Treatment addresses pain, joint function

Treatment of arthritis is limited by clinicians’ ability to diagnose it in early stages “Our ability to prevent and treat OA is limited by the difficulty of detecting this debilitating condition early in its course; it’s typically not known somebody has it until well into its clinical course,” Cameron said. 

Treatment options for OA in the military are focused on the cause, pain control and return of joint function, according to Roebuck.

“Exercise to lose weight and strengthen muscles which support joints is paramount,” he said. Pain control to allow for increased exercise and mobility is also key, he added. Treatment could be with traditional medications or nontraditional approaches, such as glucosamine and herbal supplements or even acupuncture or massage.

“If there is joint swelling or spinal-cord encroachment, steroid shots in joints or the

epidural space may be used,” Roebuck added. When exercise and medications fail to provide pain control and increased physical function, he says, then surgery is considered.

OA presents readiness challenge

Despite the numerous therapies available, says Cameron, when an active-duty servicemember develops OA, it can present a significant challenge. “A lot of times, they simply can’t be required do physical jobs,” he said. “If they can’t perform physically, it’s up to their doctor and the chain of command as to whether it should prevent them from deploying.”

As for improving prevention and treatment, says Cameron, new research may hold the answers. For example, studies of the post-traumatic injury population, which are increasing, are important because it is known that if someone is injured they are much more likely to develop OA in 10 to 15 years.

While a good deal of arthritis research has been conducted on older populations, Cameron continues, very little has been done on individuals who are much younger, so not that much is known about important contributing factors.

“For example, how do people’s mechanics and alignment lead to arthritis?” Cameron poses. “We’ve not yet gotten to follow groups over time to see who developed OA at an early age, so that limits our ability to look at some factors like lower extremity biomechanics – how people aligned and how they moved.”

Research, he added, has shown that people with physically demanding work and a lot knee-bending, like servicemembers, are at higher risk for developing OA, but the “why” remains an unknown.

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