Op-Ed: One of Every Three Veterans Are Battling Arthritis

Arthritis is a significant health concern for both military service members and veterans. According to the Department of Veterans Affairs (VA), one in three veterans develop arthritis as compared to one in four civilians.

Arthritis is a term with over 100 different varieties and osteoarthritis (OA) is the most common type among military and non-military populations. Military personnel older than 40 years old are twice as likely to develop arthritis after returning to civilian life.

About half of veterans with arthritis report limitations in their daily activities due to joint symptoms. After an injury, OA can strike at a younger age with long-lasting effects, both physical and emotional.

Another form of OA, impacting military service members, is called post-traumatic osteoarthritis (PTOA). This form, PTOA, is far more common to those serving in the military than non-military people.

Primary OA is a degenerate joint disease occurring most frequently in the back, hands, knees, and hips. This form of OA affects older people and develops slowly over time. But PTOA is significantly different!

Primary PTOA results from an injury to the joint and develops more quickly than primary OA. It can start in people at a younger age and when they are active, often due to injuries sustained during military service.

Because service members are often in their 20s and early 30s when PTOA begins, it can have a lasting impact on their ability to work and overall quality of life. Military life significantly raises the risk of joint injury.

According to Dr. Kenneth Cameron, a leading clinical OA researcher, “non-battle related joint injuries were by far the leading cause of medical evacuation from recent operations in Iraq and Afghanistan.”

“We know that people who sustain a joint injury, are five to seven times more likely to develop PTOA,” Dr. Cameron stated. “People usually have substantial degenerative changes within 10 years after joint injury, and in combat trauma injuries, we’ve seen that average is less than two years.”

“But the vast majority of joint injuries in military populations,” said Dr. Cameron, “occur during physical training, during military training and during recreational activities.”

The personal price of PTOA is very significant. Service members with PTOA generally live longer with OA pain and functional limitations, but they also are more likely to have joint replacement surgery at a younger age than the general population.

There is a possibility that the first joint replacement surgery will wear out.

“We know it’s bad to have one knee replacement, but it’s even worse to have a second knee replacement or hip replacement,” Cameron concluded.

Veterans are also at increased risk of developing comorbidities, such as obesity, diabetes, and heart disease, at an earlier age, which also can undermine their quality of life and health.

Also, PTOA can cost them their job, forcing them to start over in a job that is less physically demanding.

Dr. Jessica Rivera, formerly stationed at the San Antonio Military Medical Center, found that PTOA accounted for nearly 95% of medical discharges among Iraq and Afghanistan veterans injured in combat.

“What we found was once they survived their head trauma and their chest trauma and their abdominal trauma, they still had extremities with sometimes irrevocable injuries,” Dr. Rivera explained.

In a research study, Dr. Rivera looked at the reasons for medical disability discharge in 2001 and in 2009 among service members who served in Iraq and Afghanistan. The leading causes were OA and back pain.

My Opinion: Both OA and PTOA are not simply a result of joint “wear and tear.” It is a disease of the joint that involves inflammation. Researchers don’t know and understand about how OA and PTOA develops.

“I think there needs to be dedicated funding, particularly through research programs managed by the Department of Defense, to really address this,”

said Dr. Cameron.

“And I think it would have far-reaching benefits to the general population,” concluded Cameron, “especially the young people who would benefit from this as well.”

In the Army, there was no avoiding the daily physical training, the heavy backpacks of 50 to 75 pounds and the pounding on weight-bearing joints, like the knees and ankles. Unfortunately, there is no changing the physical requirements of military service.

Currently, there aren’t yet any effective, long-term treatments for either OA or PTOA. Some VA researchers are exploring other options such as preventing OA from developing in the first place or even intervening after a joint injury to slow its development.

Other VA researchers are developing new clinical treatments that reduce veterans’ disabilities and improve the ability of VA clinicians to provide effective care for veterans with arthritis.

Other VA researchers are using innovative techniques to design therapeutic interventions for veterans who have lost mobility or functioning.

If veterans believe that their arthritis is caused by their military service or by a specific injury/incident, they should contact the closest veteran service organization (VSO) to file a disability compensation claim.

BioSketch: John Plahovinsak is a retired 32-year Army veteran, who served from 1967 to 1999. He is the Disabled American Veterans (DAV) Department of Ohio’s Hospital Chairman and Adjutant of DAV Chapter #63 (Clermont County). He can be contacted at: plahovinsak@msn.com.