True or false? Storms make your joints hurt

Episode Transcript

Dr. Drew Glogoza:

A lot of people come in and say, I think the weather just changed last week. My knees are starting to hurt again. So I will say this is a very common thing that patients will come in and complain of.

It has been researched. It’s a little bit difficult to control. The weather doesn’t always cooperate the way that we’d like. It does seem to be true. It does seem to be that barometric pressure and humidity and then temperature do seem to affect arthritic symptoms.

Matt Holsen (announcer):

This is the “Health and Wellness” podcast brought to you by Sanford Health. The conversation today is about arthritis and joint pain. Our guest is Dr. Drew Glogoza with Sanford Orthopedics and Sports Medicine in Fargo, North Dakota. Our host is Alan Helgeson with Sanford Health News.

Alan Helgeson (host):

We’re talking about myths of arthritis and joint pain. And our doctor today is an orthopedic physician. Doctor, can you introduce yourself and a little bit about what you do and what location you work with at Sanford?

Dr. Drew Glogoza (guest):

My name is Drew Glogoza. I’m a sports medicine physician working in the Fargo location, taking care of lots of different joint pains. So hopefully I can help provide some insight on this conversation today.

Alan Helgeson:

I’ve been told on multiple occasions, “Yeah, you’ve got that.” Very informative for me, too. So first of all, can you explain arthritis?

Dr. Drew Glogoza:

So simply, I would tell you that arthritis is inflammation of the joint. This can be an acute inflammation or it can be chronic, and there’s a couple different kinds of arthritis that we have.

I think most commonly, and what we’re really going to talk about today is that degenerative arthritis – we’d call it osteoarthritis would be the actual name for it – but this is your wear-and-tear arthritis. Some of the other arthritis that people have is more inflammatory. If you think like a gout or rheumatoid arthritis, a little bit different process behind it and not so much wear and tear like the usual stuff that we’re going to talk about today.

Alan Helgeson:

How should I look for these or be able to tell these differences in my body? Can you explain a little bit of that?

Dr. Drew Glogoza:

Yeah, sometimes it’s a little bit tricky because the symptoms do really overlap for some of it. The most common complaint that people are going to come in if they have an arthritis, is going to be joint pain. That’s going to be the main problem that they’re going to come in and complain with.

But people also have stiffness, swelling, loss of range of motion. Sometimes people will have starting to form a deformity to their joint. Those are going to be the kind of the main things that people will notice when they come in.

Alan Helgeson:

Just because I want to get it clear because you know, sometimes I need to hear things a few times in arthritis. Is it different than joint pain and can you have one without the other?

Dr. Drew Glogoza:

That is a good question. So you can have, they’re both independent of each other. I would tell you that joint pain, we would call that arthralgia. So you have arthritis and arthralgia. They can be together and they can be separate arthralgia or joint pain. I would probably think about in an athlete or someone who’s active and is just having some overuse, that doesn’t necessarily mean that they’re going to have arthritis in their joint causing their pain. They might just have some pain from activity.

Now on the opposite side, you can have arthritis and not have pain in your joint. I would say most commonly we see this in clinic when we get X-rays of both knees or something like that. Or we can see two joints in one X-ray and one joint will be very arthritic and the other will not have very much arthritis in it. And there’s times where the very arthritic joint is not the one that is bothering someone.

Alan Helgeson:

That’s why you’re an expert and you know all this stuff, right? We can’t just diagnose this stuff on our own, Doctor.

Dr. Drew Glogoza:

We try hard with Google, but it doesn’t always work.

Alan Helgeson:

Let’s talk a little bit about the statistics around arthritis. OK, so maybe, maybe not, but is someone more likely to get it – are men more likely to get arthritis over women, or we’re not?

Dr. Drew Glogoza:

When we’re talking about osteoarthritis, which is that wear and tear degenerative arthritis, which is the most common arthritis, women are more likely to get it. Typically, it’s probably a breakdown of, you know, you might look at it like 47-ish% of women versus like 40% of men. So there is some discrepancy there between the two. You know, if you’re looking at population here in the United States, there’s probably a third of people in the United States that have arthritis.

Alan Helgeson:

Is some of that with women maybe being slightly higher? Does any of that have to do with osteoporosis?

