“I have arthritis in my right knee and want to stay active. What’s your best advice?”

I’m a true believer in seeing a specialist for any problem. If you had a valuable piece of antique furniture that needed restoring, it would probably be best to see a reputable furniture restorer rather than a part time carpenter. But we don’t always seem to do that with our own aliments.

So while it’s fine to see your family doctor initially, (and usually quite preferable,) if no improvement is made, seeing a specialist is certainly in order.

A number of specialists treat knees. Orthopedic surgeons are a good choice for injuries; you might even want to see one that just does knees. For arthritis, a rheumatologist might be a better choice. Physical therapists, massage therapists, and other medical providers can also be helpful if there are musculoskeletal (tight muscles, tendons etc.) involved.
But remember that we’re all imperfect structural entities. Even our right and left sides are not mirror images of each other. Simply look in a mirror and you’ll see that you have one shoulder that is higher than another, one arm that’s longer, or one foot that flattens more than the other. Any degree of abnormality will over a period of time, increase the stress on the weight bearing joints of our feet, ankles, knees, hips and back, in the same way that poorly aligned tires will cause them to wear prematurely and unevenly.

So with arthritis of these joints, having yourself evaluated structurally is very important. Correcting problems like a longer leg or flattened foot can have a profound effect on decreasing arthritic pain, and slowing the progression of the arthritis. Often, such an exam can make the difference in staying active as you age with arthritis.

This also becomes extremely important after a knee or hip replacement, because one of the most common complications of such surgery is a leg that is longer or shorter than it was before surgery. Correcting this will prevent further damage to the new joint as well as the other weight bearing joints.

The latest literature from institutions like the famed Mayo Clinic now show that structural abnormalities cause increased joint friction, and that this, not age as we have always thought, is a major factor in arthritis.
 
A former Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG at Reynolds Plantation. He works with patients who have arthritis and wish to decrease joint symptoms and remain active. He also treats athletes at all levels, including Olympic gold medalists, and helps the UGA Golf Team. For further information please see www.drloupack.com, drloupack.blogspot.com, or call (706) 454-0040.