This Issue

Exercise key
to slowing common painful condition

With more options today, surgery not the only recourse

Best remedy for osteoarthritis? Get up and go

Q & A

A closer look

Signs and Symptoms

• Pain during or after joint movement

• Limited range of motion or flexibility

• Cracking noise during joint movement

• Stiffness, especially after long periods of inactivity
• Swelling or tenderness in afflicted joints

• Bone spurs — extra pieces of bone that form around affected joint

• Muscle weakness

• Joint deformity

Signs and Symptoms

Risk Factors

A lifeline

The umbilical cord is the baby’s lifeline, but once clamped and cut after the baby is born, it can be the lifeline for someone else. Cord blood — once considered medical waste — is rich in stem cells, which can be used in transplants. But time is limited. You have to complete enrollment to donate cord blood by the end of the 32nd or 34th week of pregnancy depending on the blood bank used.

• Call the Be The Match Registry at 800-507-5427 to find out which hospitals in your state participate.

In Massachusetts, Brigham and Women’s Hospital and University of Massachusetts Memorial Medical Center take part.

• If your hospital is not listed you can still donate. Contact the Carolinas Cord Blood Bank at 919-668-2071 or Lifeforce Cryobanks at 800-869-8608

There is no cost to you and no harm to you or the baby.
If you don’t donate, the blood is thrown away.
A closer look

KNEES are commonly afflicted by osteoarthritis causing pain, stiffness and difficulty in walking and performing normal day-to-day activities. The cartilage, a smooth tissue covering the surface of joints, begins to wear away, which can lead to bone rubbing against bone, muscle weakness and malalignment of the knee.

Copyright 2011 American College of Rheumatology

THE HAND is another common site of osteoarthritis. Bony prominences called Heberden’s nodes may develop near the joint closest to the nail, while Bouchard’s nodes are bony enlargements of the middle joints. Heberden’s nodes are more common in women and may have a genetic link.

A weighty situation

Relief from pain

Initiative to Eliminate Cancer Disparities
2011 National Minority Cancer Awareness

April 17 - April 23

Boston Public Library Cancer
Awareness Display

• Codman Square Branch Library
690 Washington Street

• Mattapan Branch Library
1350 Blue Hill Avenue

• Brighton Branch Library
40 Academy Hill Road

April 28: 12 - 1 p.m.

Secondhand Smoke Exposure
Harvard Street Neighborhood
Health Center
632 Blue Hill Avenue

May 16: 11 a.m. - 1 p.m.
Skin Cancer Prevention
Roxbury YMCA
285 Martin Luther King Boulevard

April 21:
9 a.m. – 4 p.m.

Reducing Cancer Disparities & Promoting Health Equity Among Socioeconomically Disadvantaged Populations
Beth Israel Deaconess Medical Center
Riesman Lecture Hall, 330 Brookline Avenue

Registration is required:

All events are open to the public
For any additional information contact
Athene Wilson Glover at 617-632-4860

Another good reason to visit the dentist

“All you have to do is open your mouth.”

— The Head and Neck Cancer Alliance

The oral cancer examination is painless and quick … and life-saving. When cancers of the head and neck are found early, the cure rate is high. Annual screenings by a doctor or dentist should be a part of your regular physical or dental checkup. The provider:

• Inspects your face, neck, lips and mouth.

• Feels the area under your jaw and the sides of your neck, checking for unusual lumps.

• Asks you to stick out your tongue to check for swelling, color and texture.

• Using gauze, lifts your tongue and pulls it from one side, then the other.

• Checks the roof and floor of your mouth and the back of your throat.

• Feels and examines the insides of your lips and cheeks for red or white patches.

• Places one finger on the floor of your mouth and, with the other hand under your chin, presses down to check for unusual lumps or sensitivity.

Source: National Institute of Dental and Craniofacial Research

Oral, Head and Neck Cancer
Awareness Week is May 8 – 14.

Photo by Vannessa Carrington/Mass. Eye and Ear

Get screened for head and neck
cancer. It’s free, quick and painless.