Dr. Drew Glogoza:

I think it’s a good question and I don’t know that we know the exact reason for the differences between the two sexes. Different hormones of course could be playing a role in that. I’m not sure if osteoporosis that piece necessarily has a part to it, but there certainly is something because there is a difference between the two.

Alan Helgeson:

How about a time in our life and an age when it might come around for us? Is that going to be more of an indicator that we can look to?

Dr. Drew Glogoza:

Typically we start to see arthritis really start showing its angry face, around the 50s (laugh) is probably when it really will start showing up and start giving people trouble. Probably once you get to 70s or 80s, if you’ve made it that far, we’re not really seeing a whole lot of new arthritis showing up. So you might be in the clear if you’ve made it that far and haven’t had too much trouble.

Alan Helgeson:

Now when we talk specific places in the body, I’m guessing everybody can say, oh, I’ve got it right here and I’m raising my hand here. I’ve got it. I call it my thumb fat. I’m showing you here, Doctor, right here below my thumb. But where are like the more common places we’re likely to get it in the body?

Dr. Drew Glogoza:

So most commonly the knee is actually the main joint that people get arthritis in is the knee. After that it kind of breaks down. Now hand like you were showing is actually one of the next most common. Hip is shortly there quickly coming along thereafter. So, but the base of the thumb is a very common place for people to have arthritis.

Alan Helgeson:

Well, it’s nice to know I’m semi-normal I guess. Thank you. I appreciate it. That’s right.

All right, well let’s talk about some of those signs and symptoms. So if people aren’t maybe getting it yet or maybe they’ve had some pain, maybe we can talk about what some of those signs and symptoms are.

Dr. Drew Glogoza:

Pain is really going to be that main thing that people will come in and complain about. Probably the first thing that anybody would tell you they noticed about their joint when they, either they found out they had arthritis or they were concerned that they were having arthritis.

And then after that it just depends. Probably the more arthritis that’s in the joint, if it’s progressed, you’re going to start losing some of your motion in that joint, whether it’s your thumb or your knee or your hip. That’s probably another thing that’s going to be very common.

Swelling sometimes happens and doesn’t always happen but you know, people will come in and complain of that.

And then certainly you might start to notice that you might have a little bit of a deformity, and when I say that you might notice that if it’s your thumb, that’s your problem, you might have a big bump that you’re starting to get that you just didn’t have there before. Or you might start to be a little bit more knock kneed or bow-legged than you were before, if the arthritis is kind of changing the function of your – the structure of your knee.

Alan Helgeson:

Dr. Glogoza, let’s talk about risk factors to be aware of when it comes to arthritis. What are some of those risk factors of developing arthritis versus joint pain?

Dr. Drew Glogoza:

I think probably our strongest risk factor is age. Now I would tell you that it’s not necessarily perfect. Not every 70-year-old who comes into clinic has the exact same amount of arthritis, so it’s not a perfect correlation. But the older you are, the higher the risk that you are going to have arthritis.

We’ve already kind of touched on the sex differences there with females being more common and again we don’t really have a great explanation for that.

There does appear to be part of a genetic component. You can thank your parents for some arthritis. We don’t know specific genes or different things like that that maybe suggest for this wear and tear kind of arthritis, but it does seem to maybe run in the family a little bit.

A couple things that we may be able to control a little bit. Joint injuries are going to set you up to have arthritis. If you tear your ACL, that’s a very common cause of knee arthritis. So if you have a different break or you break a bone or have a fracture that goes through a joint, that can set you up to get some arthritis. So trying to avoid injuries is going to be a good thing.

Sometimes our bones just don’t always grow the way that they were designed to do, and there’s not really a lot that you can control with that. But it might set you up for an injury or a different wear pattern on the cartilage in the joint that will set you up for some arthritis as well.

And then lastly, and this is probably one of the biggest things that people deal with, is obesity. The more weight that you have, the more weight is going on these joints and makes them have to work harder and hold up against more weight. So it certainly can increase your chances of having arthritis. I think we also think that if you weigh more, there’s a chance that the arthritis might become more severe faster than what we typically would see than somebody who’s not obese.

Alan Helgeson:

Dr. Glogoza, let’s switch now. Let’s talk about arthritis and joint pain because in athletes and sports, which I know you see a good number of athletes and treat them, do people who perform at a high level of activity find themselves at maybe a greater risk for arthritis earlier or later in life?

