The Symptoms, Causes And Treatment Of Osteo Arthritis
Osteo arthritis (also known as degenerative or degenerative joint disease, and sometimes referred to as "arthrosis" or "osteo arthrosis" or in colloquial terms "wear and tear"), is a condition in which low-grade inflammation results in pain in the affected joints, caused by wearing of the cartilage that covers and acts as a cushion inside joints.
As the bone surfaces get less well protected by cartilage, the patient will experience pain upon weight bearing, such as walking and standing. Attributable to decreased movement due to the painfulness, regional muscles may atrophy, and ligaments may get more lax. Osteo is the commonest form of arthritis. The word is derived from the Greek words "osteo", meaning "of the bone", "arthro", meaning "joint", and "itis", meaning inflammation, while some sufferers have little or no inflammation.
Osteo affects almost 21 million people in the United States alone, accounting for more than 25% of visits to primary care physicians, and half of all NSAID (Non-Steroidal Anti-Inflammatory Drugs) prescriptions. It is estimated that 80% of the population will have radiographic evidence of Osteo by the age of 65, while only 60% of those will be symptomatic. Treatment is with NSAIDs, local injections of glucocorticoid or hyaluronan, and in very severe cases, with joint replacement surgery. There is currently no cure for Osteo , as it is not possible for the cartilage to grow back. If Osteo is caused by cartilage damage (for example due to an injury) Autologous Chondrocyte Implantation may be a possible treatment.
Signs & Symptoms
 The main symptom is usually chronic pain, causing loss of mobility and veru often stiffness. "Painfulness" is on the whole described as a sharp ache, or a burning sensation in the attendant muscles and tendons. Osteo can cause quite a loud crackling noise (called "crepitus") as the affected joint is moved or touched, and patients may experience muscle spasm and contractions in the tendons too. With some patients the joints may also be filled with fluid. Humid weather will increase the pain in many patients.
Osteo commonly affects the hands, feet, spine, and the larger weight-bearing joints, such as the hips and knees, though in theory, any joint in the body can be affected. As Osteo progresses, the affected joints appear bigger, are stiff and painful, and in the main feel worse, the more they are used through the day. This is one way of distinguishing it from rheumatoid arthritis.
In smaller joints, such as at the fingers, hard bony enlargements, called Heberden's nodes (on the distal interphalangeal joints) and/or Bouchard's nodes (on the proximal interphalangeal joints), may grow, and though they are not necessarily painful, they do limit the movement of the fingers significantly. Osteo at the toes can also lead to the formation of bunions, rendering them red or swollen.
Causes of Osteo arthritis
Osteo will often affect several members of the same family, suggesting that there is hereditary susceptibility to this condition. A variety of studies have shown that there is a greater prevalence of the disease between siblings and especially monozygotic twins, indicating a hereditary basis. Up to 60% of Osteo cases are thought to be caused by genetic factors. Researchers are also investigating the possibility of such things as allergies, infections, or fungi as a possible cause as well. There is suspected evidence that allergies, whether fungal, infectious or systematically induced, may be a significant contributing aspect to the appearance of osteo in a synovial sac.
Osteo may be divided into two types:
Primary Osteo arthritis
This kind of Osteo is caused by aging. As an individual ages, the water content of the cartilage decreases, and the protein composition in it degenerates, in this way degenerating the cartilage by repetitive use or misuse. Inflammation can also present itself, and stimulate new bone outgrowths, called "spurs" (osteophyte), to grow around the joints. Sufferers find their every movement so painful and debilitating that it can also affect them in other ways such as emotionally and psychologically.
Secondary Osteo arthritis
This kind of Osteo is caused by other conditions or diseases:
Congenital disorders, such as:
Congenital hip luxation
Individuals with abnormally-formed joints (e.g. hip dysplasia) are more vulnerable to Osteo , as added stress is specifically placed
on the joints whenever they move. However, recent studies show that double-jointedness may decidedly protect the fingers and hand from osteo arthritis.]
Cracking joints
The evidence is poor at best that this has any correlation to arthritis.
Diabetes
Inflammatory diseases (such as Perthes' disease), Lyme disease), and all the chronic forms of (e.g. costochondritis, gout, and rheumatoid arthritis). In gout, uric acid crystals cause the cartilage to degenerate at a much faster pace.
Injury to joints resulting from an accident
Hormonal disorders
Ligamentous deterioration or instability may play a part.
Obesity puts added weight on the joints, especially the knees.
Osteopetrosis (or High bone density).
Sports injuries, from exercising, athletic practices, or work. For example, certain sports, like weightlifting, running and even football, put undue stress on the knee joints. Injuries resulting in broken ligaments can lead to instability of the joint and over time wear of the cartilage and osteo arthritis.
Surgery to the joint structures themnselves.
Diagnosis & Treatment
Diagnosis is routinely done throughout x-rays. This is due to loss of cartilage, subchondral ("below cartilage") sclerosis, subchondral cysts, the narrowing of the joint space between adjacent bones, and bone spur formation (osteophytes) show up very clearly in x-rays. Plain films, nevertheless, often do not correlate with the findings of a physical examination in the early stages of the disease.
With or without other techniques, like MRI (magnetic resonance imaging), arthrocentesis and arthroscopy, a careful study of the duration, location and the appearance of the joints themselves, will help the physician to determine whether his patient suffers from Osteo arthritis.
There are currently no medical therapies that are proven to avert or reverse the progression of Osteo arthritis. There are medicines and other interventions that can lower the pain of Osteo and thereby improve the performance of the joint.
Included in the medication regimen for most cases, a mild pain reliever may be sufficient. In severe cases, NSAIDs are on the whole prescribed which can suppress both the pain and inflammation very effectively. These embody medications like diclofenac, ibuprofen and naproxen. High doses are very often required and prescribed. All NSAIDs act by inhibiting the formation of prostaglandins, which play a large part in inflammation and pain. But, these drugs are nevertheless tasking on the gastrointestinal tract, and may cause stomach upset, cramping diarrhoea, and peptic ulcers.
Another kind of NSAID, COX-2 selective inhibitors (like celecoxib, and the withdrawn rofecoxib and valdecoxib) bring down this risk substantially. These NSAIDs carry an elevated risk for cardiovascular disease, and some have now been withdrawn from the marketplace. Another medication, acetaminophen (paracetamol), is commonly used to treat the pains from Osteo arthritis, although unlike NSAID's acetaminophen doesn't treat the inflammation.
Application of heat - very often moist heat eases inflammation and swelling in the joints, and can help improve circulation, which has a healing feature on the local area.
Many doctors nowadays are loath to utilize steroids in the treatment of Osteo as their effects can be modest and the adverse effects may outweigh the benefits.
Coping skills
No matter what the severity, or where the Osteo lies, conservative measures like weight control, appropriate rests and exercises, and the application of mechanical support devices are generally helpful to sufferers. In the case of Osteo of the knees, knee braces, a cane, or a walker can be helpful for walking and support. Regular exercises, if reasonable, in the form of walking or swimming is encouraged. Applying local heat prior to, and cold packs following exercising, can help relieve pain and inflammation, as do relaxation techniques. Weight loss can delay progression of the illness. As such, the suitable guidance and advice by a physiotherapist go a long way in Osteo management, enabling sufferers to help get back to their previous routine.
Dealing with chronic pains can be difficult and end in depression. Communicating with other Osteo sufferers is generally very helpful, as is maintaining a upbeat attitude. People who take control of their treatment, communicate with their medic, and actively manage their osteo arthritis are more likely to experience less pain and perform better.
|
