Osteoarthritis

Description

Osteoarthritis is the most common form of arthritis, affecting millions of people around the world. This occurs when the protective cartilage that protects the ends of bones wears down over time.

Although osteoarthritis can damage any joint, the condition most commonly affects the joints of the hands, knees, hips, and spine.

Osteoarthritis symptoms can usually be managed, although the damage to joints can't be reversed. Staying active, maintaining a healthy weight and receiving certain treatments can slow the progression of the disease and help improve pain and joint function.

Symptoms

Osteoarthritis symptoms often develop slowly and get worse over time. Symptoms of osteoarthritis include:

  • Pain. The affected joint may hurt during or after movement.
  • Stiffness. The joint stiffness may be most noticeable when you wake up or after being inactive.
  • The tenderness. The joint may feel tender when you apply light pressure on or near them.
  • The loss of flexibility. You might not be able to move the joint through their full range of motion.
  • Grating sensation. You may feel a sense of grid when you use the joint, and you may hear popping or crackling.
  • The bone spurs. These extra bits of bone, which feel like hard lumps, may form around the affected joint.
  • Swefilling. This could be caused by the inflammation of the soft tissue around the joint.

When to see a doctor

If the joint pain or stiffness does not go away, make an appointment with your health care professional.

Causes

Osteoarthritis occurs when the cartilage that protects the ends of bones in the joints gradually wears away. The cartilage is a firm, slippery tissue that permits nearly frictionless joint motion.

Eventually, if the cartilage wears down completely, the bones rub on the bone.

Osteoarthritis does not affect only the cartilage. It also affects the whole. It causes changes in the bone and weakens the strong bands of tissue that hold the joint and attach the muscle to the bone. It can also cause inflammation of the lining of the joint.

Risk factors

Factors that can increase ther risk of osteoarthritis include:

  • Advanced age. The risk of osteoarthritis increases with age.
  • The sex assigned at birth. The people assigned female at birth are more likely to develop osteoarthritis, although it is not clear why.
  • Obesity. Excess body weight withtributes to osteoarthritis in several ways. The greater the weight, the greater is your risk. The increased weight adds stress to weight-bearing joints, such as hips and knees. Also, fat tissue produces proteins that can cause problems of swelling in and around the joints.
  • Lesions in the joints. Injuries, such as those that occur when playing sports or from an accident, you may increase the risk of osteoarthritis. Even injuries that occurred many years ago may increase the risk of osteoarthritis.
  • Repeated stress on the joint. If a job or a sports places repetitive stress on a joint, the joint may develop osteoarthritis someday.
  • Genetics. Some people inherit a tendency to develop osteoarthritis.
  • Deformities of the bones. Some people are born with malformed joints or defective cartilage.
  • Certain metabolic diseases. These include diabetes and a condition in which your body has too much iron, called hemochromatosis.

Complications

Osteoarthritis is a disease that gets worse over time, often resulting in chronic pain. Pain in the joints and stiffness of the can become severe enough to make daily tasks difficult.

Depression and sleep disorders can be the result of pain, stiffness and impaired mobility of osteoarthritis.

Osteoarthritis

Diagnosis

During the physical exam, your healthcare provider checks your affected joint for tenderness, swelling, and flexibility.

Imaging tests

To obtain images of the affected joint, your health care professional may recommend:

  • The x-ray. The cartilage does not show in X-ray images, but the loss of cartilage is revealed by a nscroll of the space between the bones in the joints. X-rays can also show bone spurs around the joint.
  • Magnetic resonance imaging (MRI). A magnetic resonance imaging (MRI uses radio waves and a powerful magnetic field to produce detailed images of the bones and soft tissues, including cartilage. An mri is not commonly necessary to diagnose osteoarthritis, but it can help provide more information in complex cases.

Laboratory tests

Analyzing blood or joint fluid can help to confirm the diagnosis.

  • Blood tests. Although there's no blood test for osteoarthritis, certain laboratory tests may help rule out other causes of pain in the joints, such as rheumatoid arthritis.
  • Joint fluid analysis. A needle can be used to remove the fluid from an affected joint. The fluid is then tested to determine if the pain is caused by an inflammatory arthritis, such as rheumatoid arthritis or gout, or infection instead of osteoarthritis.

Treatment

Osteoarthritis cannot be reversedd, but treatments can reduce the pain and help you move better.

Medications

Medications that can help relieve the pain of osteoarthritis symptoms include:

  • The paracetamol. Acetaminophen (Tylenol, others) has been shown to help some people with osteoarthritis who have mild to moderate pain. Taking more than the recommended dose of paracetamol can cause liver damage.
  • Nonsteroidal anti-inflammatory drugs (Nsaids).Common painkillers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), taken in the recommended doses, usually to relieve the pain of osteoarthritis. Stronger Nsaids are available by prescription. Nsaids can cause upset stomach, heart and blood vessel problems, bleeding problems, and liver and kidney damage. Nsaids such as gels applied to the skin over the affectedcted joint, have fewer side effects and can relieve pain just as well.
  • Duloxetine (Cymbalta). Although typically used as an antidepressant, duloxetine is also approved for the treatment of chronic pain, including pain from osteoarthritis.

Nonsteroidal anti-inflammatory drugs (Nsaids). Common painkillers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), taken in the recommended doses, tend to relieve the pain of osteoarthritis. Stronger Nsaids are available by prescription.

Nsaids can cause stomach upset, cardiovascular problems, bleeding problems, and liver and kidney damage. Nsaids such as gels, applied to the skin over the affected joint, have fewer side effects and can relieve pain just as well.

