Caitlin Whyte (Host): Arthritis, can it be avoided? That is the topic of our discussion today. And for this episode, we are joined by Dr. Anthony Villare, an Orthopedic Surgeon at Upland Hills Health in Dodgeville. This is the Inspire Health Podcast from Upland Hills Health. I'm Caitlin Whyte.

Doctor, today we are talking all about arthritis. So a few questions to start us off and just to get some general descriptions and info down. What is arthritis? What causes it, and what are the different kinds of arthritis out there?

Anthony Villare, DO: Well, the simple one sentence answer for what is arthritis, the answer would be it is a wearing away of the joint. Now there are lots of different types of joints in the body, so joints can wear away in different ways depending on which joint you're talking about. What causes arthritis is simply just life. We move the joint. Our body is a machine, and machines, regardless of who made them or whatever the machine will start to wear out over time. The joint in general is comprised of two bone ends that come together and there's cartilage on the end of the bone. That's the gristle on the end of a chicken bone.

That cartilage is that slippery surface that allows the joint to move. Now that joint's all held together, right? It has to be held together with something, ligaments, and then what moves the joint, tendons and muscles. So that's how it all functions. As we go through life, we're going to rub those two bones together, eventually rubbing that together a million times over a lifetime, you're going to start to wear away some of that cartilage.

Now there's also things that we do. We can play sports in high school or college, well, that's going to impart way more pressure and pounding on the joints. And we might even injure our joints. We might break our bones or something, we might sprain our ankles or our knee.

All those things all those, little injuries might cause spurring on or the beginning of some arthritis sooner than we would expect it just from normal wear and tear. How the body wears out with that, is it's simple, but it's complex. I always describe it to my patients as you're wearing the tread off the tire. We all know that. We all know if we have tires, we drive it, the car long enough, the, the tread's going to go bad. It's going to be a bald tire and we got to replace it. It's kind of the same way with our joints. Whether we ride it off road or ride it on the highway, if whether we peel wheels at the green light or we just go drive, like Ms. Daisy. Those things will depend on how quickly our joints wear out. And there's also genetic component to that. Some of us are just, we just have better genes and harder cartilage and better bone than others. And it's just the simple fact of that there are different types of arthritis.

 Rheumatoid arthritis for .One, is where, so you can have, it's built into your DNA where the joint might wear out sooner than expected, despite whatever activity, whatever injury, you might succumb to, your joint, might wear out sooner because of those genetic factors.

Host: Okay. Gotcha. So how easy is arthritis then to diagnose? Or what are the symptoms that might be some red flags that people can look out for?

Anthony Villare, DO: Off the top of my head I'm thinking of like a knee. Usually it's going to be some kind of pain, not associated with any injury though. It's just going to be like, oh, it just started to give me some aching and pain here or here, in different parts of it, or swelling, or as we get older, stiffness becomes more of an issue.

 That's a, a small beginning sign of some arthritis in the joint. So we always want to try to keep it limbered up. Our joints limbered up, so they don't get stiff. An arthritic joint is basically any joint that feels anything other than normal. But you also have to put it in context. Did I just walk 15 miles? There's some things that are obviously going to make our joints ache and it's not going to be arthritis. We as orthopedists, we live by x-rays. You come and see us, we find out what's going on with you by looking at an x-ray and sometimes it's obvious. You can see it on the x-ray. This is arthritis. We know what a normal x-ray looks like, and we know what an arthritic one looks like.

Host: So what are some different treatment types for the different types of arthritis? Is there anything that people can start to do at home to manage symptoms? And then where would you go from there?

Anthony Villare, DO: Yes, so you can definitely do things at home, as a first line of treatment. First you can just avoid what makes it hurt. I mean, if you can identify and say, boy, whenever I do this, it hurts. You can either limit that activity or avoid it altogether, and that can kind of help. You can always reach for the bottle of Advil or Aleve. Those are anti-inflammatories. They're not painkillers, they're not addictive. So they take down the inflammation caused by arthritis. So they're always helpful, as an initial step even before you see any doctor.  As we get older, our knees are going to get stiff and weak.

So an over-the-counter brace, again, I'm talking about the knee, but you know, you can't put a brace on a hip or something, if you have arthritis of your wrist, you could wear a brace, and elbow. So those are little simple things. Just give that joint a hug of support can kind of help minimize any swelling, any pain you could have.