Dr. Drew Glogoza:

It’s a really interesting question and I don’t know that we necessarily have the perfect answer for it. There is some research that’s maybe not the best research that does suggest that if you’re an elite athlete that you might have some increased risk.

Now I think you can simply think about it, if you’re an elite athlete, you’re probably playing a sport a lot, a lot of years playing a sport. A lot of time in those years playing sports you might also be at higher risk for having injuries than somebody who maybe isn’t playing something as much. So I think that there’s just a lot of things that go into that that make it a little bit difficult to fully understand. And that’s true even just for sports participation just in general. But for sure with when you get to that elite level, we do think that there might be some increased chance.

Alan Helgeson:

That’s talking about arthritis. Let’s switch and let’s fill in the blank with joint pain. Can we say something about joint pain in that same question?

Dr. Drew Glogoza:

Absolutely. I think that that’s, that’s probably going to set you up for it just because you’re going to be active. There’s definitely going to be some pain that can happen with different things and I think sometimes that’s frustrating for different levels of athletes.

Sometimes people will go years with never having an issue and then are very worried about it if they start to have a joint pain, and it is pretty common. Like I mentioned earlier, it doesn’t mean that you necessarily have arthritis. You could just have joint pain.

We do know that there is good evidence that says that recreational runners or walkers are not necessarily at increased risk for having arthritis. So this doesn’t suggest that we want you to be inactive. We know that inactivity increases your chance of arthritis probably from a piece of that overweight-obesity kind of thing that happens when we aren’t active. So we want you to be active. I’d expect that every now and then you’re going to have some joint pain but not necessarily arthritis.

Alan Helgeson:

Well let’s move on now to some things that we may have heard from our parents or grandparents or like we referenced earlier, Dr. Google or TikTok or even circulating elsewhere. Help us set the record straight on whether there might be truth to some of these things about arthritis and or joint pain. First one: weather changes can make arthritis symptoms worse.

Dr. Drew Glogoza:

That’s right. These are the questions everybody’s really been waiting for anyway, (laugh) so.

I will say I hear this a lot in clinic. A lot of people come in and say, I think the weather just changed last week. My knees are starting to hurt again. So I will say this is a very common thing that patients will come in and complain of.

It has been researched. It’s a little bit difficult to control. The weather doesn’t always cooperate the way that we’d like. It does seem to be true. It does seem to be that barometric pressure and humidity and then temperature do seem to affect arthritic symptoms.

They have done some things where they have put people into some controlled environments and they do seem to notice changes when those things that are controlled for are changed and it causes changes to their symptoms.

Alan Helgeson:

How about cracking your knuckles? Because I’ve got a string of Norwegian uncles that have cracked their knuckles. They could be in the hall of fame for this. Cracking your knuckles will give you arthritis.

Dr. Drew Glogoza:

Another good question and really a common thing that I think people wonder. I don’t think that we really have any evidence to suggest that it’s causing any joint damage by cracking the knuckle like that. So I would tell you that I think that that’s more myth than anything.

Alan Helgeson:

Eating foods like tomatoes or nightshades worsens arthritis.

Dr. Drew Glogoza:

I’m not sure if I would say specific foods like that necessarily will change or impact arthritis. We’ve talked a little bit about obesity and maybe lifestyle things. I think that if you are not eating healthy it’s probably going to set you up to have some arthritis specific foods. I’m not sure if we know exactly.

Alan Helgeson:

Resting joints is best for arthritis.

Dr. Drew Glogoza:

I think I would disagree with this a little bit. I might change the verbiage of how I would say that. I would say modifying activity is probably best for arthritis. If you are active and you’re having joint pain and we figure out that it’s from arthritis, I don’t want you to stop moving that joint. We want to keep moving it, but we might need to find a different way to do that.

If you’re a big runner, and running is killing your knees, we might have to think about bicycle cycling, that kind of stuff. Maybe we get you in the pool a little bit to get you active, but we want you to be active and keep your joint moving, not necessarily just shutting it down and resting.

Alan Helgeson:

Now this next one sounds exactly like something grandpa would say: you can’t stop arthritis.

Dr. Drew Glogoza:

This one’s pretty true. We don’t really have any disease modifying treatments to slow the progression of arthritis and I think that that’s one thing that can be very frustrating.

