As time goes by and we get older, nature runs its course and our bodies begin to age. Orthopedic problems are often a major issue for the elderly and generally require a great deal of care and caution as one approaches their senior years. The following are bone and joint diseases for which the elderly should be aware of:
The spine is one of the most affected area in the body for degenerative bone and joint diseases, whether in the form of osteoporosis, degenerative disc disease, or spondylosis or degenerative spondylolisthesis. Spondylosis can happen when the disc at a particular segment becomes degenerated and the small joints at the back part of that spinal segment develop degenerative and hypertrophic changes. The ligaments around the spine also become enlarged and cause stenosis of the spinal canal and foramen, where the nerve roots passing through are compressed, producing neurological problems. As those neural tissues control muscle power and sensation of the leg resulting in back pain, pain radiating down to the legs and the patient will feel numbness and weakness of motor function. Due to this condition, some patients are able to walk for only 10 to 20 meters before needing to rest, causing a great deal of discomfort and difficulty in everyday life and activities.
Osteoarthritis of the knee is next in the list of commonly experienced degenerative bone and joint diseases. It is caused by knee cartilage degeneration, causing the knees to be unable to support the body’s weight, as well as to lose some of the lubrication and fluid that keeps the cartilage healthy. The resulting friction and wearing down of the cartilage and bone during movement, causes symptoms such as creaking, a crackly sound when the knee moves, joint pain, and knee deformities. As a person’s ages, the pain increases. One of the major risk factors or causes of accelerated osteoarthritis is excessive body weight.
Hip osteoarthritis occurs less frequently, but is certainly no less painful than other related diseases. It is often caused by degenerative process or obstruction of blood vessels to the hip, disrupting the blood supply to the bones in that part of the joint. Without adequate nourishment, the bone in the head of the femur gradually deteriorates until it eventually collapses and arthritic changes will occur. The resultant degeneration of the hip joint leads to lessened mobility and severe pain. Risk factors making it more likely for someone to develop the disease include alcoholism, regular use of corticosteroid medications, and accidents or injuries where the hip is dislocated or fractured, etc.
Osteoporosis is a condition where bone density decreases and bone structure deteriorates. After the age of 30, the body’s creation of new bone slows and bone mass is lost faster than it is created. Women who are past menopause tend to experience bone deterioration more rapidly and up to two to three times more than men due to lowered levels of estrogen, which is the hormone that inhibits bone destruction. This causes the bones to become more fragile and brittle, allowing them to break or collapse more easily. Bones that tend to break most frequently are those of the spine, the hips, the wrist and upper arm, and the pelvis.
Osteoporosis is a chronic condition, the symptoms of which are not always immediately obvious. It slowly progresses and eventually has a severe effect on the patient’s quality of life. Those who have or are at risk for osteoporosis should work to bolster and maintain bone density and to lower the risks of the disease as far in advance as possible. Helping to maintain bone density can be accomplished through the addition to the diet of foods high in calcium and, in some cases, doctors may recommend calcium supplements, as well.
Improper habits, such as frequent resting in a recliner chair or sofa bed, propping one’s head up on high pillows while watching TV, sitting in one position for long periods of time while working or using a computer—all of these actions can affect and cause painful symptoms in the back and neck. These symptoms include neck pain or stiff neck, also known as a neck crick. Some people develop pain in the shoulder blades, also known as myofascial pain. These symptoms are warning signs that cervical discs have started to degenerate, also known as cervical spondylosis and lumbar spondylosis. If left untreated, pain can begin to radiate down the arm from neck or to the leg from the back and numbness can develop. This is a disease that can be extremely debilitating and become a major source of annoyance in one’s routines and daily life as well. As always, prevention is better than cure, and behavioral modifications and changes in your daily life can go a long way.
Treatment of bone and joint diseases in the elderly can help to relieve pain so that patients can go about their normal daily life and activities. Treatment includes pain medications, and physical therapy. If, however, symptoms do not improve or there is chronic pain lasting for more than three to six months, a doctor may recommend surgery as the next treatment alternative.
Today’s technologies provide a variety of surgical procedure options, depending on the symptoms and physical indicators present in each individual patient. For example, for those experiencing chronic back pain, one option is to open up or increase the size of the spinal canal where thickened ligaments overlying the spinal cord and nerves and disc degeneration are causing penetration into the spinal canal. Bone grafting may take place using a substance similar to the bone, or the patient’s own bone can be taken from elsewhere in the body. The purpose of this type of surgery is to expand the spinal canal, decompress the spinal nerves, and thus provide a better healing environment. Often, the surgeon will reinforce the vertebrae fusion using metal rods and screws to strengthen the union and hold it in place. This procedure is often very effective in remedying pain and improving quality of life, allowing the elderly to retain freedom of movement and thus their overall independence.
Medical treatment of the kind outlined above are, in the end, only palliative. If there are no behavioural modifications or genuine changes in one’s daily life and habits, symptoms and conditions may return, or treatment may not be as effective as hoped. In order to truly prevent illness, minimize pain and discomfort, and improve quality of life, these are doctor’s recommendations:
“If seniors can care for their bodies and keep themselves physically fit, this will ensure they stay healthy as the years go by. Bone degeneration and all its related unpleasant symptoms will at least be reduced or perhaps avoided altogether, and they can look forward to graceful aging and long, happy lives”.
M.D., Faculty of Medicine Siriraj Hospital, Mahidol University, 1961.