Could you please tell me the difference, if any, between osteoarthritis and osteoporosis?
Osteoarthritis, also known as degenerative arthritis, and osteoporosis are very different conditions. Osteoporosis, or thinning of the bone, has been the subject of a great deal of recent research and publicity, as its effects have become more widely known. It is not a form of arthritis. Bone thickness and heaviness are usually greatest at about age 30 or 35 in both sexes. They slowly decline equally in both sexes until age 45 or 50, when women typically go through menopause; bone loss in women then accelerates because of the lack of estrogen stimulation. Early menopause, removal of the ovaries at an early age, smoking, drinking alcohol, lack of exercise, hyperthyroidism or overtreatment with thyroid hormone, and other conditions all aggravate the bone loss. Bone loss in the elderly may amount to 20 to 30 percent in men and 40 to 50 percent in women. This loss of bone leads to fractures: typically vertebrae, hips, and forearms. Vertebral fractures lead to the common hunched-over posture of many elderly people.
Replacing estrogen in women after menopause will stop the bone loss, for at least 10 years, and reduces the risk of fractures. Women over age 45 should also be sure to get at least 1000mg (1 gram) of calcium in their diet daily, or 1500mg if they are not taking estrogen. It is easiest (and cheapest) to take this as calcium carbonate pills. Check the label to see how much elemental calcium is in each pill, and then take the number you need to add up to 1000 or 1500mg. Although there is no official recommendation, men could also benefit from calcium supplements after age 45.
Osteoarthritis is the most common form of arthritis. Men over age 55 tend to develop it more frequently in the hips, women in the knees. Prior injury to a joint, such as an ankle fracture, will frequently lead to the development of osteoarthritis in the joint. Repetitive trauma, particularly work-related trauma, also seems to encourage the arthritis. For example, workers using jackhammers commonly get osteoarthritis in the hands, elbows, and shoulders. Obese women, who put more weight on their knees, get osteoarthritis in these joints much more than thin women. In an osteoarthritic joint, the cartilage, which is important for the joint surfaces to slip easily over each other, begins to fray and get worn down. It may wear away completely, leaving bone touching bone in the joint.
Osteoarthritis leads to the gnarled hands one sees in many older people. It can also affect the spine, not only producing pain from the joints, but also reducing flexibility.
Osteoarthritis treatment used to be only symptomatic, that is, aimed at relieving the pain and limitations of motion, without improving the underlying condition. However, recent reports on the use of chondroitin sulphate and glucosamine, both constituents of cartilage, seem to indicate that the cartilage can be repaired to some degree. Chondroitin sulphate and glucosamine are both available in health-food stores. The usual daily dose is three capsules per day for a few weeks, then two capsules per day indefinitely. It is fairly expensive, but if you try to find a better price in a health-food store, make sure you are getting an equivalent number of milligrams of each for your money.
Finally, osteoarthritis now accounts for most of the joint-replacement surgery performed in this country. Hip replacements have been done for many years and are very successful. In fact, I had one, and it was a tremendous success, allowing me to continue playing tennis without pain. Knee replacements have not been around as long, but have become quite successful in eliminating pain and returning normal function.
As should be clear, people can have both osteoporosis and osteoarthritis; since both tend to occur in older people, probably most sufferers of one have some degree of the other.
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