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Arthritis is not a given in old age

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                                Preventing arthritis should begin many years before it is a concern — by preventing joint injuries during sports or exercise and recovering properly, said Dr. Kelli Dominick Allen, an exercise physiologist.


    Preventing arthritis should begin many years before it is a concern — by preventing joint injuries during sports or exercise and recovering properly, said Dr. Kelli Dominick Allen, an exercise physiologist.

What was once an easy run might feel tougher to complete. Or perhaps a challenging game of tennis might leave your hip or ankle sore for days.

Painful, stiff or swollen joints are a common complaint among older adults — and for many, they’re the first sign of what could feel like an unavoidable diagnosis: arthritis.

In a 2022 survey of more than 2,200 people between ages 50 and 80 in the United States, 60% said they had been told by a health care provider that they had some form of arthritis. And about three-quarters considered joint pain and arthritis a normal part of aging.

But arthritis is not inevitable as we age, said Kelli Dominick Allen, an exercise physiologist at the University of North Carolina School of Medicine.

“Sometimes people will start to get aches and pains in their joints and not do anything about it because they think everyone gets arthritis as they get older,” Allen said. “We shouldn’t think about arthritis as something that we just have to deal with passively.”

Arthritis is a catchall term for the more than 100 kinds of inflammatory joint conditions, each of which can arise for different reasons. Many of those causes have little to do with age, Allen said.

One form of degenerative joint disease, though, known as osteoarthritis, is somewhat more likely to occur as a person gets older, said Dr. Wayne McCormick, a geriatrician at the University of Washington School of Medicine. “It’s basically just worn-out joints,” he said.

Osteoarthritis is most commonly seen among people over 50, particularly women, Allen said.

Scientists don’t know precisely why some people are more prone to joint inflammation and pain with age than others. But about 12% of osteoarthritis cases are a result of joint injuries, such as meniscus or ligament tears, from when they were young.

Arthritis is also more common among people who have a family history of the condition, or who have certain chronic conditions such as obesity, heart disease or diabetes.

Some people could find that their joint pain limits their activities as they age. But others, whose X-rays might show significantly worn-out joints, could experience no pain at all, McCormick said. As a result, he added, “each person has to develop their own plan of how to stay healthy and functional with the help of their physician.”

For most people, Allen said, preventing arthritis later in life should begin many years before it is a concern — by taking steps to prevent joint injuries during sports or exercise, and recovering properly when they occur.

For those who are not at risk of developing sports- related injuries, staying physically active and maintaining a healthy weight can help to prevent excessive wear and tear on your joints and to reduce pain if arthritis sets in later in life, Allen said.

In a 2015 review of 44 clinical trials, for instance, researchers found that participants who exercised regularly had reduced knee pain related to osteoarthritis and improved physical function and quality of life.

“It actually does help if you can do low-impact exercise, like a stationary bicycle where your knees, hips and joints aren’t receiving so much impact,” McCormick said. Strengthening muscles such as the quadriceps and hamstrings helps to support the joints, he added.

In addition to regular exercise, supportive knee or ankle braces, over-the-counter pain medications such as ibuprofen or acetaminophen, or steroid injections into a problematic joint can all help relieve joint pain to varying degrees, McCormick said.

Not every option works for everyone, he said, so it’s important to find what helps you to stay active.

Similarly, dietary supplements such as glucosamine and chondroitin sulfate — or herbal remedies such as Boswellia (an herbal extract made from the bark of the Boswellia tree) — could help relieve symptoms for some people. But there isn’t much scientific evidence to support their use, Allen said.

“There have been a fair number of clinical trials, but really mixed evidence on their effects,” she said.

But McCormick said that in his experience, it’s “very unusual for these supplements to be harmful,” so they could be worth trying — or stopping if they don’t seem to help.

Ultimately, finding ways to live a pain-free, active and healthy lifestyle is the best way to reduce your risk of developing arthritis later in life, Allen said.

Many of the actions that reduce the risk for other chronic conditions such as diabetes or heart disease “are really powerful tools” for lowering age-related joint disease risk too, she said.

“Somebody who’s trying to maintain a healthy lifestyle will already be doing the things that are most important for reducing arthritis risk,” she said.

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