Osteoarthritis
Osteoarthritis (OA) is a painful condition that affects the joints of over 32 million American adults. It is sometimes referred to as “wear-and-tear arthritis.”
What causes osteoarthritis?
Osteoarthritis is caused by the breakdown of the joint cartilage between the bones over time.
Different factors can contribute to the development of OA including:
Genetic factors. People with family members who have OA are more likely to get OA.
Age. OA is not an inevitable part of aging, but it is more common in older people.
Joint injury. A break or tear can lead to OA after years.
Obesity. Extra weight can put stress on the joints and fat cells promote inflammation.
Sex. Women are more likely to get OA than men.
What are the symptoms of osteoarthritis?
Osteoarthritis can affect any joint but it occurs most frequently in the hands, knees, hips, and spine. The symptoms begin slowly.
The common symptoms of OA include:
Joint pain with activity. Improvement of pain with rest.
Joint stiffness in the morning or after resting for a period of time
Joint swelling
Trouble easily moving the joint
Over time, symptoms can improve, stay the same, or gradually worsen, especially if the contributing factors are not properly addressed.
How is osteoarthritis diagnosed?
OA is diagnosed based on symptoms, physical exam, and imaging studies, such as X-ray, to determine the extent of the disease or to help rule out other joint problems.
How is osteoarthritis managed?
There is no proven treatment yet to reverse the joint damage of OA. The goals of osteoarthritis treatment are pain reduction and improved function of the affected joint.
Non-drug therapies are a key part of OA treatment. Non-drug interventions include:
Weight loss. Weight loss may significantly reduce joint pain in the hips and knees. Weight loss of 10% or more of body weight may decrease pain by up to 50% when achieved through a combination of diet and exercise.
Physical therapy and exercise programs. Physical therapy and exercise improve flexibility and strengthens the muscles surrounding the joints.
Orthoses. These devices can help keep the joints aligned and functioning properly.
Assistive devices. Canes, walkers, raised toilet seats, tub and shower bars can reduce the stress on joints and make it easier to perform daily tasks.
Drug therapies are used in combination with or after a trial of non-drug interventions. Drugs of OA include:
Topical pain-relievers. When applied over the skin over the joint, treatments such as capsaicin cream, lidocaine, or diclofenac gel can help relieve pain for OA involving the hands and knees.
Nonsteroidal antiinflammatory drugs. Oral NSAIDs (such as ibuprofen, naproxen, and celecoxib) help relieve pain and reduce inflammation. The potential side effects include stomach ulcers, increased cardiovascular risk, and kidney injury. As such, NSAIDs should be taken at the lowest effective dose for the shortest duration.
Joint injections. Steroid injections are sometimes used in people who have severe pain that do not respond to weight loss, exercise, and other medications.
Surgery is usually reserved for severe osteoarthritis that did not respond to other treatments. It may involve arthroscopy, or repair of the joint done through a small incision. Surgery may be used to replace a damaged joint with an artificial joint if the joint damage cannot be repaired.
References
https://www.cdc.gov/arthritis/basics/osteoarthritis.htm
https://www.arthritis.org/diseases/osteoarthritis
https://www.niams.nih.gov/health-topics/osteoarthritis/advanced
https://www.uptodate.com/contents/osteoarthritis-treatment-beyond-the-basics