The one thing that I will say is that we don’t necessarily have a good rhyme or reason for how fast it progresses either. Sometimes people will progress in a year and advance pretty quickly through the different stages of arthritis. Other people will go 10 years and there’ll be no change to it.

Alan Helgeson:

Now this next one, Dr. Glogoza, I have to admit I hadn’t heard this one but wearing damp clothes causes arthritis.

Dr. Drew Glogoza:

I had not heard this one either. It does not seem like there’s really any evidence for that either to suggest that this is true. I’m not sure what the reasoning or the thought process behind it is. The damp clothes is kind of just superficial and on the skin and doesn’t really have a ton of effect on the joint.

Alan Helgeson:

Now how about this one? Arthritis only develops in older people.

Dr. Drew Glogoza:

I would say partly true. I think that we talked about the ages a little bit, so certainly we, we know that as you get older you’re going to have a higher risk for it.

We do see arthritis in in younger people and typically these are people who had an injury maybe in their teenage years or their twenties where they were playing a different sport or something like that. We would probably call this like a post-traumatic arthritis. But we do see it in younger people.

There are some other secondary causes that are side effects of medications, other things that can cause breakdown of the joint that can give you arthritis sooner. So it’s not strictly just an old person thing, but definitely more common there.

Alan Helgeson:

Growing up on a farm, this kind of feels like something that my dad would say as a farm kid. If you can move your joint, your bone isn’t broken.

Dr. Drew Glogoza:

It would be nice if that’s always true. It’s not though. Things that we see walk into clinic, I tell you what, it’s impressive sometimes what people are able to come in on. I’ve seen people walk in on broken ankles and be very surprised and we tell them that they have a fracture. So I wouldn’t say that it’s a hundred percent true.

I think that there’s probably more times when it’s broken, you don’t want to move it and that’s part of your body trying to tell you that there’s something wrong and needs to get some support in that area. But it’s not perfect. It can still be broken.

Alan Helgeson:

Let’s pivot now Dr. Glogoza. Let’s talk about some things we can do to help with joint pain or arthritis. Are there some specific treatments or relief for athletes or those that are in sports?

Dr. Drew Glogoza:

I think when we think about treating joint pain, arthritis, that kind of stuff, I would tell you that the goal is probably going to be limit pain and then try to improve function is how I would think about treating it. It’s not always easy to get rid of all the pain, so that may be an unachievable goal. So we try to limit pain to a level that is more tolerable and then improving the function so that you can get back to doing whatever you need to do. Whether that’s run the marathon or if that’s cut the grass.

But that’s how I would try to think about what we generally do for approaching treatment for these problems. Exercise is actually really good for our joints. We have really good evidence for that. Whether it be a home program that you’re working on your own or if you’re doing some formal physical therapy with a physical therapist.

We do have good evidence that the stronger your muscles can be, the better that joint is going to function. So trying to stay active is great. We also know that just a healthy lifestyle will be good. We’ve talked about different risk factors for arthritis, eating healthy, staying active, maintaining a healthy weight, all of that is going to be very good at preventing arthritis and arthritic pain in your joints.

I think that we touched about the knee pain and how much extra weight it sees and that kind of stuff. We have some evidence that suggested if you can lose 10% of your body weight you can have almost a 50% reduction in your joint pain. So that’s pretty significant if you’re able to either one lose the weight that you maybe gained over the years or if you’re able to keep it off.

Alan Helgeson:

So it’s nice to hear, Dr. Glogoza, it doesn’t matter whether you’re a ‘me’ or you are a high performing athlete that runs 5K’s or ultra marathons, whatever it might be. I mean really some of those treatments for relief – they’re the same, right?

Dr. Drew Glogoza:

Yeah, absolutely and and a lot of these exercise programs don’t necessarily need a gym membership. They’re not things that need to have big weight rooms. It’s stuff that we can do simply at home to just kind of maintain some strength in our muscles and keep us active.

Alan Helgeson:

Moving on to the next question here. Let’s talk about maybe some over the counter treatments or maybe some medications to recommend and I don’t know if you feel comfortable with this, what’s in Dr. Glogoza’s medicine cabinet that, gosh, you know, I was out doing a quick run around the neighborhood last night and I’m feeling a little sore. What does Dr. Glogoza use?

