Osteoarthritis (OA), "degenerative joint disease", is the most common form of arthritis and a leading cause of disability in North America. It occurs most often in people of middle age or older and in joints that have suffered injury. It affects more than 21 million Americans. Women are affected at a younger age than men and at a rate three times that of men. By age 65, more than half of the population has x-ray evidence of osteoarthritis in at least one joint.
OA is caused by the degeneration of the joint cartilage generally due to wear and tear on the joints. Cartilage is a smooth, rubbery tissue that covers the ends of bones, acting as a shock absorber in the joint. It becomes irritated and inflamed with OA. It then becomes rough and pieces will break off and move around within the joint. If enough damage occurs, the bone underneath will be left unprotected and outgrowths of bone (osteophytes) can form.
Risk factors include age, poor posture, obesity, injury to the joint, and congenital joint deformity. Weight bearing joints are most likely to be affected and include the ankles, knees, hips, neck and lower back. Family history of OA is also a factor in its development.
The symptoms of osteoarthritis are pain, stiffness, swelling of the affected joints and loss of movement. In some cases, crackling sounds can be heard when the affected joint is moved. Some people experience a crunching feeling of bone rubbing on bone.
A physician can diagnose OA based on a physical exam and a history of symptoms. X-rays are used to confirm the diagnosis. X-rays can show cartilage loss, bone damage and bone spurs.
Treatment for OA begins with pain relievers and progresses to nonsteroidal anti-inflammatory drugs and corticosteroidal injections. Surgery may be performed to resurface bones, reposition bones or replace joints.
Exercises help keep joints flexible and improve muscle strength. Stretch exercises are especially helpful. Heat or cold therapy is used as a temporary pain reliever. Many spas and fitness centers offer water exercises to help strengthen joints without stressing them and causing further damage.
Weight control is another method to prevent extra stress on weight bearing joints. Research shows that a ten pound weight loss results in taking a 30-pound load off your hips and knees. It will also decrease your risk of knee OA by 50%.
A relatively new treatment involves injecting a viscous fluid into the knee joint. It acts as lubrication for the joint and as a shock absorber to cushion the joint. This usually involves injecting the fluid into the joint three times, seven days apart over a 15-day period. This treatment lasts up to a year before requiring another treatment.
Patients need to learn to recognize their body's signals to prevent pain caused by over exercising. Some patients find that relaxation techniques, stress reduction and biofeedback help. Some use cause and splints to protect joints and take pressure off them. Care must be taken in the use of splints as joints and muscles need to be exercised to prevent stiffness and weakness.
Some of the effects of osteoarthritis include depression, anxiety, feelings of helplessness, limits on daily activities, job limitations, loss of everyday activities and the cost of treatment. To reduce pain and swelling, it is important to exercise but not over-exercise the affected joints and to seek treatment from your physician. A positive mental outlook and the support of friends and family members is essential in minimizing the effect of arthritis upon a patient's well-being and ability to perform daily activities.
References:
University of Washington Orthopaedics and Sports Medicine
Arthritis Foundation
National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse
All about arthritis.com
Arthritis.com
