Osteoarthritis — Know It All!

All you need to know about degenerative joint disease.

Know your ailment well, so you can manage it better!!

Here we come with Osteoarthritis today!

What is Osteoarthritis?

Osteoarthritis is the most common form of arthritis that affects millions across the globe. It happens when over time the protective cartilage which cushions the ends of your bones wears down.

Although osteoarthritis can damage any joint, your hands, knees, hips and spine are most commonly affected by the disorder.

Symptoms of osteoarthritis can usually be managed although joint damage can not be reversed. Staying active, maintaining a healthy weight and certain treatments could slow the disease‘s progression and help improve pain and joint function.

Osteoarthritis affects different people. Osteoarthritis is relatively mild for some people, and does not affect daily activities. This causes considerable pain and disability for others. Joint damage usually develops gradually over the years, though in some people it could worsen rapidly.

What happens in Osteoarthritis?

Researchers do not know what triggers or initiates tissue breakdown in the joint. However, as osteoarthritis begins to develop, all areas of the joint may be damaged including:

• Cartilage, the tissue that covers the ends where two bones meet to form a joint.
• Tendons and ligaments.
• Synovium, the lining of the joint.
• Bone.
• Meniscus in the knee.

As soft tissue damage in the joint progresses, pain , swelling and joint motion loss develop. If you have joint pain, you may be less active, and this may result in muscle weakness, which may cause more joint stress. Over time, the joint may lose its normal shape. Small growths in the bone, called osteophytes or bone spurs, may also increase on the edges of the joint. The bone shape may change, too. Bits of bone or cartilage may break off and float within the joint space as well. This causes further damage. Researchers continue to study pain causes in persons with osteoarthritis.

Who gets the disease?

Everyone can get osteoarthritis; however, as people age, it is more common. Women are more likely to develop osteoarthritis than men , particularly after age 50. This develops for many women after menopause.

Younger people can also develop osteoarthritis, usually as the result of:

• Joint injury.
• Abnormal joint structure.
• A genetic defect in joint cartilage.

What are the symptoms of Osteoarthritis?

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

• Pain. Affected joints might hurt during or after movement.
• Stiffness. Joint stiffness might be most noticeable upon awakening or after being inactive.
• Tenderness. Your joint might feel tender when you apply light pressure to or near it.
• Loss of flexibility. You might not be able to move your joint through its full range of motion.
• Grating sensation. You might feel a grating sensation when you use the joint, and you might hear popping or crackling.
• Bone spurs. These extra bits of bone, which feel like hard lumps, can form around the affected joint.
• Swelling. This might be caused by soft tissue inflammation around the joint.

Osteoarthritis symptoms can affect joints differently. For example:

• Hands. Bony enlargements and shape changes in the finger joints can happen over time.
• Knees. When walking or moving, you may hear a grinding or scraping noise. Over time, muscle and ligament weakness can cause the knee to buckle.
• Hips. You might feel pain and stiffness in the hip joint or in the groin, inner thigh, or buttocks. Sometimes, the pain from arthritis in the hip can radiate (spread) to the knees. Over time, you may not be able to move your hip as far as you did in the past.
• Spine. You may feel stiffness and pain in the neck or lower back. As changes in the spine happen, some people develop spinal stenosis, which can lead to other symptoms.

As your symptoms worsen over time, it becomes difficult to take part in activities such as stepping up, getting on or off the toilet or in and out of a chair, grabbing a pan or walking across a car park.

Pain and other osteoarthritis symptoms may lead to feeling tired, having sleeping problems and feeling depressed.

What are the Types/Stages and Progression of Osteoarthritis?OA is a five-stage progressive condition, from 0 to 4. The first step (0) is a normal join. Stage 4 stands for severe OA. Not everybody who has an OA will make progress to stage 4. Often the condition stabilises long before arriving at this stage.

People with severe OA are suffering extensive or complete cartilage loss in one or more joints. The associated bone-on-bone friction can cause serious symptoms, such as:

• Increased swelling and inflammation: The amount of synovial fluid within the joint may increase. Normally, this fluid helps reduce friction during movement. However, in larger amounts, it can cause joint swelling. Fragments of broken-off cartilage may also float within the synovial fluid, increasing pain and swelling.
• Increased pain: You may feel pain during activities, but also when you’re at rest. You may feel an increase in your pain level as the day progresses, or more swelling in your joints if you’ve used them a lot throughout the day.
• Decreased range of motion: You may not be able to move as well, due to stiffness or pain in your joints. This can make it harder to enjoy the day-to-day activities that used to come easily.
• Joint instability: Your joints may become less stable. For instance, if you have severe OA in your knees, you may experience locking (sudden lack of movement). You may also experience buckling (when your knee gives out), which can cause falls and injury.
• Other symptoms: As a joint continues to wear down, muscle weakness, bone spurs, and joint deformity may also occur.

The joint damage caused by severe OA isn’t reversible, but treatment can help reduce symptoms. Learn everything you need to know about advanced osteoarthritis.

What causes Osteoarthritis?

Osteoarthritis occurs when the cartilage in your joints gradually deteriorates, which cushions the ends of bones. Cartilage is a firm, slippery tissue which allows for almost frictionless joint movement. When the cartilage wears down completely, bone will eventually rub on the bone.

