Treatments for arthritis vary widely

Dolores "Jeanne" Streightiff asks if she can talk after she wraps up her physical therapy session.

"I'm allergic to painkillers, so there can be a lot of screaming," the retired ski instructor, 67, half-jokes during a phone interview.

Streightiff recently had knee replacement surgery because of painful, activity-inhibiting osteoarthritis and is in the middle of one of her weekly in-home sessions.

"I'm still young. Now I'll be able to do everything I did before," says Streightiff, who lives in Hollidaysburg, Pa., with her husband.

Though Streightiff decided surgery was the way to go, some, such as baseball Hall of Famer Hank Aaron, 76, sought a less invasive route for relief. Aaron says he saw numerous doctors and tried a variety of medications before injections reduced his knee pain.

It can be difficult to determine how best to treat arthritis pain, says Vonda Wright, assistant professor of orthopedic surgery at the University of Pittsburgh Medical Center for Sports Medicine, who is also Streightiff's knee surgeon.

Tough choices for patients

"People with OA (osteoarthritis) have to find the balance between rusting out — sitting around and getting stiffer and stiffer — and wearing out, pushing through the pain until you can't move anymore. It's a fine line," says Wright, author of Fitness After 40.

Wright says there is a wide range of options including inflammation- and pain-reducing medications, physical therapy to help strengthen muscles that support a joint, joint-relieving injections and surgery. She says the key is to sit down with your orthopedist, determine your life and activity goals and develop a treatment plan from there.

A chronic degenerative joint disease, osteoarthritis afflicts almost 27 million Americans and is the most common type of arthritis, the Arthritis Foundation says. It occurs as a result of wear and tear on a joint's cartilage, which causes bones to rub against each other. Stiffness, pain and loss of movement in the joint can result, says Patience White, the Arthritis Foundation's chief public health officer.

The condition can begin as early as in a person's 40s, sometimes younger, but in that group it's usually the result of an old injury, says Reuben Gobezie, an orthopedic surgeon at University Hospitals Case Medical in Cleveland. Genes, overuse and weight influence osteoarthritis' onset, he says.

The hand is the most commonly affected area, but knee and hip arthritis can be the most debilitating because they interfere with mobility, White says.