yet most profound, observation that I have made over the years. Those who keep moving, in one form or another, seem to do the best. Study after study confirms the benefits of exercise, and this is especially true for the management of any type of arthritis. With advancing age can come chronic joint pain, increasing obesity and an increasingly sedentary lifestyle, all of which can spiral together and cause further weakness and joint discomfort.
Don’t despair. Try some of the following tips to get started:
- Start slowly and simply with a modest routine such as regular walking.
- Gentle joint movement, or "range of motion" exercises, are beneficial as well, especially for areas like the shoulders, which can be prone to stiffness and freezing up.
- Heat and topical pain relievers may also be helpful in this regard.
- Physical and occupational therapy, chiropractic treatments, acupuncture and massage are all popular and generally safe.
If you have questions about joint pain or any of the conditions mentioned, talk to your primary care provider. Your condition may be addressed at your primary care clinic, but a referral can also be made to see a specialist if your condition and level of pain can't be solved by your primary care provider. To learn more or speak with a Ridgeview rheumatologist, call 952-361-2450 or visit Ridgeview's website.