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Myths and Truths About Knee Osteoarthritis

The studies and their findings that are presented in this article are for informational purposes only and are not meant to take the place of the advice of your doctor. By providing you with this information, Genzyme Corporation is not endorsing its content. You should consult with your doctor before starting any new health regimen.

Arthritis is such a familiar disease that almost everyone knows about it. Unfortunately, some of what passes for common knowledge is just plain wrong. These misconceptions can be hazardous to your health if they lead to improper or inadequate treatment. Below, we debunk some common myths about osteoarthritis (OA) of the knee.

Myth: If your knee hurts, you should rest it as much as you can until the pain goes away.

Truth: At one time, it was thought that people with OA should avoid exercise, because it would only add to joint damage. Today, though, research has shown that exercise is a crucial tool for helping keep OA under control. The key is listening to your body. If you have increased joint pain (not just muscle soreness) that lasts for more than two hours after your workout, you probably did too much. Next time, cut back a little—but don’t stop altogether, which may just make matters worse. Ask your health care provider for guidance on what type of exercise to do, how often and how vigorously.

Myth: Over-the-counter (OTC) pain pills are the safest treatment for OA knee pain.

Truth: Even nonprescription pain pills can cause serious side effects, and the risks are compounded if you use the pills improperly. Read the label on your OTC medicine. If you’re using more than the recommended dose, taking the medicine more often than advised or mixing different types of medicine, there are real safety concerns. When following the label instructions for proper use isn’t managing your pain, it’s time to talk to your doctor about other options.

Myth: A cold, wet climate speeds up the progression of OA.

Truth: There’s no evidence that climate affects the disease process underlying OA. And there’s also no such thing as an arthritis-free climate. Even people living in warm, dry locales still struggle with OA.

Many people believe their OA pain is worse on cold, rainy days, but studies that have looked for this connection have found conflicting results. One study conducted in Cordoba City, Argentina, found that OA pain was indeed associated with low temperatures and high humidity (Journal of Rheumatology, February 2002). But another study conducted in Florida found little, if any, connection between arthritis pain and weather conditions (Rheumatology, August 2003). At worst, then, weather might have a small impact on day-to-day pain.

Myth: Smoking is certainly bad for your overall health, but it doesn’t affect OA.

Truth: Research indicates that smokers with OA may have greater cartilage deterioration and more severe joint pain than nonsmokers with OA (Annals of the Rheumatic Diseases, January 2007). One study by Australian researchers found that smoking was associated with increased cartilage loss and damage mainly in people who had a parent with severe OA of the knee (Arthritis and Rheumatism, May 2007). This finding suggests that genetics and smoking may work together to cause greater problems.

Myth: The need for a knee replacement is mainly determined by how bad your knee looks on an X ray.

Truth: An X ray can show cartilage loss, bone damage and bone spurs. But there may be a big difference between how much damage shows up on an X ray and how much pain and stiffness you feel. In general, the decision about when to have surgery is based largely on subjective factors in conjunction with X ray findings; for instance, pain and disability that persist after trying several medications, interfere with your usual activities, keep you awake at night or make it hard to get around. Other factors that may figure into the decision include your general condition, weight and bone health.

References

  1. Arthritis Foundation. Understanding arthritis: eradicating myths. Available at: http://www.arthritis.org/myths.php. Accessed September 14, 2008.

  2. Arthritis Foundation. Introduction to exercise. Available at: http://www.arthritis.org/exercise-intro.php. Accessed September 13, 2008.

  3. Arthritis Foundation. Protect your joints. Available at: http://www.arthritis.org/protect-body.php. Accessed September 13, 2008.

  4. “Over-the-Counter Nonsteroidal Anti-inflammatory Drugs and Risk of Gastrointestinal Symptoms.” J. Thomas III et al. American Journal of Gastroenterology. September 2002, vol. 97, no. 9, pp. 2215-2219.

  5. Chustecka, Z. OTC pain relievers and NSAIDs aren’t taken correctly. Medscape Medical News. Available at: http://www.medscape.com/viewarticle/537855. Accessed September 19, 2008.

  6. “Gastrointestinal Complications of Over-the-Counter Nonsteroidal Antiinflammatory Drugs.” J.E. Biskupiak et al. Journal of Pain and Palliative Care Pharmacotherapy. 2006, vol. 20, no. 3, pp. 7-14.

  7. Johns Hopkins Medicine. Does weather affect arthritis pain? Available at: http://www.johnshopkinshealthalerts.com/reports/arthritis/44-1.html. Accessed September 19, 2008.

  8. “Influence of Weather Conditions on Rheumatic Pain.” I. Strusberg et al. Journal of Rheumatology. February 2002, vol. 29, no. 2, pp. 335-338.

  9. “Cigarette Smoking and the Risk for Cartilage Loss and Knee Pain in Men with Knee Osteoarthritis.” S. Amin et al. January 2007, vol. 66, no. 1, pp. 18-22.

  10. “Smoking Interacts with Family History with Regard to Change in Knee Cartilage Volume and Cartilage Defect Development.” C. Ding et al. Arthritis and Rheumatism. May 2007, vol. 56, no. 5, pp. 1521-1528.

  11. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Handout on health: osteoarthritis. Available at: http://www.niams.nih.gov/Health_Info/Osteoarthritis/osteoarthritis_hoh.pdf. Accessed September 13, 2008.

  12. Arthritis Foundation. How do you know it’s time for surgery? Available at:http://www.arthritis.org/know-time-surgery.php. Accessed September 13, 2008.

  13. “Osteoarthritis Pain and Weather.” F.V. Wilder et al. Rheumatology. August 2003, vol. 42, no. 8, pp. 955-958.

Alain Elbaz, MD. – Orthopaedic Surgeon Meet Dr Alain Elbaz
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Indication

Synvisc-One® (hylan G-F 20) and SYNVISC® (hylan G-F 20) are indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics, e.g., acetaminophen.

 

Important Safety Information

Before trying Synvisc-One or SYNVISC, tell your doctor if you are allergic to products from birds—such as feathers, eggs or poultry—or if your leg is swollen or infected. Synvisc-One and SYNVISC are only for injection into the knee, performed by a doctor or other qualified health care professional. Synvisc-One and SYNVISC have not been tested to show pain relief in joints other than the knee. Talk to your doctor before resuming strenuous weight-bearing activities after treatment. Synvisc-One and SYNVISC have not been tested in children, pregnant women or women who are nursing. You should tell your doctor if you think you are pregnant or if you are nursing a child. The side effects most commonly seen when Synvisc-One or SYNVISC is injected into the knee were pain, swelling and/or fluid buildup in or around the knee. Cases where the swelling is extensive or painful should be discussed with your doctor. Allergic reactions such as rash and hives have been reported rarely.

View the Complete Prescribing Information for Synvisc-One (PDF)
View the Complete Prescribing Information for SYNVISC (PDF)

 

© Alain Elbaz MD Orthopaedic Hip Knee & Shoulder Surgeon Cypress Houston Texas