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Osteoarthritis

What Is Osteoarthritis?

Osteoarthritis is the most common type of arthritis and is seen especially among older people. Sometimes it is called degenerative joint disease or osteoarthrosis.

Why does osteoarthritis occur?

Osteoarthritis mostly affects cartilage, the hard but slippery tissue that covers the ends of bones where they meet to form a joint.   Healthy cartilage allows bones to glide over one another. It also absorbs energy from the shock of physical movement. In osteoarthritis, the surface layer of cartilage breaks and wears away. This allows bones under the cartilage to rub together, causing pain, swelling, and loss of motion of the joint. Over time, the joint may lose its normal shape. Also, small deposits of bone—called osteophytes or bone spurs—may grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space. This causes more pain and damage.

Causes of Osteoarthritis:
 The cause of OA is not yet known, but certain factors increase the risk of developing OA

  • Heredity
  • Overweight
  • Joint injury
  • Repeated overuse of certain joints
  • Lack of physical activity
  • Nerve injury
  • Aging

Who develops Osteoarthritis?

Osteoarthritis is by far the most common type of arthritis, and the percentage of people who have it grows higher with age.

Age:   Although osteoarthritis becomes more common with age, younger people can develop it, usually as the result of a joint injury, a joint malformation, or a genetic defect in joint cartilage. Both men and women have the disease.

Sex:  Before age 45, more men than women have osteoarthritis; after age 45, it is more common in women.

Overweight: Because in an overweight individual joints have to bear extra weight, knee joints gets damaged and leads on to development of osteoarthritis

Jobs:  Jobs which puts lot of strain on the knees may lead on to development of osteoarthritis.

What Areas Does Osteoarthritis Affect?

Most common areas affected by osteoarthritis are knee joints  and hip joints. Other joints like cervical spine (Cervical spondylosis), lumbar spine (lumbar spondylosis) and fingers  also can get affected.
It usually does not affect wrist and elbow.

What are the symptoms of osteoarthritis?

People with osteoarthritis usually experience pain in the joints. Usually, osteoarthritis comes on slowly. Early in the disease, joints may ache after physical work or exercise. Later on, joint pain may become more persistent.  The joint pain which affects these joints increases with activity. For eg: pain in the knee increases with squatting or climbing stairs etc. The pain gradually becomes severe but only very rarely causes rest pain. Patients may also experience joint stiffness, particularly when they first wake up in the morning or have been in one position for a long time. These patients also can develop deformity like bending of knee. Swelling of the joints is usually not seen in osteoarthritis and may indicate some other pathology. Unlike rheumatoid arthritis osteoarthritis do not affect internal organs.

How is osteoarthritis diagnosed?

Osteoarthritis is diagnosed based on clinical examination as well as by taking Xrays. X-ray usually reveals loss of joint space in these patients. Recent developments has helped to detect changes in MRI which can predict future development of osteoarthritis.

What are the treatment options for osteoarthritis?

Main goal of osteoarthritis treatment are to improve the functionality of the patient by relieving the pain. Along with these physicians try to prevent the progression of osteoarthritis. Treatment plans often include a combination of drugs, rest, physical activity, joint protection, use of heat or cold to reduce pain, and physical or occupational therapy.

Weight loss: For every one pound of weight lost, there is a four pound reduction in the load exerted on the knee for each step taken during daily activities. It has also been shown that if a osteoarthritis patient loses 5kg of weight the pain decreases by 50%.

Exercise: Exercise plays a very important role in the management of osteoarthritis. It has been shown consistently that quadriceps strengthening exercise is an integral step in the management of osteoarthritis ( figure 7).

Pain relievers: During acute exacerbation pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce joint pain, stiffness and swelling.

Drugs : Only supplement which has been proen to be effective in the management of ostseoathritis is Glucosamine. Most of other neutraceuticals have been disappointing in well conducted clinical trials,although manufactures claims are very high

Surgery: Surgery in the form of joint replacement has seen major advances during last 2 decades. This is an important consideration in people with advanced Osteoarthritis associated with joint damage and/or marked limitations in joint function.