What is osteoarthritis?
Osteoarthritis, the most common form of arthritis, is a chronic, degenerative joint disease that affects mostly middle-aged and older adults. Osteoarthritis is characterized by the breakdown of joint cartilage and adjacent bone in the neck, lower back, knees, hips and/or fingers. The disease is also known as degenerative arthritis or degenerative joint disease.
What causes osteoarthritis?
Osteoarthritis can be classified as primary or secondary. Primary osteoarthritis has an unknown cause, while secondary osteoarthritis is caused by another disease, infection, injury or deformity. Osteoarthritis is characterized by the breakdown of cartilage in the joint and adjacent bone. As the cartilage wears down, the bone ends may thicken, forming bony growths or spurs that interfere with joint movement. In addition, bits of bone and cartilage may float in the joint space and fluid-filled cysts may form in the bone, limiting joint movement. Several risk factors are associated with osteoarthritis, including the following:
Heredity
Slight joint defects or double-jointed ness (laxity) and genetic defects may contribute to the development of osteoarthritis.
Obesity
Excessive weight can put undue stress on such joints as the knees over time.
Injury/Overuse
Significant injury to a joint, such as the knee, can later result in osteoarthritis. Injury may also result from repeated overuse or misuse over a period of time.
What are the symptoms of osteoarthritis?
The most common symptom of osteoarthritis is pain after overuse of a joint or prolonged inactivity of a joint. The most common joints affected by osteoarthritis include the hips, knees, fingers, feet and spine. Symptoms of osteoarthritis usually develop slowly over many years. The following are the most common symptoms of osteoarthritis. However each individual may experience symptoms differently. Symptoms may include
- Joint pain
- Joint stiffness, especially after sleeping or inactivity
- Limited joint movement as the disease progresses
- Grating of joints when moved (in more advanced stages of osteoarthritis) as the cartilage wears away
- Back pain
- Numbness
- Weakness in an arm or leg (in more advanced stages)
The symptoms of osteoarthritis may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
How is osteoarthritis diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for osteoarthritis may include the following:
X-ray
A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film.
Joint aspiration
This involves a removal of fluid from the swollen bursa to exclude infection or gout as possible causes.
Treatment for osteoarthritis:
Specific treatment for osteoarthritis will be determined by your physician based on:
- Your age, overall health and medical history
- Extent of the condition
- Your tolerance for specific medications, procedures and therapies
- Expectation for the course of the condition
- Your opinion or preference
The goals of treatment for osteoarthritis are to reduce joint pain and stiffness, and improve joint movement. Treatment may include:
Exercise
Regular aerobic exercise and stretching/strengthening exercises may help reduce the symptoms of and pain associated with osteoarthritis.
Heat treatment
Treating the affected joint with heat may help reduce pain.
Physical and Occupational therapy
Physical and occupational therapy may help to reduce joint pain, improve joint flexibility when performing daily activities and reduce joint strain.
Weight maintenance
Maintaining your recommended weight or losing weight (if overweight) may help to prevent or reduce the symptoms of osteoarthritis.
Medication
Medication for specific symptoms may include pain relievers (in pill form or topical cream) and anti-inflammatory medications, if inflammation is present.
Injections of thick liquids into the joints
These liquids mimic normal joint fluid.
Joint surgery
Surgery may be necessary to repair or replace a severely damaged joint.
Treatment for Arthritis
Unfortunately, there is no cure for arthritis. The goal of treatment is often to limit pain and inflammation while ensuring optimal joint function. Each treatment plan designed by a physician should be specifically tailored to the individual’s type of arthritis, as well as the severity of the condition. Treatment plans often involve both short-term and long-term relief approaches including the following:Short-term relief:
Medications
Short-term relief for pain and inflammation may include pain relievers such as acetaminophen, aspirin, ibuprofen or other non-steroidal anti-inflammatory medications.
Heat and cold
Whether to use hot or cold applications on affected joints depends on the type of arthritis present and the recommendation of your physician. Pain relief may be obtained temporarily by using moist heat (warm bath or shower) or dry heat (heating pad) on the joint. Pain relief may also be obtained by placing an ice pack wrapped in a towel on the joint. Cold applications help reduce swelling, as well. However, people who have poor circulation should not use ice packs. Consult your physician regarding the type of application and application time before use.·
Joint immobilization
The use of a splint or brace can help a joint rest and protect it from further injury. Walking devices such as canes, crutches, and assistive devices with extra large or longer handles help keep stress off certain joints.
Massage
The light stroking and/or kneading of painful muscles may increase blood flow and bring warmth to the muscle.
Transcutaneous electrical nerve stimulation (TENS)
Pain may be temporarily relieved with the use of a small TENS device that directs mild, electrical pulses to nerve endings beneath the skin in the painful joint area. TENS blocks pain messages to the brain and modifies pain perception.
Long-term relief: Medications
There are several types of medications that may be used long-term to reduce pain and symptoms including the following:
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Nonsteroidal anti-inflammatory medications
These medications, such as aspirin and ibuprofen, help to reduce pain and inflammation.
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Disease-modifying anti-rheumatic medications
These prescription medications may affect the course of the disease by slowing down its progress and influence and/or by correcting immune system abnormalities that are linked to the disease. Examples of disease-modifying anti-rheumatic medications include methotrexate, hydroxychloroquine, penicillamine and gold injections.
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Corticosteroids
Corticosteroids are medications that contain hormones to treat rheumatic diseases. These medications, such as prednisone, can be taken orally or as an injection.
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Weight reduction
Extra weight puts more stress on weight-bearing joints such as the hips and knees. Weight loss in overweight people has shown to reduce the chance of developing certain types of rheumatic disease, including osteoarthritis.
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Exercise
Certain exercises, such as swimming, walking, low-impact aerobic exercise and range of motion exercises, may help reduce joint pain and stiffness. Stretching exercises may be helpful in keeping the joints flexible.
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Surgery
In severe cases of rheumatic disease, surgery may be necessary to repair or replace a joint. There are two main types of surgery for arthritis and other rheumatic diseases including the following:o
– Repair – Surgery to repair a damaged joint may include removing debris in the joint, fusing bones or correcting a bone deformity.o — – Replace – If a joint is too damaged for repair, it may need to be replaced with an artificial joint. -
Pacing yourself
To conserve energy and reduce stress on your joint(s), alternating periods of activity with periods of rest can help protect your joints and minimize symptoms of arthritis.