Dr. Drew Glogoza:

I think that a lot of people would tell you that they’re reaching for the ibuprofen or Aleve and I think we have good evidence to say that those really do help with arthritis pain.

Now the big catch with that is as we get older, which is more common with arthritis, sometimes those medications are not available for us to be using. So we for sure need to be checking with our regular doctors to make sure that they’re still appropriate for us to be using because there are some risks for side effects that we want to make sure that we’re not setting ourself up for.

But I do think that they probably provide the best treatment of the over-the-counter stuff. There are some topical treatment options. Lots of people do Icy Hot and Biofreeze and things like that, but there is a, I call it ibuprofen in a cream, but really what it is is Voltaren gel. It’s just Voltaren is another form of ibuprofen and I think it works really well. It’s topical so there’s not as much systemic absorption. It’s probably a little bit safer for people to try and use initially if they haven’t seen a doctor recently or not sure if they should be taking it or not. You just rub it over the joint that’s been painful and see if it works.

Alan Helgeson:

Thank you doctor for giving us the answers on maybe some things to help us out with some of the pain we might be experiencing. So we’ve tried these things, we’re keeping moving. When is it time to see an orthopedic physician or a provider?

Dr. Drew Glogoza:

That question is probably different for every person and part of that is pain is really, like I told you, is the main thing that people come in and that’s just going to be really different for every person. When people really come in is when it starts affecting your life commonly. If it’s waking you up at night, a lot of times people are coming in complaining saying, my knee’s hurting me, I can’t sleep at night, or my shoulder’s hurting me, I can’t do the dishes, I can’t put stuff back in the cupboards, I can’t reach the cereal box out of the cupboard. Whatever it is.

When it starts to really affect your life, I think that’s when people really start coming in and I think that is appropriate. That could be two days after your shoulder’s been hurting or it could be 10 years after your knee’s been hurting and you’re just tired of it and you want to figure out what’s going on with it.

Alan Helgeson:

Doctor, could you speak a little bit about when it comes to orthopedics and sports medicine? You know there are people that might have been living in pain for a long time and they’re worried that if they go in because something’s been hurting for a long time, instantly, automatically the only option is to have surgery. You have so many options, right?

Dr. Drew Glogoza:

There are a lot of options. You know, certainly for myself, I’m not a surgeon. So while I know what the surgery options are, I usually try to explore all of the options to figure out what works best with someone to come up with an individualized treatment plan.

Sometimes medications are appropriate and manage your symptoms and that’s all you need. Some people want to get active again. We get them in for some physical therapy, we give them some exercises and we get them going and that’s enough to make their knee feel better.

Other times we do some injections. I do a lot of injections, and certainly there are a lot more tolerable than the immediate pain after a surgery for sure. Those are probably the main treatments that I think about that are short of surgery, but there are definitely options.

I haven’t really touched on it much, but there’s some bracing options that we try to do sometimes for people. Don’t think that just because you’ve had a lot of pain and you’ve been putting it off, that you’re going to come in here and we’re immediately going to tell you, you just have to have surgery for this.

Alan Helgeson:

What last-minute thoughts do you have as we put a bow on everything we’ve talked about here? Making us actually feeling better by sharing some great information about arthritis and joint pain.

Dr. Drew Glogoza:

I think arthritis is very common. I think joint pain is very common. We know that those things are going to happen and we’re happy to see you and try to help you through things.

I think it’s important for everyone to stay active and try and be healthy. Maintaining strong muscles is going to help you keep healthy bones, which is hopefully going to help prevent any kind of arthritic symptoms that you might develop over the years.

If you’re struggling with the joint pain, make sure to come in here and see us at Sanford. We’re happy to help you out. Come up with a treatment plan, individualize it with you and get you back to whatever your desired level of activity is.

Alan Helgeson:

Dr. Drew Glogoza, a specialist with Sanford Orthopedics and Sports Medicine. Thank you for joining us today.

Dr. Drew Glogoza:

Thanks for having me on. It’s always fun.

Matt Holsen:

This episode is part of the “Health and Wellness” series by Sanford Health. For additional podcast series by Sanford Health, listen wherever you hear your favorite podcasts and on news.sanfordhealth.org.

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