What is Osteoarthritis?
Cartilage is a protein substance that is found in the joints of bones and acts as a ‘cushion’ between the bones. Arthritis caused by the breakdown and subsequent loss of cartilage in one or more of the joints is called Osteoarthritis. Osteoarthritis is also known as Degenerative Arthritis. It usually affects the joints of hands, feet, spine, hips and knees.
Symptoms of Osteoarthritis
The most common symptom of Osteoarthritis is pain due to friction caused by degeneration of cartilage between joints. Symptoms of Osteoarthritis vary greatly from patient to patient.
Too much activity and movement can aggravate swelling and creaking of the affected joints causing pain. Pain and stiffness of the joints can also occur after long periods of inactivity, for example sitting for long during travel. In severe cases, as the ‘cushioning’ of cartilage is almost non-existent, friction between bones causes pain even when the person is at rest.
Some patients can be debilitated by their symptoms, especially in the case of Osteoarthritis of the knees, especially in obese patients. Progressive cartilage degeneration leads to deformity called ‘bow leg’ or a progressive limp.
If the pain is intermittent, the patient may not experience much discomfort in spite of major degeneration of the joints apparent on X-rays. Patients can be pain-free for long intervals in the case of Osteoarthritis of the finger joints.
Osteoarthritis of the cervical spine or lumbar spine causes pain in the neck or lower back. Bony spurs called osteophytes form along the spine which cause adversely affect the spinal nerves. This results in a tingling sensation in the affected parts, numbness and severe pain in those parts of the body.
Types of Osteoarthritis
1) Primary Osteoarthritis: With aging, there is sometimes total loss of cartilage cushion between the bones of the joints. Repetitive use of the joints worsens the condition and can even result in permanent immobility.
2) Secondary Osteoarthritis: This is caused by other diseases or conditions like obesity, repeated trauma to or surgery of the affected joint.
3) Heberden’s node: Bone enlargement of the small joint at the end of the fingers is called Heberden’s node.
4) Bouchard’s node: Bone enlargement that occurs at the middle joint of the fingers is called Bouchard’s node.
Diagnosis of Osteoarthritis
1) X-rays clearly show cases of Osteoarthritis. Findings include loss of joint cartilage, narrowing of the joint space between adjacent bones and bone spur formation. Simple X-ray testing also helps to eliminate other probable causes of pain in a particular joint. Also the severity suggests whether surgery is necessary.
2) Blood tests are performed to exclude diseases that can cause secondary Osteoarthritis.
3) In the case of finger/toe nodes (enlarged finger or toe joints), a visual examination itself would help to diagnose Osteoarthritis.
4) Arthrocentesis testing: Joint fluid is removed with a sterile needle and analyzed. This helps to eliminate other causes of pain like gout and infection.
5) Arthroscopy: This is a surgical method where an Arthroscope (viewing tube) is inserted into the joint space. This helps to not only detect but also repair any abnormalities of or damage to the cartilage and ligaments.
Causes of Osteoarthritis
Heredity: Heredity plays a major role in Primary Osteoarthritis. With aging, the protein in the cartilage degenerates. Crevasses are formed, eventually leading to total loss of cartilage in the joints. Nodes on fingers and the toes also have a genetic cause. This leads to pain due to friction and joint-immobility.
Other diseases: Bone trauma or surgery, gout, diabetes, hormonal disorders during menopause, etc can also lead to Osteoarthritis. This is called Secondary Osteoarthritis.
Obesity: This is another major cause of Osteoarthritis as obesity increases the mechanical stress on the cartilage. In fact, obesity is a bigger risk factor than aging. Osteoporosis affects some people when they are not very old because of the heavy loads that they carry, like laborers or even wrestlers and weight-lifters.
Sports: Repeated trauma to joint tissues such as ligaments, bones, and cartilage can lead to Osteoarthritis of the knees in soccer players and long-distance runners where the stress level on the knees is very high.
Congenital abnormalities: A person with the particular birth defect is vulnerable to mechanical wear and tear, early degeneration and subsequent total loss of joint cartilage. This is more common for hip joints.