Therapy

  • The physical therapy. A physical therapist can show you exercises to strengthen the muscles around the joints, increasing flexibility and reducing pain. Regular gentle exercise that you do on your own, such as swimming or walking, can be equally effective.
  • Occupational therapy. An occupational therapist can help you find ways of doing everyday tasks without putting extra stress on a painful joint. For example, a toothbrush with a great grip, it could make brushing teeth easier if you have osteoarthritis in the hands. A bank in the shower can help to relieve foot pain if you have osteoarthritis of the knee.
  • Transcutaneous electrical nerve stimulation (TENS). This uses a low voltage electric current to relieve pain. Provides short-term relief for some people with knee and hip osteoarthritis.

Surgical and other procedures

If the conservative treatments do not help, you may want to consider procedures such as:

  • Injections of cortisone. Corticosteroid injections into the joint can relieve pain for a couple of weeks. The number of cortisone injections can receive each year is generally limited to three or four, because the drug can worsen the damage to your joints over time.
  • The lubrication of the injections. Hyaluronic acid injections can relieve pain, through and cushioning inthe knee, although some research suggests that these injections do not provide more relief than a placebo. Hyaluronic acid is similar to a component that is normally found in the joint fluid.
  • Realign the bones. If osteoarthritis has damaged one of the sides of the knee more than the other, an osteotomy may be useful. In an osteotomy of the knee, the surgeon will cut through the bone, whether it is above or below the knee and removes or adds a wedge of bone. This changes the weight of your body away from the worn part of the knee.
  • The replacement of the joint. In joining thet replacement surgery, the surgeon removes the damaged joint surfaces and replaces them with the plastic and metal parts. Surgical risks include infections and the formation of blood clots. Artificial joints can wear out or becomes loose and may need to be replaced.

Self-care

Learn all you can about your condition and how to manage it, especially about how lifestyle changes can affect your symptoms. Exercise and weight loss if you are overweight, are important ways to lessen the joint pain and stiffness of osteoarthritis.

  • Exercise. Low-impact exercise can increase your stamina and strengthen the muscles around the joint, making your joint more stable. Try walking, cycling or water aerobics. If you feel any new pain in the joints, stop.
  • To lose weight. Excess weight increases the stress on weight-bearing joints, such as knees and hips. Even the smallest amount of weight loss may relieve some of the pressure and reduce the pain. Talk with a dietitian about healthy ways to lose weight.

Other things to try include:

  • Movement therapies. Tai chi and Iga involve gentle exercises and stretches combined with deep breathing. Many people use these therapies to reduce the stress in their lives. And research suggests that tai chi and yoga can reduce the pain of osteoarthritis and improve movement. Make sure that the yoga andou choose is a gentle way, and that your instructor knows which of your joints are affected. Avoid movements that cause pain in the joints.
  • The heat and the cold. Heat and cold can relieve pain and swelling in the joints. Heat, especially moist heat, you can help muscles relax and relieve the pain. The cold can relieve muscle pain after exercise, and the reduction of muscle spasms.
  • The capsaicin. Capsaicin is an extract of chili pepper. The application of capsaicin cream to the skin through a painful arthritis of the joint can help with the pain. You may have to apply 3 to 4 times a day for several weeks before you see a benefit. Capsaicin causes a burning sensation or a burning sensation. Wash your hands well after you apply capsaicin cream.
  • NSAID gels. Topical nonsteroidal anti-inflammatory gel available without a prescription. These gels can help to alleviate pain when applied to the skin over the affected joint.
  • Orthotic devices or shoe inserts. Shoe inserts or other devices can help to reduce pain when standing or walking. These devices can support the joint to relieve the pressure on the joint.
  • Assistive devices.Assistive devices can help to relieve the stress on your joints. A cane or a walker to keep weight off your knee or hip as you walk. Hold the cane in the hand opposite the leg that hurts. Tools for grab-and-grab can make it easier to work in the kitchen if you have osteoarthritis in the fingers. Check the catalogs and medical supply stores or ask your health care team about the assistive devices.

Assistive devices. Assistive devices can help to relieve the stress on your joints. A cane or a walker take the weight in your knee or hip as you walk. Hold the cane in the hand opposite the leg that hurts.

Tools for grab-and-grab can make it easier to work in the kitchen if you have osteoarthritis in the fingers. Check the catalogs and medical supply stores or ask your health care team about the assistive devices.

Alternative medicine

Complementary and alternative medicine treatments that have shown promise for osteoarthritis include:

  • Acupuncture. Some studies indicate that acupuncture can relieve pain and improve function in people with osteoarthritis of the knee. During acupuncture, hair-thin needles are inserted into the skin at precise points on your body.
  • The glucosamine and chondroitin. The studies have been contradictory about these nutritional supplements. Some have found no benefit for people with osteoarthritis, while most indicate that these supplements work better than a placebo.
  • Omega-3 fatty acids. Omega-3 are found in fatty fish and fish oil supplements, mflight help relieve pain and improve function.

Talk with your health care team about the supplements you are considering.

Coping and support

Their ability to cope in spite of the pain and disability caused by osteoarthritis often determines how much of an impact osteoarthrityou have in your life. Talk with your health care team if you are feeling frustrated. Your health care team may have ideas to help you cope or be able to refer you to someone who can help.

Preparing for your appointment

You could start by seeing your primary health care professional, who may refer you to a doctor who specializes in joint conditions, called a rheumatologist or an orthopedic surgeon.

What you can do

Make a list that includes:

  • Detailed descriptions of your symptoms and when they began.
  • Information about medical conditions that you, your parents and your brothers have had.
  • All the prescription and over-the-counter medications and dietary supplements you are taking and the dose.
  • Questions for your care team.

What to expect from your doctor

Your healthcare professiyou can do some of the following questions:

  • Is the pain continuous or come and go?
  • Do any particular activities make the pain better or worse?
  • Have you ever injured this joint?
Symptoms and treatment of Osteoarthritis