What is the main cause of osteoarthritis?
Risk factors for developing osteoarthritis include advancing age, obesity, trauma, family history of osteoarthritis, and more.
Osteoarthritis (OA) is a chronic degenerative disease of the joints affecting middle-aged and elderly people. It involves the breakdown of cartilage and associated inflammatory changes in the adjacent bone. It is a leading cause of chronic disability, affecting 30 million people in the United States alone. Osteoarthritis often affects the hips, knees, spine, and feet (weight-bearing joints) as well as the hands.
Risk factors for developing osteoarthritis include:
- Advancing age
- Family history of osteoarthritis
- Reduced levels of sex hormones
- Laborious tasks
- Muscle weakness
- Crystal deposition in the joints
- Diabetes mellitus
- Previous surgery
- Disorders of the bone
- Hormonal disorder
- Disorders of hemoglobin
- Joint deformities such as unequal leg length
- Nerve disorder
How would you know if you have osteoarthritis?
Signs and symptoms of osteoarthritis include:
- Joint stiffness usually observed after a period of immobility
- Joint pain exacerbated by prolonged standing
- Decreased joint flexibility
- Muscle weakness (muscle atrophy)
- Joint swelling
- Cracking sound when a joint bends
- Joint instability
- Bony growth at the edge of joints leads to swollen and tender finger
The progression of the disease is gradual. As osteoarthritis worsens, joints may change enlarge due to bony prominence.
What are the stages of osteoarthritis?
Based on disease progression osteoarthritis is classified as:
- Stage I: Breakdown of the cartilage occur
- Stage II: Formation of fibers (fibrillation) and erosion occurs on the surface of the cartilage, which can result in the release of complex proteins (collagen proteoglycans) into the synovial fluid found in the cavities of joints
- Stage III: These complex proteins induce an inflammatory response, which in turn further leads to complete cartilage breakdown
How is osteoarthritis diagnosed?
A physician diagnoses osteoarthritis by reviewing the symptoms, physically examining the joints, X-rays, and laboratory tests. Other methods that might be used are:
- Magnetic resonance imaging
- Computed tomography scan
- Bone scanning
- Arthrocentesis (aspiration of synovial fluid from the joint through a needle and syringe)
What joints are most often affected by osteoarthritis?
What is the best treatment for osteoarthritis?
Treatment of osteoarthritis aims to mitigate pain and improve the quality of life. A combination of medication, as well as adjunct therapy, can optimize outcomes. No proven treatments can reverse the joint damage; however, a combination of methods are frequently used in treating osteoarthritis.
Adjunct therapy involves:
- Heat and cold compress
- Weight loss
- Physical therapy such as massage and physiotherapy
- Occupational therapy
- Unloading in certain joints
Medications used in mitigating pain, inflammation, and relieving spasms are:
- Analgesics and anti-inflammatory: acetaminophen, diclofenac, ibuprofen, and tramadol
- Selective serotonin-norepinephrine reuptake inhibitor: duloxetine
- Corticosteroids: triamcinolone acetonide
- Muscle relaxants: carisoprodol
- Antirheumatics: sodium hyaluronate
If drug therapy fails to improve symptoms, the patient may require surgery:
- Osteotomy – Surgical cutting of the bone to reshape or align it properly
- Arthroplasty – Knee replacement surgery, hip replacement surgery
What should you keep in mind if you have osteoarthritis?
Patients suffering from osteoarthritis should take care of their joints by:
- Avoiding trauma to the joints
- Supporting the neck and back while sitting as well resting/sleeping
- Maintaining a proper posture while performing certain activities (bending at the knees and not at the back or waist while lifting objects from the floor)
- Avoiding frequent bending