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Arthritis- by Vic Goradia, M.D.

The bone ends of a joint are covered with a smooth material called cartilage. The cartilage cushions the bone and allows the joint to move easily without pain. A fibrous envelope called the synovium, which produces a fluid that helps to reduce friction and wear in a joint, encloses the joint. Ligaments connect the bones and keep the joint stable. Muscles and tendons power the joint and enable it to move.

Liquid Glucosamine with
Chondroitin is more
effective than the pills.

Three basic types of arthritis may affect the knee or shoulder joints:

Osteoarthritis (OA) is the most common form of arthritis. OA is usually a slowly progressive degenerative disease in which the joint cartilage gradually wears away. It most often affects middle-aged and older people.

Rheumatoid arthritis (RA) is an inflammatory type of arthritis that can destroy the joint cartilage. RA can occur at any age, and generally affects multiple joints.

Post-traumatic arthritis can develop after an injury. This type of arthritis is similar to osteoarthritis and may arise years after a fracture or ligament injury.

Symptoms and Diagnosis

Generally, the pain associated with arthritis develops gradually. The joint may become stiff and swollen, making it difficult to move the knee or shoulder. With most forms of arthritis, pain may increase after activities such as walking, stair climbing or kneeling. The pain may often cause a feeling of weakness resulting in a "locking" or "giving-way." Many people report that changes in the weather also affect the degree of pain from arthritis.

X-rays typically show a loss of joint space in the affected joint. Blood tests and special imaging tests may be needed to diagnose RA. RA is typically diagnosed and treated by your primary care physician or a rheumatologist.

Knee Treatment Options

Sportsmedinfo.net recommends Bauerfeind GenuTrain knee
brace for arthitis and osteoarthritis. Pricey but it lasts and it's worth
it. Anatomically correct design that works with your body.

GenuTrain Knee Brace for symptoms of arthritis

Circumference in inches -ORDER YOUR SIZE!
Size	Measure circumference of knee 4 3/4" below knee		Measure circumference of knee 5 1/2" above knee
0	9 3/4" - 11" below knee		13 3/4" - 15 above knee
1	11" - 12 1/4" below knee		13" - 16 1/4" above knee
2	12 1/4"- 13 3/8" below knee		16 1/8" - 17 1/4" above knee
3	13 1/4" - 14 1/2" below knee		17 1/4" - 18 1/2" above knee
4	14 1/2" - 15 3/4" below knee		18 1/2" - 19 3/4" above knee
5	15 3/4" - 17" below knee		19 3/4" - 20 3/4" above knee
6	17" - 18 1/4" below knee		20 3/4" - 22" above knee

In its early stages, arthritis of the knee is treated with conservative, non surgical measures. Helpful lifestyle modifications include losing excess weight, choose to swim or cycle instead of running or jumping exercises, and minimize activities that aggravate the condition, such as climbing stairs.

Exercises can help increase leg muscle strength, range of motion and flexibility. Supportive devices such as a cane, energy-absorbing shoes or inserts, or wearing a brace or knee sleeve can also be helpful.

Other measures may include applications of heat or ice, water exercises, liniments or elastic bandages.

Several types of drugs can be used to treat arthritis of the knee. Because patients' responses to medications vary greatly, your doctor will develop a program for your specific condition.

• Anti-inflammatory medications can include aspirin or ibuprofen to help reduce swelling in the joint.


• Glucosamine and chondroitin (kon-dro’-i-tin) sulfate are oral supplements commonly taken to relieve the pain of osteoarthritis. Although their effectiveness has not been proven scientifically, many patients report excellent pain relief.


• Corticosteroids are powerful anti-inflammatory agents that can be injected into the joint.


• Hyaluronate (hi-a-lou’-ron-ate) therapy consists of a series of injections designed to change the character of the joint fluid.

If your arthritis does not respond to these types of treatments, surgery may be another option.

Injections that can provide relief for certain types of arthritis in knees
and shoulders and prevention. Click the red link for more information.

• Cortisone Injections- Local treatment of inflammation in
  small area such as a joint (arthritis), bursa (bursitis), tendon
  (tendinitis), and myofascial pain.
• Hyalgan Injection - Works for knee pain caused by
  osteoarthritis
  which is not relieved by anti-inflammatory or pain
  medications. Benefits about 75% of arthritis sufferers
• Book on how to Avoid Knee Surgery - Written by a
  physician. How to Prevent Knee Surgery.

• Arthroscopic surgery uses fiber optic technology to enable the surgeon to see inside the joint and clean it of debris or repair torn cartilage.


• An osteotomy cuts the leg bone (tibia) or the thighbone (femur) to improve the alignment of the knee joint.

• A total or partial knee arthroplasty replaces the severely damaged knee joint cartilage with metal and plastic.

• Cartilage grafting is possible for some knees with limited or contained cartilage loss from trauma or arthritis.

Shoulder Treatment Options

As with other arthritic conditions, initial treatment of arthritis of the shoulder is conservative. For example, change activities to avoid provoking pain. This may mean you need to modify the way you move your arm to complete daily tasks. Take nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen to reduce inflammation. Ice the shoulder for 20 to 30 minutes two or three times a day to reduce inflammation and ease pain. If you have rheumatoid arthritis, your rheumatologist may prescribe a disease-modifying drug such as methotrexate or recommend a series of corticosteroid injections. Dietary supplements such as glucosamine and chondroitin sulfate may be helpful (see above).

Exercise options to build
strength and minimize joint
pain for shoulders.

If conservative treatment does not reduce pain, there are surgical options. As with all surgeries, there are some risks and possible complications. Your orthopaedic surgeon will do all that is possible to minimize these risks.

Arthritis of the glenohumeral joint can be treated by replacing the entire shoulder joint with a prosthesis, called a total shoulder arthroplasty, or by replacing the head of the upper arm bone in a procedure called a hemiarthroplasty. The most common surgical procedure used to treat arthritis of the acromioclavicular joint is a resection arthroplasty. In this procedure, a small piece of bone from the end of the collarbone is removed arthroscopically, leaving a space that later fills with scar tissue. Surgical treatment of arthritis of the shoulder is generally very effective in reducing pain and restoring motion.

Future Options

Physicians continue to search for new ways to treat arthritis of the knee and shoulder. Current research focuses on new drugs as well as on cartilage transplants and other ways to help slow the progress of arthritis.