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Osteoarthritis (OA) is the most common type of arthritis. It is also known as degenerative joint disease. It arises when cartilage that serves as a cushion for the bones deteriorates with time. It is a disease that affects any joint, however it is more likely to occur in joints located in the hands, knees, hips, and spine. It can cause pain, swelling, stiffness and deformity of the joint.
Symptoms
It is common for the symptoms of osteoarthritis to develop gradually and progress as time goes by.
- Pain in the damaged joints during or after movement, especially start movement leg stand up, climbing up & down the stair, or get out from the car
- Morning stiffness in the affected joints.
- Tenderness can be felt in the joint when mild pressure is applied.
- Limitation of motion (or flexibility) may be experienced when moving the joints with its complete range of motion becomes impossible or troublesome.
- Swelling may be caused by the inflammation of soft tissue around the joint.
- Bone spurs are the growing of extra bone that may feel like hard lumps. Bone spurs can develop around the joints that are damaged from osteoarthritis.
- Grating sensation may occur when using the joint and popping or crackling sound could be heard.
If pain or stiffness in the joint are not relieved, consulting a doctor regarding the issue is recommended.
Causes
Osteoarthritis develops from degeneration of cartilage in the joints. Cartilage is a firm rubbery cushion made up of slippery textured tissue that covers the end of bones in the joints. The primary function of cartilage is to reduce friction in the joints. If the cartilage is injured it can undergo some repair, however the body does not grow new cartilage after the injury. And when the cartilage totally wears down, the bone will rub on bone.
Osteoarthritis is a wear and tear degenerative disease. Not only the cartilage but the whole joint is also affected by the disease. Bones changes, connective tissues deterioration, and joint lining inflammation develop in osteoarthritis.
Risk factors
- Older age are at increased risk of developing osteoarthritis.
- Women are more likely to develop the disease.
- Obesity increases the risk of developing the disease in many ways. Being overweight puts stress to the weight-bearing joints, such as the hips and knees. Moreover, obesity may cause inflammation in the joints and lead to osteoarthritis.
- Joint injury that occurs during sports or from an accident can damage a joint and elevate the risk of osteoarthritis.
- Repetitive stress on the joint from occupation or sport may lead to osteoarthritis, bend the knee for long time during sitting.
- Genetics as some patients inherit a tendency of developing osteoarthritis.
- Bone deformities when patients are born with joint malformation or defective cartilage.
- Certain metabolic disease such as diabetes which can cause the inflammatory response in the body and increase the risk of osteoarthritis.
Diagnosis
Doctors will review the symptoms and do the physical exam to look for certain signs, such as tenderness, swelling, redness and flexibility of the affected joints.
Imaging tests
- X-rays can show the joint space narrowing which indicates cartilage loss. X-rays also reveals bone spurs around the joint and joint deformity or legs deformity.
- Magnetic resonance imaging (MRI) is a diagnostic test that uses radio waves and a powerful magnetic field to create detailed images of bone and soft tissues like cartilage. An MRI can be helpful for complex osteoarthritis but not used in general.
Lab tests
Blood or joint fluid analysis will help confirm the diagnosis.
- Blood tests is not required to diagnose osteoarthritis, but it can be used to rule out other causes of joint pain, such as rheumatoid arthritis.
- Joint fluid analysis is done by inserting a needle to draw fluid from the joint that has been affected to identify whether the pain is triggered by gout or an infection rather than osteoarthritis.
Treatment
Although the diseases cannot be reversed, treatments can relieve pain and help better movement.
Medications
The methods to slow the progression of knee osteoarthritis are
- Avoid to bend the knee more than 90 degree during sitting.
- Quadricep muscle exercises.
- Control or reduce body weight reached to standard BMI
- Acetaminophen. Helps patients who have mild to moderate level of pain from osteoarthritis. But it should not be taken more than the recommended dose as it can cause liver damage.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter drugs, such as ibuprofen and naproxen sodium are composed to relieve pain. NSAIDs that are come in gel type are applied on the skin of the affected joint. The drugs have side effects such as stomach upset, cardiovascular problems, bleeding problems, and can lead to liver and kidney damage.
- Duloxetine. Generally use as an antidepressant. It has shown to treat chronic pain, as well as pain from osteoarthritis.
Therapy
- Physical therapy composes of exercises that will strengthen the joint muscles. It increases flexibility and reduces pain. Regular exercises that are gentle, such as swimming or walking, can be just as effective.
- Occupational therapy designed to find out ways for patients to do carry out their daily tasks without putting additional pressure on the painful joint.
- Transcutaneous electrical nerve stimulation (TENS) uses a low-voltage electrical current for pain relief. It can temporarily relief pain for some patients who have knee and hip osteoarthritis.
Surgical and other procedures
If conservative treatments show no effective results, the following procedures may be considered:
- Cortisone injection is given into the joint, aiming to relieve pain for few weeks. Limitation of injection at three or four times a year due to its side effect of damaging the joints in time.
- Lubrication injection is an injection of hyaluronic acid which is the substance similar to the natural fluid found in the joints. It helps relieving pain by providing cushioning in the knees.
- Realigning bones is carried out when one side of the knee is more damaged by osteoarthritis than the other. The procedure is also known as osteotomy. In a knee osteotomy, the doctor will make an incision across the bone either above or below the knee. Then will remove or add a wedge of bone. This will help putting off the body weight from part of your knee that has been worn-out.
- Joint replacement is a surgical procedure that removes the joint surfaces that are damaged and replaces them with plastic and metal implants. Artificial joints or implants may also wear out or loosen like the natural joints. If that happens, they will have to be replaced again.