Other things are, it kind of goes along with the stretches. As we get older, I always think like, once you get into your fifties, you should always just take five minutes and just stretch every day. Nothing complicated, just stretch your joints out. But strengthening is also important. Arthritis wants our joints to be stiff and weak, so we want to keep them limbered up and toned. We're not talking Olympic level exercising. Just some conditioning exercises just to maintain strength. We lose muscle mass and muscle tone as we get older. So you want to fight that, try to keep that muscle tone going around that joint.

Otherwise, yeah, a weak joint is a sloppy joint, which is going to be a symptomatic joint. There's medicines out there. Topical anti-inflammatory, diclofenac or Voltaren gel. Those are topical anti-inflammatories. You rub them around your knee, like a lotion, and it absorbs into the knee and it can help minimize the pain.

So I think awareness is probably the biggest thing, knowing what it is. What's causing my joint to hurt, is the best thing a patient can be aware of. Knowledge is power. If you know what's going on, you know how to avoid it, you understand why it's doing what it's doing, why the joint is swelling, and why it's painful. Once you understand that, that's kind of like half the battle.

Host: Well, that leads me perfectly into my last few questions here, Doctor. Being aware and realizing that you're dealing with something, something's wrong, something hurts, something is going on. So when should you go then see a doctor if you're experiencing these symptoms?

Anthony Villare, DO: Try the simple things first. Advil, brace, the minimizing your activities. But when you find that even that's not working, you've given up the whatever, whether it's a task or whether it's something you enjoy doing, if you've been giving that up and you find, geez, this thing just isn't going away, it's just becoming more of a problem, then you should probably, I'd say start with your family doctor.

Go see your family doctor, get an x-ray. Have them assess you, make sure that's what it is, and it's not something else, and they can either recommend, maybe physical therapy or something to fine tune some exercise program for you, or maybe even just do a little course correction.

Maybe you're doing something you don't even know you're doing it. You might be aggravating that joint. So, just discussing that with your family doctor might be helpful. If they can't do it, that's why God made us, it's like we're sort of the experts in the joint thing.

So, if they can't handle it, they'll just say, you know what, I think you should go see the orthopedist maybe he has some better ideas for you, then we can kind of talk to you about our options. And they're not always surgical. Some aren't. But anything's an option.

It's always, we don't know whether it's going to work. We're not guaranteeing anything, but these are just options that we can just try. But I don't think patients in general want to go see doctors for every little thing. So I think they're going to try to take care of it on their own, assess it on their own, and when it doesn't work, that's when we can help.

Host: Wonderful. And Doctor, it sounds like this awareness is so key to just kind of discovering and treating arthritis, but would you say there is an advantage to catching it early, going to see your doctor or starting to use that brace as soon as you feel these symptoms? Is that really something that could kind of change the course of treatment?

Anthony Villare, DO: Well, sometimes, but I can't say all the time it will. Partly because we're creatures of habit. Once we get into doing something, we'll want to keep doing it. And as physicians, we want, we want to help patients have a full and active life. And in the profession I'm in, it's very mechanical driven. If the joint isn't working, if, if that part of the body isn't functioning right, it's our job to kind of help make it function right, to get you back and staying as active as you want to be. The problem is when you've tried all that and you've given up everything for the sake of this arthritic joint or this pain or whatever you're having, and it isn't working. Remember, I'm all fine with being aware and not being careless and haphazard with your body, whether physically but life is meant to be lived and enjoyed. And you don't want to be sitting in the chair while your family is out having a fun time because, well, that's how you're going to minimize arthritis.

 People always talk to me about how they had an injury, or have arthritis now, but it, you could tell it was from an injury when they played high school basketball or field hockey or something like that. They'll say something like, oh, wow, so I shouldn't have done that. And I'm like, no, you can't like, just not do anything in high school and your twenties to prevent arthritis in your fifties. That doesn't make any sense. That's not life. You're smart, you do a calculated risk of activity in sports and other things, but you know, no, you want to enjoy life. Be physically active. We always promote physical activity. It's good for the body, it's good for the heart, the lungs, everything, you know, so you want to do it, but you want to be smart about it. And then as life changes, you kind of change how you do it. You don't have to give it up. Like, I always say, like, I don't know, I don't know if it's a good idea for people over 50 to be running, cause now you're pounding the joints, so maybe you should just be cycling. Or Nordic Trac, something where you're, something where you're gliding and, and imparting less impact on your joints. You still get a workout, but you're just doing it differently.

Host: Thank you so much Doctor for being such a great guest. We really appreciate your time. Find out more about Dr. Villare and all of our arthritis resources on our website at uplandhillshealth.org. This has been the Inspire Health Podcast from Upland Hills Health. I'm Caitlin Whyte. Be well.