The Basics of Osteoarthritis

 

Also known as degenerative joint disease, osteoarthritis (OA) typically begins after the age of 40 years. hip arthritis pictureCurrently, there is no cure for this condition, and treatment focuses on relief of pain and improvement of mobility. OA is a common condition, affecting around 14% of the adult population, which is around 27 million Americans. The incidence of OA is known to increase with age, and it occurs more often in females.

 

Causes of Osteoarthritis

 

OA is characterized by the degeneration (breakdown) of cartilage, which is the tissue that cushions the end of the bones inside the joints. With this condition, there is also deterioration of ligaments and tendons, inflammation of the joint lining (synovium), and bony changes of the joints (nodules).

According to new research, OA is not only a “wear-and-tear” disease. In addition, OA is the result of a systematic condition that leads to cartilage degradation. Excessive mechanical stress on the joints (especially the knees) seem to be the main factor in OA development. Cartilage breakdown depends on aging, obesity, and/or trauma.

 

Risk Factors for OA

  • Older ageKnee pain
  • Obesity
  • Family history
  • Joint injury
  • Overuse and repetitive use of joint(s)
  • Joint deformity (bowlegs, knocked knees, unequal leg length)

 

Symptoms of OA

  • Swelling of the joint
  • Joint pain and stiffness
  • Crepitus (cracking/grinding noise with movement)
  • Decreased joint function

Diagnosing Osteoarthritis

The doctor will conduct a physical examination, evaluating the painful joint for redness, swelling, motion, and tenderness. In addition, the doctor will do some imaging tests. X-rays are used to assess for narrowing between the bones of the joint that occurs with cartilage loss. The doctor also uses x-rays to look for bone spurs and bony deformities. A magnetic resonance imaging (MRI) scan uses radio waves and a powerful magnetic field to provide digital images of the soft tissues, bones, and cartilage. This is used for complex cases of OA.

For OA diagnosis, laboratory tests are used to analyze the blood and joint fluid. Certain blood test indicate inflammation and help the doctor rule out other causes of joint pain. A joint fluid analysis involves aspirating fluid from the affected joint to determine if the pain is related to infection or gout.

 

OA Treatment Options

 

  • Medications – This includes the use of topical anesthetic creams and patches, as well as oral NSAIDS, painkillers, and acetaminophen.

 

  • Physical therapy – A therapist will work with the patient to each strengthening and flexibility exercises.

knee injection

  • Bracing/Cane

 

  • TENS Unit

 

  • Physical measures – This includes weight loss and exercise, as excess pounds put stress on the weight-bearing joints (knees, hips, and low back).

 

  • Steroid joint injections – Anti-inflammatory corticosteroids (cortisone) can be injected into the joint to relieve inflammation.

 

  • Regenerative Medicine Injections – PRP Therapy and stem cell procedures are becoming increasingly popular due to the excellent results being shown in small studies. These are outpatient procedures, low risk and have the potential to regenerate joint tissue and cartilage.

 

  • Hyaluronic acid joint injections – Hyaluronic acid (Synvisc and Orthovisc) is a form of lubricant injected into the joint. This works by replenishing lost synovial fluid and is a highly effective treatment.

 

  • Joint replacement – When other treatment measures fail, surgery to replace the worn joint can be done by traditional or arthroscopic means.

 

References

Centers for Disease Control and Prevention (2014). Osteoarthritis. Retrieved from: http://www.cdc.gov/arthritis/basics/osteoarthritis.htm

Mutsert R, Heijer M, Rabelink TJ, Smit JWA, Rominj JA et al. (2013). The Netherlands Epidemiology of Obesity (NEO) study: study design and data collection. European Journal of Epidemiology, 23(6), 513-523.