Overview of Osteoarthritis

Osteoarthritis is a progressive joint disease that causes pain and stiffness in the joints. It is also known as degenerative joint disease or osteoarthrosis.

Osteoarthritis is the most common form of arthritis. It is a condition where the cartilage in the joints deteriorates and eventually wears down. This causes the bones of your joints to rub against each other instead of being cushioned by the cartilage. This leads to joint pain, swelling, stiffness and limited movement.

Osteoarthritis affects people with all types of joints, but it mainly affects weight bearing joints like hips, knees and ankles. This can cause problems while walking or standing up straight leading to use of walking sticks or crutches in some cases.

In some cases, osteoarthritis may be caused by injury or trauma to the joint such as an accident or fall which leads to damage of cartilage lining around the joint surface. This can lead to inflammation of synovial membrane lining which surrounds each joint space causing pain when moving around due to friction between bones rubbing against each other without support from cartilage lining.

Expert Management of Osteoarthritis

Your doctor will advise you on which treatment is most appropriate for you.

Exercise

Exercise is one of the most effective ways to manage osteoarthritis, as it improves muscle strength and joint function. Exercise also increases blood flow to joints and helps them work better. There are many different types of exercise that can be used for people with osteoarthritis, including walking, swimming or cycling; yoga or pilates; or weight training if you have sufficient muscle strength for it. Your GP or physiotherapist can recommend suitable exercises for you based on your symptoms and ability level.

Causes and Risk Factors of Osteoarthritis

Osteoarthritis is caused by the breakdown of cartilage (the smooth, slippery tissue that covers the ends of bones), which allows bones to rub against each other and causes pain and stiffness. Cartilage wears out over time as we get older and becomes less flexible.

Cartilage contains cells called chondrocytes which produce a protein called collagen. This protein helps keep cartilage strong and flexible but with repeated wear and tear it breaks down into smaller pieces which can’t be reabsorbed by the body so float around freely in the joint space between bones. These pieces make it difficult for fluid to circulate normally around your joints so they become inflexible, swollen and painful.

Osteoarthritis usually affects people over age 65, but it can occur at any age. It is more common in women than men and more common in Caucasians than African-Americans.

Risk factors for osteoarthritis include:

• Age (over 60 years of age)
• Obesity
• Genetic predisposition
• Injury to the joint

Symptoms of Osteoarthritis

Pain in the joints and muscles. Pain is the most common symptom of osteoarthritis and can be experienced in any joint in the body. The pain may vary from mild to severe and can be made worse by activity or by standing for long periods of time. Other symptoms, such as swelling and stiffness, may also occur with arthritis pain.

Stiffness in the joints. As the cartilage wears away, bones rub against each other, causing stiffness and discomfort when you move your joints.

Loss of mobility in affected joints. As cartilage continues to wear away, bone surfaces become rougher and irregular-shaped bone spurs (osteophytes) often form around the edges of joints, which makes movement even more difficult.

Diagnosing Osteoarthritis

There is no blood test for the diagnosis of osteoarthritis. Blood tests are performed to exclude diseases that can cause secondary osteoarthritis, as well as to exclude other arthritis conditions that can mimic osteoarthritis.

X-rays of the affected joints are the main way osteoarthritis is identified. The common X-ray findings of osteoarthritis include loss of joint cartilage, narrowing of the joint space between adjacent bones, and bone spur formation. Simple X-ray testing can be very helpful to exclude other causes of pain in a particular joint as well as assist the decision-making as to when surgical intervention should be considered.

Arthrocentesis is often performed in the doctor’s office. During arthrocentesis, a sterile needle is used to remove joint fluid for analysis. Joint fluid analysis is useful in excluding gout, infection, and other causes of inflammatory arthritis. Removal of joint fluid and injection of corticosteroids into the joints during arthrocentesis may help relieve pain, swelling, and inflammation.

Arthroscopy is a surgical technique whereby a doctor inserts a viewing tube into the joint space. Abnormalities of and damage to the cartilage and ligaments can be detected and sometimes repaired through the arthroscope. If successful, patients can recover from the arthroscopic surgery much more quickly than from open joint surgery.

Treatment for Osteoarthritis

Treatment for osteoarthritis can help you manage your symptoms, reduce the progression of the disease and improve your quality of life. Treatment may include:

Pain relievers. Over-the-counter pain relievers can help ease your joint pain until your doctor prescribes medicine that works better for you. Nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) — are often used first. If they don’t help, a prescription NSAID may be given. Side effects of NSAIDs include stomach upset and heartburn.

Corticosteroids. Corticosteroids are injected into the painful joint to relieve inflammation while healing occurs. They work quickly but aren’t long lasting.

Immunosuppressants. These medications reduce the body’s immune response by blocking certain immune cells from attacking healthy tissue in the joint. Side effects include increased risk for infections and cancerous growths (rare).

Steroid injections. Steroid injections into painful joints can provide quick relief from inflammation caused by osteoarthritis for up to six months; however, they carry no long-term benefits and may cause side effects such as bruising.