Good to the Bone

The 76 million baby boomers in the United States are wildly different from one another. After all, that group includes Bill Clinton, Cher, Geraldo Rivera, Justice Clarence Thomas and rocker Pat Benatar. But there's something they all share, and they're vocal about it: aches and pains. The older this group gets, the more wear and tear their muscles and bones show.

Some of the most common complaints are back, knee, shoulder, foot or ankle problems. In fact, Americans made 31 million visits to doctors' offices for back problems in 2003. They made 19 million visits for knee problems, 14 million visits for shoulder problems, and 11 million for foot and ankle problems.

That's a lot of problems!

None of that escapes the attention of the American Academy of Orthopaedic Surgeons, which has noticed such a trend of injuries among baby boomers that they've given it a name: "boomeritis." In fact, the AAOS has joined with the National Athletic Trainers' Association in a campaign to "Prevent Boomeritis." What both groups hope to minimize are the banes of the aging frame: tendonitis, bursitis, arthritis and the sports injuries that catch up with this group of weekend warriors.

As people age, the musculoskeletal tissues change. Bones become more brittle, muscles weaken, joints stiffen. People get heavier, too, which puts even more stress on the body.

Baby boomers' musculoskeletal injuries happen for predictable reasons: normal wear and tear in tendons and joints, muscle loss, overuse of a particular joint, and old injuries that flare up again, often due to osteoarthritis. Osteoarthritis happens when the smooth, elastic cartilage on the ends of bones, which acts as a cushion, wears away and becomes rough. Then the joint that used to move effortlessly sticks, clicks or even grinds.

To treat the pain and swelling, the doctor might inject anti-inflammatories or prescribe them in pill or tablet form. They often prescribe physical therapy to improve joint flexibility, increase range of motion, strengthen bone and cartilage and reduce pain. If the patient is an athlete, the doctor may suggest substituting lower-impact sports. Sometimes it helps to apply ice several times a day to an affected joint. Elastic bandages, splints, braces, canes or crutches may be called for.

When conservative treatments don't work, there are three common surgical options.

In arthroscopy, a surgeon uses a small fiber-optic camera and an access tube, called an arthroscope, which is about the size of a pencil. With a couple of small incisions, the surgeon treats the problem, such as removing bone spurs, cysts, damaged cartilage or loose tissue fragments.

In joint fusion, pins, plates, screws or rods hold bones in place while tissue heals. In this case the joint will no longer be flexible, but sometimes that's preferable to the symptoms.

And in joint replacement, a surgeon replaces cartilage and bone with metal and plastic, creating an artificial joint.

Fortunately for boomers, some revolutionary procedures are making the aging process a little easier.

Arlyne Trelease, 73, recently went through knee-replacement surgery. The Sarasota great-grandmother had had knee pain for a couple of years. Her doctor, Daniel S. Lamar Jr. of Coastal Orthopedics and Sports Medicine in Bradenton, first treated her with cortisone injections. Like other orthopedic surgeons, Lamar tries more conservative treatments first whenever possible, but sometimes surgery is the best choice.

The good news is that in many types of orthopedic surgery, the instruments have gotten highly sophisticated and much, much smaller, meaning the incisions are smaller and so is the recovery time. The result is minimally invasive surgery, sometimes called atraumatic surgery.

About five weeks after she had knee-replacement surgery, Trelease says, she went outside to walk her dogs "and a neighbor said to me, 'I thought you were going to have surgery.' I said 'Hi, Bill,' and pulled up my pant leg and said, 'I did.' He couldn't believe it."

Trelease wasn't keen on the idea of surgery at first. But as a few years went by, wear and tear on her knee were worsened by osteoarthritis, and the pain got worse. And then she got hit by a car.