Osteoarthritis is the most common form of arthritis. It affects approximately 20 million Americans and that figure is expected to dramatically grow with the graying of the Baby Boomer population.

There are a number of myths or half-truths surrounding osteoarthritis. The first is that osteoarthritis is just a consequence of getting old. While the incidence of osteoarthritis increases with age, osteoarthritis is not inevitable nor is it a "normal" process. Studies indicate that osteoarthritis can actually start in adolescence.

There is a complex interplay between genetic factors as well as environmental triggers that cause osteoarthritis to develop. The most important environmental trigger is trauma and injury to the joint that causes injury to cartilage.

Cartilage is the gristly substance that caps the ends of long bones inside a joint. Cartilage consists of cells called chondrocytes, that are surrounded by an extracellular matrix that is manufactured by the chondrocyte. Picture grapes inside a gelatin mold.

Injury to the joint leads to cartilage damage. This causes mechanical receptors in the chondrocytes to begin to make chemicals called cytokines. These cytokines, along with other destructive enzymes, also produced by the chondrocyte, or by the action of the chondrocyte on surrounding tissue, degrade cartilage.

Because cartilage has no blood supply, it does not repair itself well.
Another misconception is that an x-ray or MRI scan tells us how much damage there is from osteoarthritis. What we see on imaging studies doesn't correlate with a patient's function. Imaging results also don't correlate with the amount of disability a person might have from osteoarthritis.

Another example of the inadequacy of imaging is that probably 100 per cent of people past the age of fifty will have tears of the meniscus cushion in their knee on MRI but very few of these people will have symptoms of knee pain. And, more importantly, the meniscus damage on MRI may not be the cause of a person's knee pain. The danger here is that a patient may undergo a procedure for an abnormality seen on MRI which is not the cause of their knee pain! Not good.

Here's another myth. Nothing can be done for osteoarthritis. Wrong!

First, palliative therapies, meaning treatments that help with symptoms are abundant. They include physical therapy, exercises, thermal modalities (heat or cold), various oral and topical medicines, injections (glucocorticoids or viscosupplements [lubricants]), and braces. For those patients who have progressive disease, there are excellent surgical techniques. All of these strategies are designed to alleviate pain and improve quality of life.

Finally, exciting new research has shown that autologous (a patient's own) mesenchymal stem cells may be of value in healing damaged cartilage. This is an exciting area of therapeutics. While research in this area is relatively new, the early results from our center looks very promising.

Another misconception is that exercise will make the damage worse. This is false. A number of excellent studies have shown both the short term as well as long-term benefits of exercise in helping to improve pain and function in osteoarthritis.

What does make osteoarthritis pain worse is excess weight... so an exercise program along with weight loss is key.

Here's another fallacy... It's just aches and pains...Nothing I can't live with... The fact of the matter is that early diagnosis and treatment can help improve both pain as well as improve the quality of life. Why live with constant nagging aches and pains when you don't have to?