Osteoarthritis

Osteoarthritis, also known as OA, represents a condition that causes joint inflammation, which is a consequence of cartilage degeneration. More specifically, it harms the slippery tissue between the bones, which inevitably makes them to rub together and in time, change their normal shape. Moreover, there is a possibility for small fragments of bones to break off and remain suspended in the joint space, thus increasing severity of damage and implicitly, symptoms. This common type of arthritis mostly affects elders and manifests with pain and stiffness in the respective area. However, young people who experienced joint injuries can become susceptible to this condition. Even though any joint in a person’s body can suffer damage provoked by osteoarthritis, it generally targets the spine, hips, hands and knees. When establishing a diagnosis, doctors perform several procedures helpful for ruling out other potential problems, except for blood tests. This allows them to provide medical treatment for the patient with osteoarthritis while taking into consideration the affected joint. The main goal is to maintain joint function and relieve the painful symptoms by using medications, alternative therapies and even surgery. Fortunately, this condition does not affect internal organs, in comparison to other forms of arthritis.

 

Causes of Osteoarthritis

Normally, daily exposure of joints to low damage does not cause symptoms because the body acts immediately in order to ensure protection. Nevertheless, osteoarthritis destroys the protective cartilage of bones leading to swelling, pain and mobility problems. Furthermore, it can provoke the appearance of bony growths and inflammation of the area in question. Specialists cannot explain the main cause that leads to the development of osteoarthritis, but they do acknowledge several risk factors linked to this condition, including:

  • Age: Elders face a higher possibility of developing osteoarthritis.
  • Family history: Although researchers have not discovered a single gene accountable for this condition, they still believe that osteoarthritis may run in the family.
  • Joint injuries: People who play demanding sports as well as those who suffered an accident recently or in the past that required operation can also expect to suffer from osteoarthritis at some point in their life.
  • Obesity: Extra body weight represents a risk factor because it adds more stress on joints than normally, especially on knees and hips, not to mention that proteins produces by fat tissue can lead to joint inflammation.
  •  Other conditions: Previously or currently having a condition that provokes severe damage to the joints, namely gout or rheumatoid arthritis, practically exposes a person to the chance of developing osteoarthritis.

In terms of complications, being a degenerative disease, osteoarthritis worsens in time causing severe symptoms that impede performing daily tasks and activities. Because work becomes mission impossible for some people, doctors may resort to surgery for joint replacement.

 

Symptoms of Osteoarthritis

People with osteoarthritis mainly experience stiffness and pain in the affected joints, which obstructs their mobility as well as the ability to engage in certain activities. In severe cases, symptoms are continuous while in mild cases, factors like activity levels and weather can trigger specific symptoms of osteoarthritis. Apart from the most obvious signs that help doctors diagnose this condition, namely pain and stiffness after a longer period of inactivity, other symptoms involve muscle wasting and weakness, joint tenderness, crackling sounds in the respective area, slightly larger appearance of the joints, and limited range of motion. Although practically any joint in the body can suffer damage caused by osteoarthritis, hips, knees and hands are the major areas.

  • People with osteoarthritis of the hip sometimes encounter difficulties walking, putting their shoes on or getting into the car. The pain worsens during movement but it can also remain present during rest or sleep. Because patient may experience pain in other areas like thigh, groin, buttocks and knees, doctors must pay close attention when establishing a diagnosis.
  • Osteoarthritis of the knee makes simple accomplishments, such as walking up a hill or climbing down the stairs, challenging missions that cause pain. Those suffering from this condition are not able to straighten their legs properly and they hear grating sounds when moving the affected joint.
  • Osteoarthritis of the hand can lead to swollen, painful and stiff fingers as well as bumps development on finger joints. The pain will eventually disappear but the swelling and bumps usually remain. In some people, the fingers bend sideways or present painful cysts, which are lumps filled with fluid. Manual tasks like writing and opening jars become difficult to perform because of the pain.

 

Diagnosis of Osteoarthritis

Before establishing a diagnosis of osteoarthritis, doctors start by gathering information concerning the patient’s medical history and symptoms then proceed by performing a physical examination of the affected joint with the purpose to notice potential signs of bony swelling, tenderness and redness, muscle thinning, joint instability, excess fluid, creaking sounds and reduced movement. Even though blood tests cannot help doctors diagnose osteoarthritis, they are useful for excluding other arthritis conditions with similar symptoms. Furthermore, imaging and laboratory tests allow doctors analyze detailed images of the damaged joint as well as blood and joint fluid, thus reaching an accurate conclusion and providing the proper treatment for the patient.

  • X-rays in patients with osteoarthritis usually reveal loss of joint cartilage, formation of bone spur and limited joint space.
  • Magnetic resonance imaging (MRI) produces images of the patient’s bone and soft tissue using a strong magnetic field and sound waves. The purpose of MRI is to provide additional details regarding osteoarthritis in complex cases.
  • Arthroscopy represents a surgical technique that allows doctors detect and sometimes repair abnormalities and damage of the ligaments and cartilage. Generally, patients recover quickly from the arthroscopic surgery.
  • Joint aspiration is a procedure that consists in removing joint fluid with the help of a sterile needle for analysis purposes. Consequently, doctors can exclude other potential causes of the symptoms including infection and gout. When removing joint fluid, they also inject corticosteroids to relieve inflammation and pain.

