28 Jan Osteoarthritis
Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage that cushions the ends of your bones wears down over time.
Although osteoarthritis can damage any joint, it most commonly affects joints in the hands, knees, hips and spine. The level of pain experienced varies greatly, and it does not often correlate with the degree of change in the joints, such as those seen on x-rays.
Osteoarthritis symptoms can usually be managed, although the damage to joints can’t be reversed. Staying active, maintaining a healthy weight and some treatments might slow progression of the disease and help improve pain and joint function.
Symptoms
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 may 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 – Extra bits of bone, which feel like hard lumps, around the affected joint.
- Swelling – This might be caused by soft tissue inflammation around the joint.
Causes
Osteoarthritis is caused by inflammation, breakdown, and eventually, loss of cartilage in the joints. In healthy joints, cartilage is smooth and slippery and acts as padding to prevent bones from rubbing against each other. Eventually, if the cartilage wears down completely, bone will rub on bone. Osteoarthritis also affects the entire joint, causing changes in the bone and deterioration of the connective tissues that hold the joint together and attach muscle to bone.
Risks and complications
Factors that can increase your risk of osteoarthritis include:
- Age Osteoarthritis becomes more common with increasing age
- Gender Women are more likely than men to develop osteoarthritis
- Obesity Extra body weight contributes to osteoarthritis in several ways, and the more you weigh, the greater your risk. Increased weight adds stress to weight-bearing joints, such as your hips and knees.
- Previous joint injury or damage This can include a previous joint infection, break (fracture) in the bone around a joint, or a previous ligament injury that caused a joint instability
- Repeated stress on the joint If your job or sport places repetitive stress on a joint, that joint might eventually develop osteoarthritis
- Bone deformities 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 (hemochromatosis)
- Genetics Some people inherit a tendency to develop osteoarthritis.
Complications from osteoarthritis can arise because it is a degenerative disease that worsens over time, often resulting in chronic pain. Joint pain and stiffness can become severe enough to make daily tasks difficult.
Depression and sleep disturbances can result from the pain and disability of osteoarthritis.
Diagnosis
If you are experiencing joint pain, it is important to see your health professional for a diagnosis and development of a management plan. Many different conditions can cause joint pain and they require different treatments.
X-rays are sometimes used to confirm the diagnosis of osteoarthritis or to assist with planning treatments, such as surgery. Magnetic resonance imaging (MRI) is rarely required.
Treatment
Osteoarthritis can’t be reversed, but treatments and management techniques can reduce pain and help you move better.
Learning how to manage your osteoarthritis effectively involves building skills such as goal setting, decision making, problem solving, and self-monitoring designed to reduce the impact of osteoarthritis on your daily life. Research shows that people with osteoarthritis who participate in self-management education programs improve their skills and confidence to manage their condition. This can also improve both mental health (including anxiety and depression) and physical health.
Medications If you are experiencing pain related to your osteoarthritis, there are several medicine options for you to choose from. Starting with a cream or gel before moving to oral medicines may be a good option.
- Topical medicines (creams or gels) that reduce inflammation can be rubbed on to the skin over affected joints for pain relief.
- Oral medicines
- Paracetamol is commonly used to treat osteoarthritis, but on its own may offer minimal pain relief, and large doses can damage the liver.
- NSAIDs (non-steroidal anti-inflammatory drug) such as ibuprofen, naproxen or diclofenac, may be helpful if paracetamol or topical treatments do not provide suitable pain. It is recommended that you speak with your doctor, nurse or pharmacist to ensure oral NSAIDs are an option for your condition.
- Opioids are a group of medicines commonly used to treat acute pain. However, international osteoarthritis guidelines only recommend strong opioids in exceptional cases. They are only available with a prescription.
Physical and Occupational therapy A physical therapist can show you exercises to strengthen the muscles around your joint, increase your flexibility and reduce pain. Regular gentle exercise, such as swimming or walking, can be very effective.
An occupational therapist can show you how to do everyday tasks without putting extra stress on your already painful joint. For instance, a toothbrush with a large grip could make brushing your teeth easier if you have osteoarthritis in your hands.
Surgical and other procedures If conservative treatments don’t help, you may want to talk to your doctor about procedures such as:
- Cortisone injections
- Lubrication injections
- Realigning bones through surgery
- Joint replacement (such as a hip replacement).
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 who have knee osteoarthritis
- Glucosamine and chondroitin. A few studies have found benefits for people with osteoarthritis, but most indicate these supplements work no better than a placebo They can interact with blood thinners such as warfarin and cause bleeding problems
- Avocado-soybean unsaponifiables. This nutritional supplement is a mixture of avocado and soybean oils and is widely used in Europe to treat knee and hip osteoarthritis. It acts as an anti-inflammatory, and some studies have shown it can slow or even prevent joint damage
- Omega-3 fatty acids. Omega-3s, found in fatty fish and fish oil supplements, might help relieve pain and improve function.
Always talk to your doctor about supplements you’re considering.
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