There’s no doubt about it, an osteoarthritis appointment can sometimes feel a bit like an exam. In addition to a complete physical examination, x-rays, MRIs and laboratory tests, your doctor will ask you many questions. Each one you have to answer accurately so that you can be correctly diagnosed and appropriately treated.
It is best to prepare in advance for your appointment, so that you don’t forget to mention something important. To help you do this, here are some of the questions you’ll likely be asked.
1.Where is the pain?
This essential question gives the doctor an idea about the location and severity of your osteoarthritis. In the knee, most commonly there is medial joint pain (pain on the inside) as that’s the first place to wear out due usually due to previous injury such as loss of the meniscus or an ACL injury and subsequent increased loading of stress on that compartment.
2. What does the pain feel like?
Osteoarthritis pain is not the same for every patient. For some it may be dull and achy and for others the pain may feel sharp and intense. Sometimes the pain may be accompanied by a sensation of warmth and the area may even feel warm to touch. Some patients feel the pain to be coming from deep within the joint, perhaps radiating to other areas of the body. Some patients note that they can feel their bones grating or catching.
3. How long have you had the pain?
Osteoarthritis pain often develops slowly, over a number of years. Your doctor can judge the duration of your aliment and assess the severity of cartilage loss and treat accordingly. Information on the duration and the type of the pain provides insight to the type of arthritis. Sudden acute flares of pain associated with joint swelling can signal an infectious or inflammatory agent may be the cause, and the cause may be curable if treated promptly.
4. What makes the pain worse and what makes it better?
Discussing aggravating and relieving factors can help in the diagnosis of arthritis. Your doctor will ask you whether the pain intensifies during and after a period of increased activity or after repeated use of the joint. Does rainy weather affect the pain? Does the pain get better after you rest? Inflammatory arthritis has pain at rest also.
5. Are any of your other joints sore?
If you experience stiffness in the morning that lasts 30 minutes or more, have pain in small joints of hands, pain in more than 3 major joints and other such symptoms then it is more likely you have inflammatory arthritis rather than osteoarthritis.
6. Has the joint ever been injured?
It’s possible that you have what’s called post-traumatic arthritis, the result of an old injury. An injured joint is more likely to develop OA for many reasons. In the knee even a small loss of meniscus tissue can lead to big changes in force concentration on the tibia (shin bone) and eventually arthritis. A torn anterior cruciate ligament (ACL) can also lead to OA. An old injury to the knee joint where the kneecap was dislocated often leads to anterior knee pain and arthritis. Depending on the stage of OA, it may be possible to repair or replace the damaged meniscus or ACL and reverse the symptoms. Associated injuries should also be treated, for example surgeons tend to forget to check the posterolateral corner injury with an ACL ligament injury, which is one of the primary reasons for the failure of ACL reconstructions. Improved treatment techniques mean that the development and progression of arthritis may not be a fait accompli. Make sure you ask your doctor about these treatments.
7. Are you taking any medication?
Your doctor will want to know what medication you take and how much you need for it to relieve your symptoms. Do you use any cartilage protection drugs? How do they work for you? Note down all medication you take (for whatever reason) before the appointment. The use of steroids and any drugs leading to poor bone quality may indicate external causes of arthritic pain that could be treated by modifications in your drug regimens or by the introduction of new lubricating injections, growth factors or stem cells.
8. Do you remember an illness, tick bite or travel to an unusual location before the onset of your symptoms?
Each of these questions helps define whether or not infection might be a cause of your arthritis. These types of arthritis sometimes can be cured with antibiotics.
9. What activities are you no longer able to do that you wish to do?
This is an important discussion to have, as defining which activities you desire to get back to helps set goals for your treatment. Sedentary lifestyles may require less intervention than trying to return to marathon running. Whether you’re an athlete hoping to return to sport or wish to be active again with the grandkids, your doctor will come up with an appropriate treatment to help you reach your goals.
Here are questions to ask your doctor:
1. What is the stage of my OA?
Not all cartilage loss should be labeled as OA as the treatment will vary for isolated post traumatic OA, unicompartmental OA and complete bone on bone tricompartmental OA.
2. What is new in treatment of OA?
Orthopedic science is evolving. The old advice to use pain medications for OA, rest the joint and wait until you are over 60 for an artificial joint have been replaced by treating the cause of the arthritis, replace the missing cartilage, meniscus and ligaments, become active in rehabilitation exercises. If artificial joint replacement is needed, it’s best to only replace the worn out portion of the joint (called unicompartment replacement or partial knee replacement) leaving full joint replacement for severe tricompartmental disease.
3.How can I beat OA?
Become fit and optimize your weight. If you get an injury to the cartilage or ligaments have it repaired or replaced early. Exercise every day, drink at least eight glasses of plain water daily and eat natural foods.