Boston Medical Center
Moakley Building Lobby
830 Harrison Avenue
Date: April 2
Time: 8 a.m. - noon

Tufts Medical Center
860 Washington Street
Date: May 12
Time: 2:30 – 4:30 p.m.
Mass Eye and Ear
243 Charles Street
Date: May 13
Time: TBA
Dedham Family Dental
Dr. Helaine Smith
30 Milton Street, Dedham
Date: May 11
Time: 9 a.m. – 1 p.m.

Mass General Hospital
Voice Center

One Bowdoin Square,
11th Floor
Date: May 13
Time: 9 a.m. – 1 p.m.
Remember to call ahead to confirm
time and date
of screenings.

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Risk Factors

• Age — the incidence increases with age

• Gender — women are afflicted more than men after age 45

• Continued overuse of or trauma to joints

• Overweight and obesity

• Fractures and other joint injuries or infections

• Congenital defect or weakness in a joint

• Occupations that include tasks that place repetitive stress on a particular joint

• Other types of arthritis, such as gout and rheumatoid arthritis

• A genetic defect in joint cartilage

Questions & Answers

Paulette Denise Chandler, M.D.
Internal Medicine
Brigham and Women’s Hospital
1. Is osteoarthritis (OA) preventable?

Sometimes. Some risk factors, such as older age, female gender and family predisposition for OA are not controllable. However, a variety of factors including obesity, joint injury, repetitive use of joints and muscle weakness can be monitored, thereby decreasing the risk of OA.

2. Is there a cure?

No. However, people can maintain their independence by improving their strength, balance and coordination. The combination of exercise and weight loss provides greater improvement in mobility and frailty than either alone.

3. Is it possible to prevent the disease from progressing once a person is diagnosed?

Yes. Exercise, physical therapy and a healthy diet may slow the progression of OA. Obese people should aim for at least a 10 percent reduction in weight to reap the benefits of improvement in symptoms of OA. Also, slower progression of the disease may occur in persons with moderate intake of vitamin C-rich foods (e.g. brussel sprouts, tomatoes, kiwi) and high blood levels of vitamin D, but it is not known if supplementation with these vitamins has the same effects. Also, emotional outlook may have a greater influence on pain and mobility than joint abnormalities. Psychological stressors such as depression or anxiety may worsen joint pain.

4. Why is weight a risk factor for osteoarthritis?

Hormones and mechanical factors drive the impact of weight on the development of OA. Excess weight puts more stress on the joints and wears down the cartilage that lines the joints and contributes to malalignment of the joints. Excess body fat also releases hormones and other chemicals that promote chronic inflammation in the joints. Even modest weight loss lowers the risk of developing knee arthritis. For each pound lost pressure on knees decreases by about 4 pounds.

5. When is surgery recommended as a treatment?

Surgery is a necessary part of treatment if severe arthritis limits activities and does not respond to other arthritis treatments. It is important to have surgery before severe complications of arthritis such as muscle loss and joint deformities occur. Surgery can be done to remove the damaged joint cartilage or replace or fuse the damaged joint.

6. If joint movement is painful in osteoarthritis, why is exercise recommended?

Mild to moderate exercise reduces joint pain, boosts mood, improves movement and strengthens muscles. Exercise contributes to cartilage healing and reduces risk for injury. Less exercise can lead to an increase in joint stiffness and loss of joint motion. Start slowly and increase exercise gradually. Exercise increases the ability to perform daily activities such as light housework, shopping and gardening. Exercise should be done daily. Water exercises may be beneficial for patients with severe pain. Exercise with a friend or group class may improve chances of sticking with an exercise routine. Walking is a great exercise option because it requires minimal equipment.

7. Can a healthy lifestyle, such as exercise and healthy eating reduce the risk of osteoarthritis?

Yes. Good foods keep the joints lubricated and burn fat. A well balanced diet abundant in fruits and vegetables, whole grains, beans and nuts is satisfying with fewer calories than a diet with more processed foods. Limit overeating. Chronic overeating with excessive sugar and caloric intake contributes to joint inflammation and cartilage damage.

8. Does genetics play a role in the development of osteoarthritis?

Yes. Further work is needed to determine the nature of the genetic influence. It may involve a structural defect in cartilage or bone development or a risk factor for OA such as obesity. Family history of OA can come from your father as well as your mother. It is important for you to know your family history of OA and joint replacement for OA and share it with your health care provider.