DEAR DR. DONOHUE: I have osteoarthritis of the hands, and my fingers have bony knobs on the knuckles. They look bad and hurt part of the time. I was a registered nurse and did lots of lifting of patients. Is the arthritis genetic or from the lifting? I go to the gym two to three times a week and have been doing so for two years. Am I making it worse? — C.S.
ANSWER: Osteoarthritis is the most common kind of arthritis. At age 65, onethird of people have evidence of knee osteoarthritis, and close to 100 percent of women have evidence of osteoarthritis of their hands and fingers. Not all these people have symptoms. The tiny bumps on the knuckle below the fingernail are part of the arthritis picture. Genes are involved. Age, misalignment of bones and injury are other contributors. Exercise is not responsible. Continue your exercise program. Strong muscles protect joints, and exercise keeps them limber. Only if an exercise is painful should you stop it.
A joint is the place where two bone ends meet. The ends are covered with cartilage, and the entire joint is surrounded by a tough covering called the joint capsule. Cartilage makes it possible for one bone end to move over the other painlessly. Joint fluid, contained in the joint by the joint capsule, oils the joint and also keeps it operating without friction. In osteoarthritis, the joint cartilage begins to fray and crumble, and the joint fluid thins.
There is no cure for osteoarthritis; there are treatments. Tylenol is one of the best and safest drugs. Aspirin and nonsteroidal antiinflammatory medicines (Aleve, Advil, Motrin, etc.) are widely prescribed. They can cause ulcers, so they have to be used in moderation. Voltaren gel is an antiinflammatory applied to the skin over an affected joint. Less is absorbed this way, so it has fewer side effects. The doctor can inject a bothersome joint with cortisone.
Artificial joints are always worth consideration when arthritis severely limits motion and is quite painful. The joint at the base of the thumb is often bothersome in women. An operation that inserts a small piece of cartilage or other synthetic material can cushion that joint and bring great relief.
The arthritis booklet discusses osteoarthritis, rheumatoid arthritis and lupus. Readers can obtain a copy by writing: Dr. Donohue — No. 301W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./ $6 Canada. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Have clubfeet disappeared? When I was a child, I knew several children who were born with them. Now I never hear about it. I am 92. — R.T.
ANSWER: Clubfeet have not disappeared. It happens to about one in every 1,000 newborns.
This is something that happens during fetal development. The foot bones are misaligned. The result is the soles of the feet turn to face each other, like the position of praying hands with palm against palm.
Taping, strapping and casting are some of the ways used to treat clubfeet. Some infants require surgery to attain normal foot alignment.
Readers may write Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853- 6475.
©2009 North America Synd.