DEAR DR. ROACH: I’m a 67-year-old black female who’s been diagnosed with “a little arthritis” in my right hip. Now retired from a desk job, I unfortunately still am not getting enough exercise. My issue is that after sitting for a length of time, I’m in excruciating pain and can’t stand up at all. Once I straighten up and get moving, the pain subsides. I’ve been told “you’re getting old,” but I’m not old! I’m about 30 pounds overweight. Also, when I stand for any length of time, my lower back aches. Would taking a morning walk and a yoga class alleviate this problem? I’m so embarrassed when I get out of my car or get up from the dinner table. — S.H.
ANSWER: There are many types of arthritis, and the answer to your question varies a bit depending on type. I think you probably have the most common form, osteoarthritis, so I’m going to answer you assuming that’s the case.
Stiffness in the morning, quickly relieved by exercise, is a hallmark of osteoarthritis. It’s common, treatable and not something to be embarrassed about. Exercise is an effective treatment for osteoarthritis. It can be difficult to get started, but the more people exercise, the more they are able to do. Walking and yoga both are excellent ideas, but the best exercise is the one you will want to keep doing.
Osteoarthritis affects a fair number of 67-year-olds, but it’s important to remember that it’s not your age that is causing the pain: It’s the arthritis. Although we know of no treatments that can reverse the course of osteoarthritis, medications (including a few supplements), exercise and physical therapy all can ease symptoms and improve function. Losing weight takes stress off the joints and is recommended, but is not easy.
Finally, severe arthritis can be treated surgically, with a joint replacement. That’s not a procedure to take lightly or have done too early.
DEAR DR. ROACH: I’m 85 years old. I have numbness in my hands — sometimes the right, sometimes the left; sometimes both hands or not at all. It lasts only a while. My doctor feels that it’s a pinched nerve in my neck. Can you give me any advice? — J.B.
ANSWER: A pinched nerve in the neck becomes more prevalent as people age. The nerve can be compressed by bony structures in people with osteoarthritis in the neck (this is spinal stenosis), or by disk material in someone with a herniated disk. Having symptoms on both sides is less common than having symptoms consistently on one side only. A careful physical exam can give clues that this is the case, but an MRI or other imaging study is the best way to be sure of the diagnosis.
Hand numbness also may be caused by the nerve being “pinched” in other locations: in the carpal tunnel in the wrist or in the cubital tunnel in the elbow. An EMG test can help sort out where this is coming from. It’s certainly possible to have carpal tunnel syndrome on both sides.
My best advice is not to rush into surgery at any age, but especially not at age 85. Physical therapy can prevent many people from needing surgery. However, if numbness progresses to weakness, it’s time to reconsider.