What causes pain as people age?Osteoarthritis is the most common cause of pain as people age. It occurs when the protective cartilage that cushions the bones in the joints wears down. Other common causes of chronic pain in the aging population include pain from nerve damage (neuropathy) resulting from diabetes, herpes infection and other nerve disorders. Cancer and its treatments can also cause chronic pain.

What is osteoarthritis?Osteoarthritis is a degenerative disease that wears out the cushions between bones where they meet. It occurs as a result of regular use of your joints over time. The joints most commonly affected by osteoarthritis are in the neck, lower back, hands, hips, knees and feet.

What causes osteoarthritis?While aging is the most common cause, there are other factors that increase the likelihood of developing osteoarthritis. Those include:

  • genetic make-up
  • female gender
  • excess weight
  • joint injury or repetitive use of a particular joint
  • lack of exercise

What are the signs of osteoarthritis?The common signs of osteoarthritis are:

  • intermittent pain and swelling in the joint
  • stiffness with decreased range of motion in the joint

    What happens if you ignore the pain from arthritis?We often hear people say that pain is a normal part of aging. But the truth is ignoring arthritis pain can cause additional problems.

    • More limited activity. Joint pain worsens if it is not addressed. It can interfere with your ability to perform regular, everyday activities, such as walking, bathing, dressing, cooking, cleaning, driving, and even sleeping.
    • Increased risk of falls. The pain in a joint can reduce your mobility and balance, which increases the risk of falls. According to one study, people with pain in one lower joint, either a knee or hip, were 53 percent more likely to fall. Those with two affected joints had a 74 percent higher chance of falls, while having three to four painful joints increased the chance to 85 percent.
    • Risk of fractures increases. Bones fracture more easily in older individuals, and often result from falls. As the risk of falls increases with pain, so does your risk for fractures and broken bones.

    How can you manage or prevent pain from arthritis?Several measures can help with controlling and preventing pain associated with arthritis:

    • Contact your physician for evaluation and guidance. Your physician will advise you on over-the-counter pain medications that are safe for you to use. The doctor may also give you tips on healthy diet and active lifestyle habits that will slow the progression of arthritis. Your physician may also run tests to determine the severity of arthritis and may refer you to an orthopedic physician for management of pain or for surgery.
    • Remain active. Exercise for half an hour at least five days a week. Low impact exercises such as walking, cycling, and swimming do not stress the joints too much and decrease the risk of injury to the joints. Wear protective equipment when appropriate for your exercise.
    • Lose excess weight. Being overweight puts more stress on the weight bearing joints -- hips, knees and feet. By losing just 10 to 12 pounds, an overweight individual can significantly improve arthritis pain and mobility. Adopting a healthy diet that includes more vegetables and fruits, avoiding high sugar foods, and getting your daily exercise are the best way to get and stay in shape!

    When should you seek help from a doctor for osteoarthritis?Please contact your physician immediately if:

    • you are having more frequent episodes of joint pain, several times a month
    • your arthritis pain is persistent for three or more days  
    • you develop intense pain after a fall
    • you have difficulty moving the involved joint

    How the coronavirus pandemic affected individuals with arthritisThe COVID-19 pandemic brought with it restrictions such as social distancing and the closing of gyms, and community and senior centers. Over time, this had a notable impact on the physical health of the older adults - both those living in the community and nursing home residents.

    Among other health problems, the decreased physical activity resulted in worsening physical strength and stamina. It also caused increased pain in many of the older adults especially those with back problems, knee and hip arthritis.  

    During the pandemic when the level of the COVID infection was high, in-person visits in outpatient clinics decreased significantly. We were able to use telehealth to manage patients’ concerns, to some extent.  

    Patients who required an in-person physical exam were very hesitant to come into the office. Also, patients who received a recommendation for surgery were hesitant to undergo elective procedures such as joint replacement surgery for fear of getting the virus during hospitalization. As a result, we found that many of our patients say they suffered in pain longer than they would have in pre-pandemic times.

    Now with widespread vaccination, the patient flow in the clinics has resumed and physical therapy services are once again available. This helps us to manage our patients’ arthritis-related problems more effectively. Of course, we still offer telehealth appointments for patients who have difficulty coming in.

    Remember, you don’t have to live with pain. Don’t ignore it.

    Arthritis pain treatment near youIf you are experiencing joint pain or arthritis, the specialists in the Lifespan Orthopedics Institute in Rhode Island can help.

    Sakeena Raza, MD

    Dr. Sakeena Raza is a geriatrician with Rhode Island and The Miriam hospitals, and an assistant professor of medicine at The Warren Alpert Medical School of Brown University.