Osteoarthritis
Basic Information
Osteoarthritis is the most common type of arthritis. Arthritis refers to any condition where there is inflammation of the joints. Osteoarthritis, also called "degenerative joint disease", is caused by the wearing away of the cartilage that covers the bone-ends that meet at the joints. Cartilage is a kind of tissue that absorbs shock, provides flexibility, and protects the joints. It also supports the bones. As cartilage degenerates, it becomes thin and abrasive, which increases the friction that occurs when bones move against each other at the joint. In severe cases of osteoarthritis, the cartilage can break down to such an extent that the bones actually rub against each other. Additionally, when cartilage has broken down to a sufficient extent, the bone ends develop bony growths (called bone spurs) that can further inflame the joint. Osteoarthritis eventually causes stiffness and swelling of the joints. Typically, it is a gradually disabling disease, in which there is mild pain or discomfort that can be alleviated with reset. There are some cases, however, in which it results in severe pain or loss of mobility.
In many cases, this deterioration of the cartilage is a natural process that happens with age. Normally, osteoarthritis affects the spine, knees, shoulders, hands, feet, and the hip. Unlike rheumatoid arthritis, it does not spread through the entire body, but remains in the specific joints it initially affects. For the most part it affects the joints that bear the majority of the body's weight, and it is also more likely to occur in a joint that has been previously injured.
There are other factors that can increase the possibility of developing osteoarthritis. It is thought that people can be genetically predisposed to developing osteoarthritis. Also, people who are overweight are more likely to be affected because the excess weight puts additional stress on the weight-bearing joints, particularly the knees. If a person develops osteoarthritis, it is very important that they reduce their weight in order to prevent rapid deterioration of the joints. Poor posture, lack of exercise, overuse of the joints, and naturally defective cartilage can all increase the risk of being affected.
Osteoarthritis is extremely common. An estimated 16 million Americans have the condition to some extent. The incidence of osteoarthritis greatly increases with age. A third of all people over the age of sixty have the condition, and of those people over the age of seventy, more than seventy-five percent are affected. Women are more likely to develop osteoarthritis than men.
Symptoms
The symptoms of osteoarthritis include:
- pain, aches and stiffness in the joints
- enlargement of the last joint of the fingers
- bony swelling in the joint
- crackling noises when the joint is moved
- mild inflammation in a joint; it is rheumatoid arthritis that causes intense inflammation
- loss of joint mobility
The pain associated with osteoarthritis is extremely variable. In most cases, it goes away with rest. It typically increases at night and during humid weather. It can also be brought on by injury or after a period of elevated physical activity. Conversely, stiffness often results from inactivity, and can be relieved by stretching. Many people say that they do not feel the pain directly at the joint, but in the area surrounding. As the condition progresses, the pain becomes more constant.
When osteoarthritis occurs in the knees, it can cause intense pain and swelling. It often results in grating. This is an especially sensitive joint because it bears so much of the body's weight. In advanced stages, an osteoarthritic knee can make it difficult to move around, particularly when it comes to the negotiation of stairs.
In osteoarthritis of the hip, there is usually pain around the groin, the buttocks or inner thigh. It sometimes causes the person to walk with a limp.
With osteoarthritis of the fingers, the person often develops bony lumps in the joints, particularly at the first digit. These are referred to as "Bouchard's nodes". It is more common in women than men.
Osteoarthritis of the spine can cause stiffness of the back, muscles spasms, and reduced mobility. In some cases, the affected person complains of sensations of pressure directly on both the spine and the nerves that pass through the spinal cord. When these sensations are present, there is some chance that the person will also experience problems with swallowing, loss of balance, problems with bladder control, numbness and muscle weakness.
Finally, osteoarthritis in the feet usually debilitates the joint at the base of the big toe. Stiffness or bony lumps may result.
Diagnosis/Treatment
During a medical examination, a doctor will begin with the person's symptoms, and may ask if there is a history of osteoarthritis in the person's family. They may also inquire if the person has ever injured the affected joint.
During a physical examination, a doctor may feel the joints for any kind of bony growth, tenderness or swelling. A doctor may also gently extend and move the joints to test for limited mobility or crackling sounds.
