Friday, March 13, 2009

Dr. Barry Waldman featured in the Baltimore Sun today

The Baltimore Sun this week featured a question-and-answer column on arthritis with Barry Waldman, M.D., co-director of the Center for Joint Preservation and Replacement at the Rubin Institute for Advanced Orthopedics at Sinai Hospital in Baltimore. The column also appeared in the Cape Cod Times.

Here's a transcript of the conversation:

Question: What is arthritis?

Answer: The word means inflammation of the joint. This inflammation causes the cartilage in the joint to wear out. As it wears out, it causes four problems: pain, redness, swelling and deformity.

Q: Are all those symptoms usually present?

A: No. They don't have to be. And there are all kinds of arthritis. The one we're most familiar with is osteoarthritis, the premature wearing out of the joints. There are other kinds caused by a number of diseases called inflammatory arthritis.

Q: Who is most susceptible to osteoarthritis?

A: Past trauma and family history can play a role. But the vast majority of people just get it, and we don't know why.

Q: How is it diagnosed?

A: Generally by X-ray.

Q: What are the most common symptoms?

A: Pain and swelling. The pain tends to be worse when sedentary. With activity, the joint hurts less.

Q: Why?

A: We don't know, but cartilage tends to be healthier when it's moving.

Q: When should someone seek treatment?

A: When the symptoms are interfering with things they want to do, whether it is walking or exercising.

Q: Does delaying treatment make the condition worse?

A: We encourage people to see a doctor because there are some kinds of arthritis that can be slowed with medication.

Q: Some people say weather makes their arthritis worse. Does research support that?

A: There have been a lot of studies done on arthritis and weather, and it seems that weather doesn't make a difference in arthritis pain.

Q: What are the treatment options for osteoarthritis?

A: The best early treatment is exercise. Getting the muscles stronger around the joint will help. The next thing we try is acetaminophen, otherwise known as Tylenol. Then we move on to anti-inflammatory medicines like Motrin or Aleve. If that doesn't work, there are medicines we can inject into the knee or shoulders. We can try anti-inflammatories like cortisone. We have one injectable medicine made of cartilage that can act as a cushioning agent.

Q: Do over-the-counter remedies such as glucosamine help?

A: There was recently a large study that National Institutes of Health did that found that glucosamine and chondroitin didn't help. The American Academy of Orthopedic Surgeons now recommends against taking it.

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