Osteoarthritis

The most common type of arthritis that is especially prevalent among older people. Sometimes known as degenerative joint disease, it often affects the cartilage. The cartilage is a firm, slippery tissue that permits nearly frictionless joint motion. Healthy cartilage allows bones to glide over one another and absorbs energy from the shock of physical movement. When someone has osteoarthritis, the surface layer of cartilage breaks and wears away. This causes bones under the cartilage to rub together which causes pain, swelling and loss of motion of the joint.

The joint may lose its normal shape over time. Osteophytes (small deposits of bone) or bone spurs may also grow on the edges of the joint. Bits of bone or cartilage may break off and float inside the joint space and cause more pain and damage.
People with the condition normally experience joint pain and stiffness. Unlike other forms of arthritis like rheumatoid arthritis, osteoarthritis only affects joint function. The skin tissue, the lungs, the eyes, or the blood vessels are not affected.

Why does it occur?

This condition occurs when the cartilage that cushions the ends of bones in the joints gradually deteriorates.
The slick surface of the cartilage becomes rough and eventually, if the cartilage wears down completely, you may be left with bones rubbing against each other.

Who is affected by Osteoarthritis?

Osteoarthritis becomes more common with age. However, younger people may also develop it. Usually as the result of a joint injury, a joint malformation or a genetic defect in joint cartilage. More men than women have osteoarthritis before the age of 45. After age 45, it is more common for women to develop it. This condition is also more likely to occur in people who are overweight and in those with jobs that put stress to particular joints.

What factors increase the risk of Osteoarthritis?

• Older age: Risk increases with age
• Gender: Females are more likely to develop osteoarthritis
• Obesity: Extra body weight contributes to osteoarthritis in numerous ways. The more you weigh, the greater your risk. Increased weight puts added stress on joints like your hips and knees. Additionally, fat tissue produces proteins that may cause harmful inflammation in and around your joints
• Joint injuries: Injuries that occur when playing sports or from an accident may increase the risk of osteoarthritis. Injuries that occurred many years ago and have seemingly healed can also increase your risk
• Certain occupations: Jobs that involve repetitive stress on a particular joint may cause that join to develop the condition
• Genetics: A tendency to develop osteoarthritis may be inherited
• Bone deformities: Malformed joints or defective cartilage can increase the risk of osteoarthritis

 

 

WHAT ARE THE SYMPTOMS OF OSTEOARTHRITIS?

The symptoms often develop slowly and worsen over time. They include:

• Pain: Painful joints during or after movement.
  
• Tenderness:Tender joints when you apply light pressure to it.
  
• Stiffness:Joint stiffness when you wake up in the morning or after a period of inactivity.
• Loss of flexibility: Inability to move your joint through its full range of motion.
• Grating sensation:A grating sensation when you use the joint may be heard or felt.
• Bone spurs:These extra bits of bone (feel like hard lumps) may form around the affected joint.

 

WHAT ARE THE TREATMENT OPTIONS?

A combination of approaches tailored to the patient’s needs, lifestyle, and health is normally the most successful treatment. Most of the treatment programs include ways to manage pain and improve function.

There are currently no ways to reversed this condition. Having said that, symptoms can normally be managed effectively with lifestyle changes, physical and other therapies, medications, and surgery. The most important methods to treat the condition are exercising and achieving a healthy weight. Your doctor may also suggest:

Medications

• Acetaminophen: This type of medication has been shown to be effective for people who experience mild to moderate pain. Consuming more than the recommended dosage of acetaminophen can cause liver damage.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter NSAIDs, including ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others) can typically relieve osteoarthritis pain when taken at the recommended doses. Stronger NSAIDs (available by prescription), may also slightly reduce inflammation along with relieving pain.

It’s important to note that NSAIDs can cause an upset stomach, cardiovascular problems, bleeding problems and liver and kidney damage. Topical NSAIDs on the other hand have fewer side effects and may relieve pain just as well.

• Duloxetine (Cymbalta): This medication is normally used as an antidepressant. It has also been approved to treat chronic pain including osteoarthritis pain.

Therapy

• Physical therapy: An individualized exercise program can be created to help strengthen the muscles around your joint, increase your range of motion and reduce pain. Regular gentle exercise such as swimming or walking can be equally effective.
• Occupational therapy: Discover ways to do everyday tasks or do your job without putting extra stress on your already painful joint with your occupational therapist. For example, a toothbrush with a large grip could make brushing teeth easier if you have fingers are affected by the condition. Placing a bench in your shower could help relieve the pain of standing if you have knee osteoarthritis.

You may want to consider other types of procedures if conservative treatments don’t help. The include:

• Cortisone injections: May relieve pain in your joint. Your doctor numbs the area around your joint and places a needle into the space within your joint and injects medication. The number of injections you can receive each year is normally limited to 3 or 4 injections as the medication can worsen joint damage over time.
• Lubrication injections: May offer pain relief by providing some cushioning in your knee. However, some research suggests these injections offer no more relief than a placebo. Hyaluronic acid is similar to a substance normally found in your joint fluid.
• Realigning bones: If one side of your knee has been damaged more than the other, an osteotomy might be helpful. A surgeon will cut across the bone either above or below the knee and then remove or add a wedge of bone. This will shift your body weight away from the worn-out part of your knee.
• Joint replacement (arthroplasty): A surgeon will remove damaged joint surface and replace them with plastic and metal parts. Surgical risks include infections and blood clots. Artificial joints can wear out or become loose and may need to be replaced eventually.

 

DIAGNOSTIC SERVICES FOR OSTEOARTHRITIS

• Consult with doctor and physical exam: Questions about your lifestyle, symptoms you are having, medical history and previous traumas will be asked. Your doctor will closely examine your affected joint during physical examination, checking for tenderness, swelling or redness and for range of motion in the joint. Your doctor may also recommend imaging and lab tests.

• X-rays:Cartilage does not show up on X-ray images. However, cartilage loss can be revealed by a narrowing of the space between the bones in your joint. X-ray may also show bone spurs around a joint. Some people may detect osteoarthritis even before they experience any symptoms.
• Magnetic resonance imaging (MRI):
  Radio waves and a strong magnetic field are used to produce detailed images of bone and soft tissues including cartilage. It isn’t commonly needed to diagnose osteoarthritis but it may help to provide more information in complex cases.

• Blood tests: Even though there is no blood test for osteoarthritis. Certain tests may help to rule out other causes of joint pain such as rheumatoid arthritis.
• Joint fluid analysis: A needle may be used to draw fluid out of the affected joint. Examining and testing the fluid can determine if there is inflammation and if your pain is caused by gout or an infection.