Q. I have been having on-and-off joint pains for many years now, but the aches have grown worse lately, so I consulted a doctor last week. He told me I have osteoarthritis, which he said is arthritis that comes with age. I am 62. I know arthritis is a normal part of aging but is there something I can do to relieve my joint pains? I was advised by friends to limit my intake of high-protein food because this leads to high uric acid which causes arthritis. Are they right?

Evelyn L., San Fernando City, Pampanga

A. Osteoarthritis is the most commonly occurring of the about 200 types of arthritis. The disease indeed comes with age and it spares no one. By age 40, 90 percent of all individuals will have x-ray findings in their joints that are consistent with osteoarthritis, although many will still be without symptoms. But by age 55, at least 80 percent of all people will occasionally or continually experience a symptom or two of the disease, which include morning stiffness, pain, tenderness, and limitation of movement of the involved joints.

The joints that are usually affected by osteoarthritis are those of the fingers and toes, between the thumb and the hands, between the big toes and the feet, the hips, the knees, the neck, and the lower back.

Osteoarthritis is generally attributed to the wear and tear that occurs in a joint because of use. Changes in the joint include erosion of the cartilages that cover the surfaces of the articulating bones that enable the bones to glide smoothly, and degeneration of the articulating bones. The exact mechanisms that cause these changes are not yet known, and this partly explains why there is no cure for the disease yet. But we know that development and progression of osteoarthritis is aggravated by trauma, joint instability, and obesity, and influenced by hormonal and genetic factors.

Initially, the signs and symptoms of osteoarthritis come only occasionally and are mild and tolerable. But the disease is a progressive one and the signs and symptoms become really bothersome and persistent in later life. In some people, movement in the involved joints becomes severely limited and the bones become prominent and deformed.

There is no cure yet for osteoarthritis, but old people need not simply put up with it. There are things that they can do to relieve the symptoms, preserve or restore joint function, and prevent progression of the disease. In other words, the disease can be controlled enough to enable people to live normally.

For mild osteoarthritis, treatment consists of weight reduction, appropriate exercise and physical therapy—to ease pain and strengthen the muscles around the joint. In moderately severe or intractable cases, anti-inflammatory drugs—mainly non-steroidal anti-inflammatory agents (NSAIDs) and steroids—are added to the foregoing regimen. These drugs are very effective in controlling pain and inflammation, but they have adverse effects and must be used only with the supervision of a physician.

Agents that reportedly can regenerate cartilage are likewise available in the market. The two most popular of these are chondroitin sulfate and glucosamine. Several clinical trials have shown that these substances when taken orally and regularly have significant symptom-modifying effect and good safety profile; and, they also retard the progression of the disease.

In very severe cases, especially if there are marked deformities of the bones and limitation of motion in the joint, surgery to repair, reconstruct, or replace the joint is an option.

By the way, restricting your intake of protein-rich food will not contribute to the control of your osteoarthritis. Protein restriction helps only those who are suffering from a relatively rare type of arthritis that has a familial tendency called gout. Gout, which affects mainly adult men, accounts for only about five percent of arthritis cases.

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