Osteoarthritis has often been termed a disease of “wear and tear.” But apart from cartilage breakdown osteoarthritis affects the whole joint. It causes changes in the bone and the connective tissues to deteriorate which hold the joint together and attach muscle to bone. It also causes joint lining to become inflamed.

What are the risk factors of Osteoarthritis?

Certain factors may make it more likely for you to develop the disease, including:

• Aging.
• Being overweight or obese.
• History of injury or surgery to a joint.
• Overuse from repetitive movements of the joint.
• Joints that do not form correctly.
• Family history of osteoarthritis.

What are the complications of Osteoarthritis?

Osteoarthritis is a degenerative disease that has aggravated over time, often leading to chronic pain. Joint pain and rigidity can become severe enough to complicate the daily tasks.

Depression and sleep disturbances may be due to osteoarthritis pain and disability.

How to diagnose Osteoarthritis?

Your doctor will check your affected joint for tenderness, swelling, redness and flexibility during the physical examination.

Imaging tests

To get pictures of the affected joint, your doctor might recommend:

• X-rays. Cartilage does not show up on X-ray images, but a narrowing of the space between the bones in your joint reveals cartilage loss. Also an X-ray may show bone spurs around a joint.
• Magnetic resonance imaging (MRI). To produce detailed images of bone and soft tissues, including cartilage, an MRI uses radio waves and a strong magnetic field. An MRI is not commonly needed to diagnose osteoarthritis but may be helpful in complex cases to provide more information.

Lab tests

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

• Blood tests. Although there’s no blood test for osteoarthritis, certain tests can help rule out other causes of joint pain, such as rheumatoid arthritis.
• Joint fluid analysis. Your doctor may use a needle for extracting fluid from an affected joint. The fluid is then tested for inflammation, to determine whether gout or an infection is causing your pain rather than osteoarthritis.

What is the treatment for Osteoarthritis? (Treatment plan / Treatment Options)

Medications that can help relieve osteoarthritis symptoms, primarily pain (for pain relief) include:

Medications:

• Acetaminophen. Acetaminophen has been shown to help some people with osteoarthritis who have mild to moderate pain. Taking more than the recommended dose of acetaminophen can cause liver damage.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as ibuprofen and naproxen sodium taken at the recommended doses, typically relieve osteoarthritis pain. Stronger NSAIDs are available by prescription.
  NSAIDs can cause stomach upset, cardiovascular problems, bleeding problems, and liver and kidney damage. NSAIDs as gels, applied to the skin over the affected joint, have fewer side effects and may relieve pain just as well.
• Duloxetine. Normally used as an antidepressant, this medication is also approved to treat chronic pain, including osteoarthritis pain.

Therapy:

• Physical Therapy: A physical therapist can show you exercises to strengthen your joint muscles, increase flexibility and reduce pain. Equally effective can be regular gentle exercise you do on your own, such as swimming or walking.
• Occupational Therapy:An occupational therapist can help you find ways to perform daily tasks without putting additional stress on your already painful joint. For example, if you have osteoarthritis in your hands, a toothbrush with a large grip could make it easier to brush your teeth. If you have knee osteoarthritis, a bench in your shower could help to relieve the pain of standing.

Surgical and other procedures:

• Cortisone Injections:

Corticosteroid medication injections can help relieve pain in your joint. Your doctor numbs the area around your joint during this procedure, then places a needle in the space inside your joint, and injects medication. Generally speaking, the number of cortisone injections you can receive each year is limited to three or four injections, since the medication can worsen joint damage over time.

• Lubricant Injections:

Hyaluronic acid injections can help relieve pain by providing some cushioning in your knee, although some research suggests that these injections offer no more relief than a placebo. Hyaluronic acid resembles a component that is normally found in your joint fluid.

• Realigning Bones:

If osteoarthritis has caused more damage to one side of your knee than to the other, an osteotomy may help. In an osteotomy of the knee, a surgeon cuts through the bone, either above or below the knee, then removes or adds a bone wedge. This will shift your body weight away from the worn out knee part.

• Joint Replacement:

Your surgeon removes your damaged joint surfaces in joint replacement surgery (arthroplasty), and replaces them with plastic and metal parts. Surgical risks include blood clots and infections. Artificial joints may wear out or become loose, and eventually need to be replaced.

How to Cope up:

There are many things you can do to help you live with osteoarthritis, including:

• Heat and cold therapies can reduce joint pain. Heat therapy increases blood flow, tolerance for pain, and flexibility. Cold therapy numbs the nerves around the joint to reduce pain and may relieve inflammation.
• Support or assistive devices such as a cane or walker can help you move around safely, provide stability, and lower pain. If you have arthritis in your hands, you may find it helpful to use devices to help you grip, such as jar openers.
• Try to avoid repetitive motions, such as frequent bending.
• Shoe inserts or braces can help support your joint and help lower pain and pressure on the area. This can be helpful when you stand or walk.
• Make appointments to see your health care provider. This allows you to participate in your treatment and talk about your symptoms. Some people find it helpful to join a class that provides information on osteoarthritis and how to manage the symptoms to allow you to live an active lifestyle.
• Support groups, both online and in your community, can help you cope and offer tips on how to emotionally manage having the disease and live a healthy lifestyle.

References:

https://www.healthline.com/health/osteoarthritis#diagnosis

niams.nih.gov/health-topics/osteoarthritis/

https://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/drc-20351930

By,

Gopala Krishna Varshith,

Content Developer & Editor,

Clipo.