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Osteoarthritis

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Overview of osteoarthritis

Osteoarthritis is considered as the most common joint disorder, affecting individuals aged above 65 years worldwide. It is a chronic disorder of the joints characterized by continuous degeneration of the tissues of the joints.1 Osteoarthritis usually affects the joints of the hands, knees, hips and the spine resulting in pain, swelling stiffness and loss of mobility in these joints.2 However, most individuals may remain asymptomatic. It affects both men and women equally, though the occurrence is increased in case of women after the age of 55 years.

Signs and symptoms of osteoarthritis

Most of the individuals are asymptomatic for certain duration of time during which the destruction of the tissues is gradually progressing. The common symptom noted in individuals with osteoarthritis is the pain in the joints. The pain during the initial stages is generally restricted to the joints and is noticed during any activity involving the movement of the affected joint. This pain is relieved when the individual takes rest or consumes mild painkillers. As the disorder progresses the pain may not respond to medications. Stiffness of the joints in the mornings that lasts for less than half an hour may also be noted during the initial stages.4  

Osteoarthritis of the knees usually takes years together to progress and the chances of recovery of the joints are low. While, in case of osteoarthritis of the hip chances of recovery are high. Osteoarthritis of the joints of the hands may recur after regressing. Bony swellings may also be noted in case of the joints of the hands.1        

Causes of osteoarthritis

Although the exact cause of osteoarthritis is not known, recent researches have suggested that multiple risk factors may have a vital role in the occurrence of this disorder. The main factors that have been identified include heredity, environmental and biomechanical stresses. Other factors that are considered as potential risk factors include: age above 50 years, high amount of minerals in the bone, long-term immobilization of the joints, injury to the joints, obesity and prolonged stress to the joints (such as those due to occupation or sports).3 These factors result in chronic degeneration of the supporting tissues of the joints and leads to abnormal formation of the bone at the joints ultimately resulting in narrowing of the joint space.1   

Diagnosis of osteoarthritis

The diagnosis of osteoarthritis is based on a comprehensive review of the history of the condition, signs and symptoms noticed, physical examination and other investigations. The pain is noticed only in one or few joints while they may be symmetrically affected. Morning stiffness in these joints resolves within 30 min. The doctor performs certain physical tests on the joints to verify the ability to move the joints, check the swelling and the presence of pain in the joints. Certain blood tests and specialized evaluation of the fluid present normally within the joints may be advised to rule out the presence of other underlying disorders. Radiographs of the joints may also be advised to confirm the diagnosis though the findings do not always correlate with the stage or severity of the condition.3

Treatment of osteoarthritis

The treatment options given to the individual varies and is designed specifically for that individual based on the stage and severity of osteoarthritis.

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Various treatment options commonly employed include the following:

  • Disease education
  • Moderate exercises
  • Weight loss programs
  • Physiotherapy for the joints
  • Mechanical aids or appliances
  • Medications
  • Surgery

The affected individual is taught about the disease process and the risk factors associated with it. This helps one to understand the condition better and take precautionary steps to prevent further progression. Aerobics and mild flexing of the affected joints are taught to prevent the changes occurring due to immobility of the joints. Obese people have obtained significant relief after undergoing weight loss, which reduces the pressure on the affected joints. Shock absorbing footwear and walking sticks help the reduction of the impact on the joints while walking and makes it easier for the affected individual to walk around. Multiple medications that include simple painkillers, steroid injections and other medications are available for pain relief. Simple painkillers that are available as over-the-counter medications include ibuprofen, aceclofenac, diclofenac sodium and valdecoxib. These medications should always be taken under the doctor’s guidance. Surgery that involves the clearing of the diseased tissues of the joints or insertion of graft materials is some of the options available for individuals who are not relieved with nonsurgical procedures. Joint replacement is the ultimate treatment protocol, which provides relief of up to 20 years.1, 3

Alternative therapy of osteoarthritis

The alternative therapies that are available include ginger and other herbal supplements, mind–body interventions, counselling and acupuncture. However, these options are usually advised as an adjunct to the ongoing therapy with other options and are not efficient enough while used alone. A doctor’s opinion must always be taken before initiation of such therapies.5, 6

Complications for osteoarthritis

The possible complications of osteoarthritis include decreased ability to walk and perform daily activities along with those associated with long-term use of medications or surgery.

Prevention of osteoarthritis

There are no specific preventive measures to avoid the occurrence of osteoarthritis. The complications such as fracture in case of obese individuals can however be reduced by following weight loss programs. Mild exercises also prevent long-term immobilization of the joints thereby preventing further complications.

Living with osteoarthritis

The disability associated with osteoarthritis though severe at times can be managed effectively with proper treatment and care. Proper care helps the individual to overcome the symptoms associated with osteoarthritis more confidently.

References:

1. Haq I, Murphy E, Dacre J. Osteoarthritis. Postgrad Med J. 2003; 79: 377–383.

2. Goldring SR, Goldring MB. Clinical aspects, pathology and pathophysiology of osteoarthritis. J Musculoskelet Neuronal Interact. 2006; 6(4): 376–378.

3. Hinton R, Thomas SF. Osteoarthritis: Diagnosis and therapeutic considerations. Am Fam Physician. 2002; 65(5): 841–848.  

4. Altman RD, Lozada CJ. Clinical features of osteoarthritis. In: Hochberg, Silman, Smolen, Weinblatt, Weismann (eds). Practical Rheumatology. 2004: 503–510.

5. Rubin BR. Osteoarthritis. JAOA. 2001; 101(4): S2–S5.

6. Morelli V, Naquin C, Weaver V. Alternative therapies for traditional disease states: Osteoarthritis. Am Fam Physician. 2003; 67(2): 339–344.

Written by: healthplus24.com team

Date last updated: February 05, 2015