In some cases, a doctor may perform a blood test. When a person has osteoarthritis, the substance called hyaluronic acid which provides lubrication in the joints decomposes. This decomposition can be detected in a blood test. Using this test as a diagnostic tool, the doctor can also determine to what extent the disease has damaged the affected joints. Blood tests will also pick up elevated levels of C-reactive protein, a substance that the body makes in order to alleviate inflammation. If there are high levels of this substance in the body, it is often a sign that the person has developed osteoarthritis in the knee.
An X-ray can reveal if a person has suffered from any bone damage as a result of osteoarthritis. An X-ray can also show the extent of any cartilage deterioration.
In order to confirm a diagnosis, a doctor may also perform an extraction of the synovial fluid. The synovial fluid is a substance that encases the joint. If there are cartilage cells present in the fluid, it is likely that the person has osteoarthritis.
Although osteoarthritis cannot be prevented or cured, early detection of the disease can be extremely helpful when it comes to managing the symptoms and slowing down the progression of the joint damage. If left untreated, the disease can cause a great deal of pain and potentially demobilize the affected person. Treatment focuses on relieving symptoms, maintaining flexibility of the joints, and neutralizing the disease's progress. Treatment is usually successful at mitigating the negative effects of osteoarthritis.
In most cases, treatment consists of resting the joints, exercise, and medication to reduce swelling. Personal relaxation methods that focus on breathing or light stretching are helpful. Exercise is very important because it increases the strength of the muscles surrounding the joint, which reduces strain on the joint. Conversely, it is important not to overwork the joint. If inflammation or an injury occurs, it is essential that the person allow the affected area time to heal. Taking this into consideration, it might be a good idea to consider lighter, less impact forms of exercise.
Another form of treatment that can reduce strain on the joint is proper diet. If a person is obese, they can greatly mitigate the joint pain by losing weight. Loss of weight can also slow down the disease's progress, which can be accelerated by excess pressure placed on the joints due to obesity.
Another possible treatment is using either hot or cold compresses. How long the compress should be kept on the joint, or which degree of temperature is more effective, depends on the person. It is suggested that a person does not leave the compress on for longer than twenty minutes. While heat is generally used to loosen the muscles, cold can reduce the pain caused by a sore joint.
Doctors try to avoid prescribing medications because some medications have undesirable side effects. However, if diet and exercise prove ineffective when it comes to managing symptoms, it might be necessary to resort to medications. There are many types of medication that can be used to reduce pain caused by osteoarthritis. Some of these medications are available without prescription.
A common drug that a doctor might recommend is an analgesic, which is a pain reliever. Analgesics, such as acetaminophen, generally do not irritate stomachs like some other pain relievers do. In order to be effective, it ought to be taken regularly. While analgesics can successfully mitigate pain, they do not alleviate inflammation or swelling.
Another popular form of over-the-counter treatment is topical pain relievers. Topical pain relievers are sprays or creams that can be directly applied to the affected join, and which can relieve pain for short periods of time. While most of these medications do not induce side effects, some people comment that they can sting or burn when applied to the skin.
Drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) can also be used to treat symptoms associated with osteoarthritis. Unlike analgesics, they not only alleviate pain, but also reduce inflammation of the joints. Of all the NSAIDs, doctors typically recommend ibuprofen and naproxen because they are both effective and do not usually have negative side effects. Aspirin, another NSAID, can cause stomach irritation, and in some instances can lead to ulcers.
Corticosteroids are a last resort medication used to treat symptoms of advanced osteoarthritis, and cases where the patient does not respond to mild therapy. While corticosteroids can reduce both pain and swelling, they often have negative side effects. They are administered as an injection directly into the affected joint.
Typically, medication successfully relieves the symptoms of osteoarthritis. There are occasions, however, when surgery becomes necessary. Most people who develop osteoarthritis will never need to undergo surgery. In the past, surgery has been used to correct abnormalities in the joint, to prevent the joint from becoming misshapen, to replace the joint, and to remove bone spurs. Surgery has been very successful at increasing the person's range of motion, and at relieving pain.
In almost all scenarios, people are able to manage the symptoms of osteoarthritis and lead healthy, active lives.