Osteoarthritis in Workplace Claims
As more is learned about arthritis, it is believed that its prevalence in the U.S. has been substantially underestimated, especially among adults younger than age 65. According to the Arthritis Foundation, over 90 million adults have either doctor-diagnosed arthritis or report symptoms consistent with an arthritis diagnosis. For people aged 18 – 64, the working population of our country, about one in three people, both men and women, have the disease, or report its symptoms.
A leading cause of disability among adults in the U.S., it is estimated that annually 172 million work days are lost due to arthritis and other rheumatic conditions. Inflammation of the joint is the number one cause of temporary disability. In 2013, combined medical costs and earnings losses due to arthritis were $304 billion, about 1% of the U.S. GDP. With an aging population, and aging workforce, those numbers are only forecast to grow.
Such statistics explain why arthritis accounts for some percentage of workers’ compensation claims. The contribution of repetitive work and the development of arthritis continues to be investigated.
Osteoarthritis, the Arthritis of Aging
Arthritis is defined as joint inflammation, a condition where the joints connecting bones together are damaged. There are more than 100 medical conditions associated with the disease, but we’ll focus on the most common type, osteoarthritis (OA), also called degenerative joint disease or degenerative arthritis. Commonly referred to as the arthritis of aging, OA occurs when the cartilage that cushions the joints deteriorates. The progressive damage to joint cartilage leads to swelling, increasing levels of pain and decreased range of motion. Osteoarthritis is most commonly experienced in the major joints, such as knees and hips. Symptoms may come and go, and can be mild, moderate or severe. They may stay the same for years but may progress or get worse over time.
Occupational Risk Factors
Anyone who injures or repetitively impacts their joints, including athletes, dancers and people who work physically demanding jobs may be more susceptible to developing this disease as they age.
The type of work, plus nature and frequency of movements are considered in assessing a workers’ compensation claim. For example, repetitive work, or assignments requiring awkwardly sustained positions for long periods can play a role in the development of joint disease symptoms. For example, studies show increased risk of OA for people who reported prolonged kneeling or squatting, walking over 2 miles per day, or regularly lifting 55 lbs. or more at work. A thorough job description is helpful in determining causation.
Acute injuries can also lead to the development of arthritis and joint degeneration. A thorough history and physical exam can help determine the cause. In addition, MRIs or other diagnostic tests can prove to be important tools in the evaluation of arthritis and help determine any relationship to a specific work injury. Complete medical records can also help identify a pre-existing injury or condition.
Nonsurgical and Surgical Treatment Options for Osteoarthritis
Unfortunately, there is no cure for arthritis, but there are tools for identification, prevention and treatment of symptoms. Early diagnosis and treatment are key. A physician trained in physical medicine and rehabilitation (PM&R) or an orthopedic surgeon can identify symptoms and target treatment that can provide pain relief, control inflammation, increase joint mobility and strength, and prevent further loss of joint cartilage.
Studies have shown that physical activity can reduce pain and improve physical function by about 40%. Strengthening muscles around a joint may result in decreased pain and increase stability. Swimming is one of the best exercises, as is cycling, elliptical machines and walking. Weight loss can also be helpful by decreasing the stress on joints. A well-balanced diet consisting of non-inflammatory foods, coupled with regular exercise has been shown to be beneficial.
Medications including non-steroidal anti-inflammatory medications (NSAIDs) can be helpful in addressing symptoms, particularly in early or moderate arthritis. Steroid injections have been used for years to help reduce inflammation and pain. More recently stem cell injections are being evaluated as a more natural way to delay progression of the disease.
When non-surgical solutions are found to no longer be effective at controlling pain, joint replacement surgery is the primary surgical solution. Worn cartilage and bone are removed and replaced by an implant. Knee replacements and hip replacements continue to grow in use for treating arthritis.
OrthoAtlanta orthopedic and sports medicine specialists is conveniently located across the greater Atlanta, Georgia, area with 14 physician offices, dedicated workers’ compensation coordinators and on-site physical therapy facilities to serve you.
This article was authored by OrthoAtlanta physiatrist, Yolanda Scott, MD, a medical doctor specializing in Physical Medicine and Rehabilitation (PM&R) providing non-surgical orthopedic care, including non-surgical spine, musculoskeletal medicine, functional medicine, and regenerative medicine. This article was featured in Georgia 1st, a workers’ compensation publication (Q1-2019).