Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei
Hayeshua Hospital
Want to know what is the most common disease of the elderly
in the Western world? It's probably osteoarthritis, or
arthritis for short. "Mir tut vey de bainer" ("My
bones hurt me") is a common complaint of the elderly and
they are probably referring to their joints.
As one ages there is less synovial fluid -- that's the fluid
in the joints whose job it is to lower friction in the
joints. Furthermore, cartilage, the cushioning material,
becomes harder and shrinks. The result is that every
movement of the joint is now bone grinding against bone,
which can be very painful. Furthermore, joints attempt to
deal with this problem by remodeling, but that often results
with misshapen joints that can look knobby in fingers and
even cause the joint to be so poorly functional that it
needs to be replaced. Hips and knees are commonly replaced,
but the results are not always perfect, and pain can
persist.
No, "cracking your knuckles" does not cause arthritis, but
lack of exercise and previous fractures of bones and joints
does contribute. Arthritis easily shows up on x-ray films,
and while it is more common in some joints than others, it
can appear in all joints of the body.
Anti-inflammatory drugs that are good pain relievers have
long been the mainstay of arthritis therapy, with aspirin,
ibuprofen, and naproxen being the most commonly used. The
problem is that these drugs can cause bleeding in the stomach
which can be lethal, as well as stomach upset, and kidney
failure. Paracetomol (acetaminophen) may be safer and cheap
and studies show is as effective. Recently new drugs have
come out which have less effect on the stomach (Vioxx and
the like) but they still affect the kidney. Unfortunately
there isn't much more to offer as therapy or treatment.
Once again, I trumpet the needs for exercise on a daily
basis. We'll talk more next week. Write me in care of the
Yated. A special hello to Rabbi David Orlofsky -- I
appreciate your kind comments.
A message from Glaxo, sponsor of this column. Seizure
disorder, that is epilepsy, is never pleasant, but these
people can live normal lives. Hard to treat epilepsy was a
problem until Lamactil came around. Now there is hope for
all sufferers of epilepsy.
