PHOTO: SHUTTERSTOCK

Arthritis is more than just the wear and tear of our joints. Statistics show 1 in 3 adults ages 18 to 64 have arthritis and it is the leading cause of disability among adults in the U.S.

Dr. Tony DiGioia, medical director of the UPMC Center for Bone and Joint Health at Magee-Womens Hospital in Oakland, notes arthritis can affect any joint in the body and the rates of diagnosis across the country are increasing.

“Arthritis is one of the most common diseases in all of medicine,” he says. “It has a huge impact on daily living and the ability to work. The expense of treating musculoskeletal disorders is the second highest cost in health care.”

The Center for Bone and Joint Health was established in 2020. It’s the first of its kind in the country, according to UPMC, to give patients a comprehensive look at what could be causing their arthritis, ways to prevent arthritis and help in improving other areas of their wellbeing, such as nutrition and mental health wellness.

Other services include osteoporosis care, pain management, women’s wellness (arthritis affects more women than men) and bladder and pelvic floor care (bladder, pelvic and musculoskeletal health are directly related).

In January 2022, Dr. Helana Pietragallo became co-medical director of the center and helped to expand the partnership with Magee’s Midlife Health Center. The center also partnered with Dr. Jocelyn Fitzgerald to establish connections with the Women’s Center for Bladder and Pelvic Health and a team of occupational therapists who address chronic pain at the Centers for Rehab Services.

“Arthritis is a whole-body disease,” DiGioia explains. “Not one specialty can handle it all. The whole idea behind the center is to help slow down that wear and tear.”

The center’s staff evaluates each patient and creates a treatment plan based on their individual needs. The first step is to ask them questions that surround the theme: “What matters to you?” Do you hope to lose weight, move more, quit smoking, sleep better? The model of care focuses on setting — and achieving — goals that matter.

There are more than 100 types of arthritis and related conditions that fall under two main categories — inflammatory autoimmune arthritis such as rheumatoid, psoriatic and lupus-based arthritis, where the body attacks its own joints; and degenerative, which is directly related to the wear and tear of various joints, particularly the hips, knees, shoulders and ankles.

DiGioia notes early diagnosis is important, especially with autoimmune-related arthritis.

“The treatment has become so successful at reducing the long-term effects of inflammatory arthritis that medicines can literally turn off the autoimmune response and stop the destruction of the joints,” he says. “With early diagnosis, you can literally cure your patients that suffer from autoimmune related arthritis.”

There is no medical cure for degenerative arthritis; once you lose your cartilage, there’s no way to replace it without a total joint replacement. The average age for a joint replacement is now between 50 and 65 years. Before, DiGioia notes, it was mainly done in patients ages 65 and older.

What can you do to help prevent degenerative wear and tear on your joints?

DiGioia says behavioral changes are needed to keep our joints intact for as long as possible, and moving more can help to reduce inflammation in the joints.

“The need for hip and knee replacements has grown between 20% and 30% in the last five years, and we expect it to continue to grow at that pace for the next 10 years,” he says. “For the knees and hips, body weight is very important. For every pound of body weight, your hips and knees feel 5 to 6 pounds of pressure, and it builds up. So, if you lose 10 pounds, you’ll take 50 to 60 pounds of pressure off of your knees and hips.”

Another facet of the center’s services includes community outreach and education, thanks to partnerships with the AMD3 Foundation, Magee-Womens Research Institute and Foundation, and the Magee-Womens Outreach Department.

“We have found that there are a lot of disparities in care, particularly among minorities,” he says. “Women and men also have different forms of arthritis and handle the disease differently.”

Some programs the center has launched include:

• Your Health, Your Way — A program that helps patients understand and meet their personal health goals in a fun and motivating small-group setting
• Operation Change Pittsburgh — A community-based wellness program for Black and Latina women who are experiencing limited mobility due to joint pain
• Events that bring bone and joint education into Pittsburgh neighborhoods
• A PCP Starter Kit to help non-orthopaedic experts know more about the center and their own role in helping patients build bone and joint health
• Expanded knowledge and resources to support good sleep, hygiene and dental health.

DiGioia adds the center plans to open a satellite office in Homewood to bring care to underserved communities.

“Arthritis definitely affects people’s quality of life. This is a very important topic that needs to be talked about more,” DiGioia says.