(Degenerative Joint Disease; Arthritis, Osteo-)
Definition
Definition
Osteoarthritis is a progressive, degenerative joint disease characterized by chronic inflammation of the joint lining. People with osteoarthritis usually have joint pain and limited movement of the affected joint.
Joints Affected by OsteoarthritisCopyright © Nucleus Medical Media, Inc.
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Causes
Causes
Healthy cartilage is a cushion between the bones in a joint. With osteoarthritis, the cartilage wears away over a long period of time, causing bones to rub together. The exact cause is unclear, but it may be a combination of genetics and the environment.
Risk Factors
Risk Factors
Osteoarthritis is more common in older adults. Factors that may increase your chance of osteoarthritis include:
- Excess body weight
- Family history of osteoarthritis
- Certain endocrine, metabolic, or neuropathic disorders, and avascular necrosis
- Having an injury or surgery to the joint surface, especially the cartilage
- Having an occupation or doing physical activities that put stress on joints
Symptoms
Symptoms
Osteoarthritis usually affects the hands, feet, spine, hips, and knees. Common symptoms include:
- Mild to severe pain in a joint, especially after overuse or long periods of inactivity, such as sitting for a long time
- Creaking or grating sound in the joint
- Swelling, stiffness, limited movement of the joint, especially in the morning
- Deformity of the joint
Diagnosis
Diagnosis
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
- Blood tests
- Arthrocentesis
Images may be taken of your bodily structures. This can be done with:
Treatment
Treatment
There is no treatment that stops cartilage loss or repairs damaged cartilage or bones of the joint. When cartilage wears away, bone on bone friction causes pain and inflammation. The goal of treatment is to reduce joint pain and inflammation, and to improve joint function.
Options may include:
Weight Reduction
Losing weight can lessen the stress on joints affected by osteoarthritis. The more weight lost, the greater the benefit. Consider talking to a dietitian who can help you with meal planning.
Exercise and Physical Therapy
Strengthening the muscles supporting an arthritic joint (particularly the knee, lower back, and neck) may decrease pain and absorb energy around the joint. For example, if you have arthritis in the knee, exercise and strength training can also help improve knee function. Swimming and water aerobics are good options. They do not put stress on the joint.
Another option is transcutaneous electrical nerve stimulation (TENS). With TENS, you are connected to a machine. The machine sends electrical signals through the skin to nerves. This type of therapy may decrease pain in some people.
If you have knee osteoarthritis, manual therapy, including massage therapy and manipulation, may be helpful.
Medications
Medications may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Cyclooxgenase-2 (COX-2) inhibitors
- Topical pain medications that are applied to the skin
- Antidepressants
- Opioids and similar medications
- Viscosupplementation injection
- Corticosteroid injection
Heat and Ice
Applying heat with hot water bottles, warm soaks, paraffin, or heating pads helps joints and muscles move more easily. It can also lessen pain. Using ice packs after activity can also help.
Dietary Supplements
Glucosamine and chondroitin are two commonly used supplements. But, research has shown that these are not beneficial for most people with osteoarthritis. Talk with your doctor before taking any herbs or supplements.
Mechanical Aids and Assistive Devices
Shoes with shock-absorbing
in
soles may provide some relief while you are doing daily activities or exercising. Splints or braces help to properly align joints and distribute weight. Knee and wrist joints may benefit from elastic supports. Canes, crutches, walkers, and orthopedic shoes can help with advanced osteoarthritis in the lower body.
If you are having difficulty getting around due to arthritis pain, your doctor might recommend that you install handrails and grips throughout your home. These are useful in the bathroom and shower. You may need elevated seats, including toilet seats, if you’re having difficulty rising after sitting.
Alternative Treatments
Some doctors report that acupuncture has been successful in reducing the pain of osteoarthritis. However, the evidence is not consistent.
While more studies are needed, balneotherapy (hot water therapy), relaxation therapy, exercise, yoga, and tai chi may be helpful.
Surgery
Surgery may be needed for joints with severe damage. It may be done to remove loose pieces of bone or cartilage from joints or reposition bones to redistribute stress on the joint. Some may need to have the joint replaced with an artificial joint.
Prevention
Prevention
To help reduce your chance of osteoarthritis:
- Maintain a healthy weight.
- Do regular, gentle exercise, such as walking, stretching, swimming, or yoga.
- Avoid repetitive motions and risky activities that may contribute to joint injury, especially after age 40.
- With advancing age, certain activities may have to be stopped or modified. It is important to continue to be active, so find an activity that suits you.
RESOURCES:
The Arthritis Foundation http://www.arthritis.org
CANADIAN RESOURCES:
References:
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Last Updated: 9/3/2014