What is Osteoarthritis?
Osteoarthritis is a chronic 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 (DJD). It is the most common form of arthritis.
What are the symptoms of osteoarthritis?
Pain is the most common symptom of osteoarthritis after overuse 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. Causes and Risk Factors
In osteoarthritis, the breakdown of cartilage in the joint and adjacent bone occurs. As the cartilage wears down, it becomes thinner, and 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 include: are associated with osteoarthritis, including the following:
• Heredity
Slight joint defects or double-jointedness (laxity) and genetic defects may contribute to the development of osteoarthritis.
• Obesity
Excessive weight can over time put undue stress on such joints as the knees . 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.
• Female Gender
• Sports activities
Diagnosis
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 (with a needle) - involves a removal of fluid from the swollen bursa to exclude infection or gout as possible causes.
Treatment
Treatment for osteoarthritis is designed to reduce joint pain and stiffness, and improve joint movement. Treatment may include:
• Exercise
Regular, aerobic exercise, and stretching and 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.
Specific treatment for osteoarthritis will be determined by your physician based on your:
• age, overall health, and medical history
• extent of condition
• tolerance for specific medications, procedures, and therapies
• expectation for the course of the condition
• opinion or preference
Medication Choices
Drugs that may be used to treat osteoarthritis include:
Analgesics - e.g., Tylenol, codeine, oxycodone, or propoxyphene
Anti-Inflammatories (NSAIDS) - e.g., aspirin, ibuprofen, naproxen, and selective COX-2 inhibitors such as celecoxib (Celexa) and etoricoxib
Steroids - for intraarticular Injection - e.g., triamcinolone and methylprednisolone
Hyaluronans - for intraarticular Injection - e.g., sodium hyaluronate (Hyalgan, Supartz, and Nuflexxa)
References:
1. Cooper, C, Egger, P, Coggon, D, et al. Generalized osteoarthritis in women: pattern of joint involvement and approaches to definition for epidemiological studies.
2. J Rheumatol 1996; 23:1938. Hochberg, MC. Prognosis of osteoarthritis. Ann Rheum Dis 1996; 55:685. Kirwan, JR, Elson, CJ.
3. Is the progression of osteoarthritis phasic? Evidence and implications. J Rheumatol 2000; 27:834.
4. Reijman, M, Hazes, JM, Bierma-Zeinstra, SM, et al. A new marker for osteoarthritis: cross-sectional and longitudinal approach. Arthritis Rheum 2004; 50:2471.
5. Steultjens, MP, Dekker, J, Bijlsma, JW. Avoidance of activity and disability in patients with osteoarthritis of the knee: the mediating role of muscle strength. Arthritis Rheum 2002; 46:1784
6. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum 2000; 43:1905.
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