 

Healthy Joint vs. Osteoarthritis

 

Treatment for Osteoarthritis

Doctors are well aware that osteoarthritis has no cure and for this reason, when providing medical treatment their main priority is to reduce the symptoms with medications, physical therapies, lifestyle changes and surgery. Moreover, exercising and maintaining a healthy weight are imperative when living with this type of arthritis. Treating this condition demands work team between the patient and several health care professionals including primary care doctors, rheumatologists, orthopedists, physical therapists, dietitians, rehabilitation specialists, chiropractors and massage therapists, among others.

Medications: The doctor will recommend a certain type of painkiller after determining the severity of the pain and inquiring about other existent conditions or health problems. Non-steroidal anti-inflammatory drugs (NSAIDs) represent a solution when over the counter medications that do not require a prescription do not provide the much-needed effects because they are much stronger. NSAIDs refer to ibuprofen, naproxen and COX-2 inhibitors, which have the purpose to reduce inflammation. Patients can also apply cream on the affected areas to ease pain and reduce swelling. Some people with certain conditions like angina or asthma or those who experienced a heart attack or stroke in the past may not have the permission to take NSAID tablets. Opioids are other painkillers that can help the patient cope with the pain but they usually come along with unpleasant side effects including nausea, drowsiness and constipation. Doctors can recommend opioids in tablet form or inject them directly into the patient’s vein, except for those with epilepsy or chronic obstructive pulmonary disease (COPD). Doctors intervene with corticosteroid injections when the osteoarthritis does not respond to painkillers. These injections have the power to fight against characteristic symptoms like pain and swelling. However, the patient can only receive three corticosteroid injections annually.

Supportive treatments: Thermotherapy, which consists in applying hot or cold packs on the damaged joints, can prove to be quite beneficial for some people with osteoarthritis because it reduces pain as well as other symptoms of the condition. A physiotherapist can provide manual therapy as treatment by helping the patient learn stretching techniques for maintaining joint flexibility and suppleness. Inactivity can provoke muscle waste and increase stiffness. If the patient has mobility problems or encounters difficulties in performing normal everyday tasks, an occupational therapist can teach him to use assistive devices in his benefit. For instance, when dealing with patients suffering from osteoarthritis in the legs, the occupational therapist may recommend special footwear or adding shock-absorbing soles to his current shoes to liberate the joints from the pressure caused by walking. Moreover, leg supports and braces spread the body’s weight more evenly. Patients who suffer from osteoarthritis in the hands undoubtedly need assistance with certain tasks like turning on the kitchen tap and installing special devices both at home and at the workplace will facilitate their life.

Surgery: Doctors usually resort to surgery when other treatments do not offer a satisfactory result or when facing severe cases of osteoarthritis that caused major damage to one of the patient’s joints. This solution improves the symptoms and mobility, thus allowing the patient to enjoy a better life. In terms of surgery, doctors have several options including joint replacement, arthrodesis and osteotomy. Joint replacement consists in replacing the affected joint with an artificial one composed of metals and special plastics, which can last approximately 20 years. For younger patients, the surgeon may choose resurfacing, a type of surgery that involves just metal components. Arthrodesis requires joint fusion in a permanent position. Even though it practically obstructs movements, the patient will have a stronger and less painful joint. The doctor chooses this variant only when joint replacement is not suitable for the patient. Osteotomy is another alternative for joint replacement in people with osteoarthritis in the knee and consists in removing or adding a section of bone below or above the knee joint. The goal of this surgery is knee realignment by impeding the weight to focus on the affected part of the patient’s knee. Although it relieves the symptoms of osteoarthritis, the patient still needs to undergo knee replacement surgery at some point in the future.

Alternative therapies: Some people with osteoarthritis consider complementary and alternative therapies including aromatherapy and acupuncture very useful, although there is no medical evidence that supports their efficiency. Nutritional supplements, such as glucosamine and chondroitin can treat this condition without causing many unpleasant side effects. Furthermore, applying creams and gels on the area in question produces a warm and reddening effect, but they do not improve the symptoms of osteoarthritis.

Lifestyle changes: When battling this type of arthritis, people need to bring their own contribution by accepting to make some important changes in their lifestyle. Exercising and losing weight must gain priority in order to notice a significant difference in terms of osteoarthritis symptoms. The patient’s physical activity must rely on exercises combinations that have the purpose to strengthen his muscles and improve his general fitness. In addition, any psychotherapist can confirm that exercise relieves stress and improves posture. He can also inform the patient regarding all these benefits as well as create a personalized exercise plan for him. Following this plan exactly is very important because if the patient does unsuitable exercises or simply overreacts, he can end up causing more self-harm than good.  People who suffer from osteoarthritis and are obese may experience more severe symptoms due to the strain extra weight puts on the joints. Therefore, adopting a more balanced diet and reaching a more healthy weight will significantly improve the pain as well as the overall health.

The outlook for osteoarthritis is positive taking into consideration medical treatment and therapy. If the patient seeks medical advice as soon as he notices characteristic symptoms, he will receive the proper care, which will increase the quality of his life.

vlad

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