Osteoarthritis

1 What is Osteoarthritis?

Osteoarthritis is a common form of arthritis caused by wear and tear of the protective cartilage in the joints. 

It is also characterized by changes in the structure of the joint, including deterioration of tendons and ligaments, and inflammation of the lining. It is most commonly seen in middle-aged and elderly people. 

Symptoms are seen in hands, hips, knees, great toe, and spine. The most common symptom of osteoarthritis is the pain in the joint. 

It is diagnosed by physical examination and imaging techniques. Treatment focuses on reducing pain and inflammation, and improving the function of the affected joint.

2 Symptoms

Pain that becomes worse with repeated use of the joint is the most characteristic symptom of osteoarthritis. Pain affects joints like knee, hip, finger, foot, wrist, or shoulder, and is also associated with limited range of motion of the joint. 

The affected region may also show swelling and warmth. A period of inactivity, like sitting for a long period of time or sleeping, may lead to stiffness of the joint. Severe form of osteoarthritis is characterized by pain even when at rest. 

This is due to complete loss of cartilage in the joint that causes friction between the bones in the joint. 

Symptoms may vary from person to person. Some patients may have severe symptoms, while some othesr may have very few symptoms even with a significant loss of cartilage in the joints. 

There may be a symptom-free period in some patients. As the disease progresses with loss of cartilage, osteoarthritis may cause deformity of the joint. Osteoarthritis of the weight-bearing joints like knees may lead to disability in walking, or walking with a limp. 

Loss of cartilage in the spine may result in lower back pain or neck pain. Formation of bony spurs lead to numbness, tingling, and severe pain. 

Osteoarthritis of fingers causes the formation of hard, bony enlargements called Heberden’s node. These nodes are characteristic of osteoarthritis and help in diagnosis. 

3 Causes

Degeneration of the cartilage that cushions the joint causes primary osteoarthritis, and is a result of natural aging. 

As the disease progresses, repetitive use of the joint leads to inflammation of the lining that causes pain and swelling. Loss of cartilage causes friction between the bones in the joint which limits the range of motion in the region. 

Inflammation leads to the formation of bony outgrowths around the joints. 

Risk of osteoarthritis increases with other diseases and conditions like obesity, repeated trauma or surgery, congenital abnormalities, gout, diabetes, and some hormone disorders. 

Certain genetic makeup is also implied in increased risk of developing this arthritis. Women are more likely to get osteoarthritis when compared to men, and the risk increases with age. 

4 Making a Diagnosis

Making a diagnosis of osteoarthritis is done during the physical examination.

Tenderness, swelling, and warmth in the joints, revealed during the physical examination is an indication of arthritis

Imaging techniques are used to obtain a detailed image of the joint. X-ray images reveal the reduction of space between bones caused by degeneration of cartilage. 

MRI produces a detailed visual of the soft tissues in the joint. It is usually recommended only for complex cases of osteoarthritis. 

Blood tests are suggested to rule out chances of other condition like rheumatoid arthritis. Analyzing the fluid in the joint helps to differentiate pain caused by gout or infection.

5 Treatment

Symptoms of osteoarthritis can be treated by medications, physical therapy, surgery, and changes in lifestyle. Damage caused by osteoarthritis is permanent.

Medications help in reducing pain and inflammation. Acetaminophen is useful in reducing mild to moderate pain. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium are also recommended to reduce pain associated with osteoarthritis. 

Duloxetine, an anti-depressant, is prescribed to alleviate chronic pain. 

Cortisone injections are sometimes prescribed to reduce pain in the joint. Hyaluronic acid injections are used to provide certain amount of lubrication in the joints to relieve pain. 

Physical therapy includes a set of customized exercise to strengthen the muscles of the joint, and to improve the flexibility of the region. Regular exercise also help to reduce pain. 

Occupational therapy is a method which makes routine jobs easier without putting extra strain on the joint. 

Osteotomy is recommended in people with more damage on one side of the knee, when compared to the other. In this procedure, the surgeon cuts across the bone in the joint and adds/removes a wedge of bone to shift the body weight away from the affected part. 

The damaged part of the joint is removed and replaced with prosthesis in a joint replacement surgery. 

6 Prevention

Avoiding joint injury is the only way to prevent osteoarthritis.

7 Alternative and Homeopathic Remedies

Homeopathic remedies for symptoms of osteoarthritis include:

  • bryonia alba,
  • ruta graveolans,
  • sulphur,
  • causticum,
  • colcynthis,
  • pulsatilla nigricans,
  • antimonium crudum,
  • benzoic acid,
  • calcara fluorica,
  • rhus toxicodendron.

Acupuncture is suggested to relieve pain, particularly in osteoarthritis of knees. Nutritional supplements of glucosamine and chondroitin are considered to be beneficial for people with this form of arthritis

Avocado and soybean oil supplement is used to treat knee and hip osteoarthritis. Yoga and tai chi includes exercises for relaxing, improving flexibility, and to reduce pain.

8 Lifestyle and Coping

Lifestyle changes are very important to control symptoms of osteoarthritis. Exercise helps to improve the strength of muscles, and the range of motion in the affected joint. 

Maintaining optimum body weight is very important as excess body weight adds strain on the weight-bearing joints like knees. Muscle spasms and pain can be relieved by cold compresses, while heat pads help in reducing stiffness of the joints. 

Capsaicin can be used as an alternative for NSAIDs. Shoe inserts and strapping tape are recommended to reduce pain while walking. 

Many assistive devices are now available to make routine activities easier. Having a good support system is essential to cope with the progressive condition.

9 Risks and Complications

There are several risks associated with osteoarthritis.

Symptoms of osteoarthritis, like pain and stiffness of joints, worsens over time. This may affect their ability to work or make everyday activities hard.

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