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used properly, they will have a relatively long life. If forced to endure extra pressure and friction constantly, however (such as when you slam on your breaks or “ride” the brake when going downhill) the pads will wear out faster than they are meant to. Of course, when it comes to a car, you’re lucky. When your brake pads wear out, you can just get new ones. Your joints don’t work this way. You can’t grow new cartilage. When it’s gone, it’s gone for good. What are the signs that osteoarthritis is setting in? Obviously pain is the most common symptom, particularly in weight-bearing joints and after repetitive use. Make no mistake about it: When bone starts to rub against bone, whether in your vertebrae or knee, it hurts! Swelling, inflammation, and loss of flexibility also mark this disease. Unfortunately, losing weight cannot reverse any damage osteoarthritis inflicts, but it can alleviate some pain, improve flexibility, and decrease the degeneration rate. Consequently, weight loss is usually the first course of treatment. It can make a substantial impact on comfort, function, and the course of the disease. Physicians will also usually recommend range-of-motion exercises and muscle-strengthening work under the watchful eye of a physical therapist. For pain, something as simple as two Tylenol® (acetaminophen) or a heating pad can make a world of difference, but doctors might also prescribe a mild narcotic painkiller or nonsteroidal anti-inflammatory medica- tions like high-dose ibuprofen (Motrin®) to take off the edge. These courses of treatment effectively manage arthritis for most people. For some, only more extreme measures work. Injecting anti-inflammatory hormones (also called corticosteroids) directly into the joint is one common short-term treatment, but doctors usually limit these shots to only two or three treatments per year. Surgery is another option. Surgery to resurface (smooth out) bones, repo- sition bones, or simply remove loose pieces of cartilage from the joint if they are causing mechanical symptoms like pinching, buckling, or locking is not uncommon. The most extreme procedure is joint-replacement surgery, but

72 / Health Issues Caused by Obesity

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