Osteoarthritis (OA)

What is osteoarthritis?

Osteoarthritis is a condition where the cartilage and ends of the bone in a joint are eroded. Cartilage acts as a cushion to the ends of the bones and allows ease of movement at the joints. The breakdown of cartilage exposes the underlying bones thereby causing the ends to rub against each other. This makes the joints stiff, painful and less flexible. Therefore, osteoarthritis is a condition associated with wear and tear. It may affect any joint but is more common in larger joints and weight bearing joints such as the knees, elbows, thighs and hips. Osteoarthritis is a progressive disease that gradually worsens with time. Although there is no cure, medication may relieve pain and improve joint function.

What are the symptoms of osteoarthritis?

The main signs and symptoms of osteoarthritis are:

  • Pain – caused due to weakening of muscles around the joint. Affected person experiences less pain in the morning and gets worse in the evening after a full day’s activity.
  • Stiffness – after periods of rest or inactivity that goes away once the activity is resumed. Morning stiffness is the typical sign of arthritis.
  • Changes in gait – the pain and stiffness affects the ability to walk in a normal manner.
  • Abnormal joint sounds – grating and cracking sounds may be audible with joint movement.
  • Swelling – not usually present with osteoarthritis but can occur with acute inflammatory states.

What causes osteoarthritis?

Any specific cause of osteoarthritis is not known. However, there are several risk factors that should be avoided to minimize the risk. The primary cause of developing stiff joints is age-related. The mobility and function of joints deteriorates with wear and tear of joint tissues that gets worse during old age.

Obesity or increased body weight play a crucial role in the development of arthritis. It particularly affects the knees that carry the entire weight of the body. Excessive use of joints strains it. Injury and increased stress on joints have a high risk of developing OA. Genetic abnormalities that affect the shape or stability of the joints can lead to arthritis. It is more common in joints that don’t fit together smoothly or due to unequal leg length.

Diseases like diabetes may cause loss of sensation in nerves and prevent the affected individual from sensing the injury. Thus, diabetes makes a person more prone to stiff joints.

Other possible causes include:

  • Inflammation of joints in diseases like chronic gout and rheumatoid disease.
  • Broken bones or damaged cartilage
  • Metabolic errors like Paget’s disease and Wilson disease
  • Genetic defects that initiate or accelerate breakdown of the protective cartilage like Ehlers-Danlos syndrome
  • Women are more likely to develop osteoarthritis than men.

How is osteoarthritis treated?

There is no cure for osteoarthritis. Treatment of osteoarthritis usually aims at reducing pain and associated discomfort. Medication usually includes over-the-counter anti-inflammatory drugs like acetaminophen. Opioid analgesics are reserved for very severe cases. Regular exercises, reducing weight and avoid stressing the joints often turns effective. Consulting a physiotherapist provides a better option.

Severe and unresponsive cases of OA also require surgical interventions like:

  • Hyaluronic acid injection for lubrication of joints
  • Corticosteroid injections for relieving intense pain
  • Replacement of damaged joint architecture with some synthetic material like plastic

The replaced joint also runs the risk of wearing out and may need to be replaced again. In some cases, bracing also helps in distributing weight and restricting movement that prevents osteoarthritis. Keeping a positive outlook and knowing your work limits may help combat the risk of developing OA.

 

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