Osteoarthritis Doctor Discussion Guide

Talking openly and honestly with your doctor about your osteoarthritis is the first—and best—step to getting the most effective treatment for your condition. Along with voicing your normal concerns, here are some questions you might want to ask your doctor. The answers we got from a leading osteoarthritis specialist, Neil Roth, M.D., of Lennox Hill Hospital in New York City, can be used as a basis for discussion with your own doctor.

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Are there things I can do to slow the progression of my osteoarthritis?

No one knows if you can halt the progression, but you can alleviate symptoms. If your symptoms are under control, you're dealing with the progression.

What's the best thing to do during a flare-up?

The best thing is to hit it hard with everything to modify the pain. Icing is your best friend. Take anti-inflammatory medications such as Advil, Motrin, and Aleve. You can ask your doctor for a prescription for these in a higher strength if you need it. Use creams like prescription strength Volataren gel, which delivers anti-inflammatories directly to the knee. Don't give up activities, but do non-impact workouts like swimming or biking. Keep stretching and strengthening.

What lifestyle changes should I make?

Keep active. If you're a runner and haven't run in a couple of years, start slowly and gradually. Build up your aerobic capacity, cross-train. Eat a well-balanced diet, don't overindulge. Keep hydrated. I've never told a patient to lose weight, but it's very tough to be active if you're in pain.

Should I change my diet to help inflammation?

If you eat a healthy diet, including all the major food groups, you'll be in good shape. You can take herbal anti-inflammatory meds, but make sure they're not interacting with your standard over-the-counter or prescription medications. Be especially careful of blood thinners—some vitamins and herbal medications also have blood thinning properties and so do anti-inflammatories like ibuprofen or Advil. Check with your doctor or pharmacist before you add anything to your medication regimen.

Should I alter my routine at all during changing weather?

Weather is funny; lots of people attribute symptoms to it. Pressure changes do affect the joint, which is a closed space. Arthritis does get worse in the rainy season. Do what you can do when you have flare-ups. Try both heat and cold: take a hot shower and then use an ice pack. You need to warm up for activity, but, in general, inflammation responds best to cold.

What stretches do you recommend to get started?

There are a host of good stretches. The best way to find what works for you is to look online for some that are good for the particular group you're trying to stretch. Most trainers recommend doing a warm stretch. Don't stretch from scratch, first walk for five minutes, then stretch, then exercise. Or ride your exercise bike for five to 10 minutes and then stretch. Sometimes stretching cold muscles causes strain.

What exercises do you think I am ready for?

This is very individual. But in general focus on exercises that strengthen major muscle groups around the knee, including the quadriceps, hamstrings, and calf muscles.

How often should I be exercising?

Every day for a half hour to an hour. But three times a week is also great if that's all you can do.

How will I know if I'm overexerting myself?

If you feel pain the day after a strenuous workout that's an indication you overdid it. Give yourself time to recover. Take 24 to 48 hours, and when you feel you're back to where you were, start the activity again. Don't push through pain. Listen to your pain and modify your activities accordingly.

Are there any new treatment options we should explore?

I recommend the new braces that take the load off joints. Braces historically have been very bulky and not customizable. We now have low-weight braces that are customizable. One type is the nano-brace from DonJoy. Insurance generally covers these braces.

Are there any specialists I can see to help my treatment?

If your condition doesn't require a surgical intervention, you can be managed by a good primary care doc who's up to date on treatments. Or you can see a physiatrist who specializes in physical medicine and rehabilitation. They don't operate, but they can do injections.

Are there any arthritis-specific support groups you recommend?

Attend a workshop such as the Arthritis Self-Management Program and the Chronic Disease Self-Management program. They're low cost and available in communities across the country. Attending one of these programs can help with learning ways to manage pain, exercise safely, and gain control of arthritis.