Treatment of Osteoarthritis
1) Arthrocentesis treatment: Along with removal of joint fluid for analysis, corticosteroids are injected into the joint to help relieve pain and also reduce swelling and inflammation.
2) Occupational therapy: A combination of medication, diet control for weight reduction, physical and occupational therapy is used for the treatment of Osteoarthritis of the large, weight-bearing joints like hips or knees or even fingers.
3) Surgery: In severe cases, a dysfunctional knee joint may not respond to medication and may require total knee replacement with the use of surgical procedures.
4) Exercise: Activities like swimming, walking, cycling, supervised weight training, etc can go a long way in keeping the movement of joints smooth and prevent freezing up of joints. This also strengthens the joints and increases endurance of the joints for exertion and weight. It also relieves pain and inflammation.
5) Sufficient rest: Sore joints need rest to decrease stress on the joints and relieve pain. Exercise need not be stopped, but the intensity/frequency of activities which increase the pain have to be controlled.
6) Mechanical support devices: Physical therapists suggest the use of support devices like splints, canes, walkers, braces, etc. They also recommend the patient to use paraffin wax dips, warm water soaks, nighttime cotton gloves or socks, neck collar, lumbar corset and a firmer mattress to ease the symptoms and pain.
7) Oral medication: Oral pain relievers, anti-inflammatory medications, acetaminophen have been used effectively to relieve pain and reduce intensity of the disease. Fish-oil capsules (omega-3 capsules) can reduce inflammation of arthritis.
External medication: Pain-relieving creams like those containing capsaicin or methyl salicylate, anti-inflammatory lotions or patches containing diclofenac can be applied on the skin over the joints to provide relief from minor arthritic pain.
9) Injections: For persistent pain in severe Osteoarthritis of the knee which does not respond to weight reduction, exercise, or oral medications; a series of hyaluronic acid injections are used for treatment.
10) Osteotomy: When nothing else works, a bone-removal procedure is used to realign some of the deformity in selected patients, usually in Osteoporosis of the knees. This is done by bone fusion (Arthrodesis) or replacement with an artificial joint (Arthroplasty). Total hip and total knee replacements have been tried successfully.
11) Calcium: Calcium supplement should be taken, about 1200mg per day. But the total daily intake of calcium should not exceed 2000 mg.
12) Vitamin D: Vitamin D is necessary for the absorption of calcium hence intake of vitamin D is essential with calcium.
Living with Osteoarthritis
All races appear equally affected by Osteoarthritis. Unlike Osteoporosis, Osteoarthritis is a disease purely of the joints and does not affect other organs of the body, but it can have a minor or major impact on the life of the patient. In men, it can affect from the age of 45 and in women it is usually noticed after 55 years of age.
Severe cases can be crippling as they restrict mobility, especially in the case of large joints like hips and knees. Heberden’s and Bouchard’s nodes restrict the movement of the fingers/toes joints and adversely affect day-to-day functions. The pain can restrict daily functions, personal life as well as professional life of a person afflicted by Osteoarthritis.
Prevention of Osteoarthritis
1) Balanced nutrition containing adequate amounts of calcium and vitamin D is a must for the prevention of Osteoporosis. This is more so where heredity shows that the person is at risk.
2) Regular exercise is needed to keep the joints flexible and healthy.
3) Bad habits like cigarettes and alcohol have to be avoided at any cost.
4) Over-dieting and anorexia should be avoided.
5) Calcium-rich foods like dairy products should be consumed.
6) Where necessary, calcium carbonate supplement should be consumed. If the side effect of this medication is constipation, calcium phosphate or calcium citrate can be taken instead.
The National Health and Nutrition Examination Survey (NHANES) in its 1998 report states that 70% of persons aged between 55 and 78 years are afflicted by Osteoarthritis. A large number of them are disabled and rendered jobless. The report states that health systems around the world will need to develop strategies for primary and secondary prevention.
Read also
- Herbs The Natural Way For Healthy Bones and Joints
- Healthy Habits for Longevity
- How To Gain Weight The Healthy Way?
- Women Under Stress Out of Dual Roles
- Children Coping with Stress
