Osteoarthritis

Osteoarthritis (AH-stee-oh-ar-THREYE-tis)Â is the most common type of arthritis, particularly among older people. Sometimes it is called degenerative joint disease or osteoarthrosis.

Osteoarthritis is a joint disease that primarily affects the cartilage. Cartilage is on the surface of the bones allowing them to glide over one another. In osteoarthritis, the cartilage breaks down and wears away, causing bones under the cartilage to rub together, leading to pain, swelling, and loss of motion of the joint. With progression bone spurs may grow on the edges of the joint.

Osteoarthritis is one of the most frequent causes of physical disability among adults affecting more than 20 million people in the United States. Before age 45, more men than women have osteoarthritis, whereas after age 45, it is more common in women.

Researchers have not yet identified the cause for osteoarthritis, but a combination of factors are suspected, including obesity, the aging process, joint injury, and stresses on the joints from certain jobs and sports activities.

Symptoms

Osteoarthritis affects each person differently. Generally symptoms develop slowly, pain may be mild at first and progress to severe pain with limited joint motion. Early symptoms include joint aches after physical work or exercise. The joints most commonly affected by osteoarthritis include the knees, hips, fingers, thumbs, neck and lower back and presents differently in each.

  • Hands: May develop small, bony knobs appear on the joints of the fingers. Fingers can become enlarged and gnarled, and they may ache or be stiff and numb. The base of the thumb joint also is commonly affected by osteoarthritis.
  • Knees: The knees are the body’s primary weight-bearing joints. For this reason, they are among the joints most commonly affected by osteoarthritis. They may be stiff, swollen, and painful, making it hard to walk, climb, and get in and out of chairs and bathtubs. If not treated, osteoarthritis in the knees can lead to disability.
  • Hips: Osteoarthritis in the hip can cause pain, stiffness, and severe disability. People may feel the pain in their hips, or in their groin, inner thigh, buttocks, or knees. Walking aids, such as canes or walkers, can reduce stress on the hip.
  • Spine: Stiffness and pain in the neck or in the lower back can result from osteoarthritis of the spine. Weakness or numbness of the arms or legs also can result.

Diagnosis

No single test can diagnose osteoarthritis, however a thorough medical history and physical examination are often sufficient to establish the diagnosis. X-rays of the involved joints may help to confirm the diagnosis and assess the severity of the condition. Laboratory testing may be ordered in order to rule out other similarly presenting conditions.

The doctor will try to find out what is causing the symptoms by ruling out other disorders and identifying conditions that may make the symptoms worse. The severity of symptoms in osteoarthritis is influenced greatly by the patient’s attitude, anxiety, depression, and daily activity level.

Treatment

Most successful treatment programs involve a combination of therapies tailored to the patient’s needs, lifestyle, and health. Osteoarthritis treatment has four general goals:

Osteoarthritis treatment plans often include ways to manage pain and improve function. Such plans can involve exercise, rest and joint care, physical therapy, pain relief, weight control measures, medications, injections, surgery, and nontraditional treatment approaches.

  • Exercise: Research shows that exercise is one of the best treatments for osteoarthritis. Exercise can improve mood and outlook, decrease pain, increase flexibility, improve the heart and blood flow, maintain weight, and promote general physical fitness. Aerobic, non-aerobic and aquatic exercises may be utilized; check with you doctor or physical therapist before starting an exercise program.
  • Rest and joint care: Patients must learn to recognize the body’s signals, and know when to stop or slow down, which prevents pain caused by overexertion. Some use canes and splints to protect joints and take pressure off them. Splints or braces provide extra support for weakened joints. They also keep the joint in proper position during sleep or activity.
  • Physical therapy: A guided physical therapy program can improve pain, increase muscle strength and improve joint mobility.
  • Nondrug pain relief: Warm towels, hot packs, or a warm bath or shower to apply moist heat to the joint can relieve pain and stiffness. In some cases, cold packs can relieve pain or numb the sore area. (Check with a doctor or physical therapist to find out if heat or cold is the best treatment.) Water therapy in a heated pool or whirlpool also may relieve pain and stiffness.
  • Weight control: Weight loss for those who are overweight or obese can can reduce stress on weight-bearing joints and limit further injury. A dietitian can help patients develop healthy eating habits. A healthy diet and regular exercise help reduce weight.
  • Medications: Doctors may prescribe medicines to eliminate or reduce pain and to improve functioning. The decision on the type of medication depends on the intensity of the pain, location of the pain and the potential side effects of the medicine. Oral and topical formulations are available.
  • Injections:
    • Corticosteroids (or “cortisone”) may be injected into the arthritic joint to temporarily relieve pain. This is a short-term measure, generally not recommended for more than two or three treatments per year.
    • Hyaluronic acid, another medication for joint injection. This substance is a normal component of the joint, it helps to lubricate and absorbs shock in the joint. It is indicated for those individuals who do not get relief from exercise, physical therapy, or simple analgesics.
    • Platelet rich plasma (PRP) and Stem cell injections: There are several newer injectable formulations available, ask your doctor if they are appropriate for you.
  • Surgery: For many, surgery helps relieve the pain and disability of osteoarthritis.
  • Nontraditional Approaches: Among the alternative therapies used to treat osteoarthritis include acupuncture, folk remedies (ie. herbs, bracelets, etc…) or nutritional supplements (glucosamine and chondroitin sulfate).