I’m one of those odd people that enjoys distance running. I end up spending a lot of time in the company of other runners. And when we’re not running, we’re usually griping about our running injuries. As the cohort that I run with ages, the injuries are getting more prevalent. Besides the acute conditions, the chronic problems are starting to appear. Our osteoarthritis years are here.
As the available pharmacist, I get a lot of questions about joint pain. What’s reassuring, I tell them, is that they shouldn’t blame running. Osteoarthritis is common — the most frequent cause of joint pain. For some, it starts in our twenties, and by our seventies, osteoarthritis is virtually certain. Regardless of your level of exercise, the passage of time means the classic osteoarthritis symptoms — joint pain and morning stiffness, that worsens over time.
Osteoarthritis progresses gradually. Blame biomechanics and biochemistry. It starts with a breakdown of the cartilage matrix. Stage 2 progresses to erosion of the cartilage and a release of collagen fragments. Stage 3 is a chronic inflammatory response. The goals of treatment are to reduce inflammation and pain, and stop progressive disease. There’s no drug therapy that’s been show to actually improve joint function. Reduce pain, or slow inflammation, yes. Analgesics, like Tylenol, and anti-inflammatories are mainstays. But repair damage? Sorry: you lose it, it’s gone. Chondrocytes don’t seem to be able to repair the overall matrix — which is made mainly of collagen. (more…)