A Simple Guide to Osteoarthritis
Osteoarthritis
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What is Osteoarthritis ?
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Osteoarthritis
is a degenerative condition of the joints in the human body.
It is the most common form of arthritis.
The cartilage lining of the joint are worn down such that the underlying bone come in contact with each other.
In addition bone spurs may form and joint fluid is reduced.
------------------
What is Osteoarthritis ?
----------------------------
Osteoarthritis
is a degenerative condition of the joints in the human body.
It is the most common form of arthritis.
The cartilage lining of the joint are worn down such that the underlying bone come in contact with each other.
In addition bone spurs may form and joint fluid is reduced.
This causes mechanical and chemical reactions giving rise to the symptoms of Osteoarthritis.
What causes Osteoarthritis ?
----------------------------------
1. Genetics
has found to have role in the predisposition of Osteoarthritis.
Genes on chromosome 2q,4 & 16 have been linked with Osteoarthritis.
2. Aging
is a risk factor of Osteoarthritis.
More than 80% of those above 65 years suffer from Osteoarthritis.
3. Excessive physical activity is a potentially correctable cause of Osteoarthritis.
Activities like long distance running and other high endurance sports may place
the joints under high stress for prolonged periods resulting in overuse injuries and
accelerated wear and tear.
4. Gender plays a role in Osteoarthritis. Osteoarthritis is more common in men for a
cohort of under 50 years and more common in women in the cohort of 50-80 years.
5.Trauma is a common cause of Osteoarthritis in the younger age groups.
What are the symptoms of Osteoarthritis?
-------------------------------------------------
Most common symptom are pain and swelling:
Stiff,painful and swollen joints after a workout
Stiffness in the joints in the mornings which can last about half an hour
Loss of flexibility in one's joints
Bony lumps at the base of the thumb or on the middle of the end joints of the fingers
Pain in the joints after repeated use
Osteoarthritis is often associated with joint surgery or related injury
What are the complications of Osteoarthritis ?
-------------------------------------------------------
Osteoarthritis is the top cause of disability in older women and ranks second in older men.
Besides pain and swelling, quality of life suffers in patients with Osteoarthritis due to their loss of mobility and depression.
The loss of mobility is progressive with age.
Where does Osteoarthritis occur ?
----------------------------------------
It can affect the any joint of the body although the most commonly affected joints are the weight bearing joints:
knee
hip
ankle
spine.
Other non-weight bearing joints such as
shoulder ,
elbow,
fingers
can also be affected.
How do you treat Osteoarthritis ?
----------------------------------------
Osteoarthritis is not curable and the purpose of treatment is to:
1. improve functions and
2. reduce pain and discomfort.
Treatment of Osteoarthritis can be broadly classified into:
1. Non-interventional
a. non-pharmaceutical
Weight loss is an effective way to reduce the stress on the joints and minimise the pain
Walking sticks are useful ways to offload the stress on the affected weight bearing
joints such as hips or knee. The walking aids should be used on the opposite side.
It can be in the form of a sturdy umbrella instead of a crutch.
Hot packs are useful aids in the morning to soften a stiff arthritic joint whereas braces
and knee guards are useful supports to give some comfort to the knee.
Exercises that improve strength, agility and flexibility are useful to minimise
the disability of Osteoarthritis.
A range of motion exercises is useful to keep the joints supple and mobile .
Water based exercises are a good alternative form of aerobic workout by patients afflicted
by Osteoarthritis. The warm water especially is a good medium for joint mobility and
together with the buoyancy of water it helps to minimise the body weight impact
on the joints.
b. pharmaceutical
There are 2 main types of drugs:
1. symptom modifying drugs help to alleviate the symptoms but do not change the
natural history of the conditions.
Examples are Non-steroidal Anti-inflammatory Drugs(NSAIDs) like diclofenac.
2. disease modifying drugs such as glucosamine has been shown to slow down the
wear and tear of the cartilage but it does have the ability to grow new cartilage.
It has also being found to work better with chondroitin.
2. Interventional:
a. non-surgical
Joint aspiration is a procedure where fluid from the swollen joint is removed,
helping to decompress the tension and bring relief for a while .
Vasosupplementation is a procedure whereby a lubricant is injected into the affected
joint thus reducing the the frictional wear of the joint surfaces.
In addition the lubricant has anti inflammatory properties to reduce the inflammation in the
lining of the joints and may ease the pain for months in early osteoarthritic cases .
b.surgical
Surgical intervention is usually the last resort when all other above treatment fail and in
advanced cases:
Debridement is an arthroscopic (keyhole) procedure to clean the joint of torn cartilages,
loose pieces of bones, etc.
Its main use is to remove the worn out debris which may cause pain and can mechanically
cause friction.
High tibial Osteotomy is a procedure to correct the alignment of deformed legs which
then reduce the stress on the joint.
Prosthetic joint replacement is a procedure to replace the diseased portion of the joint
with a prosthesis or artificial joint allowing painless good range of movement.
It is more suitable for older patient because there is a shelf life to these implants.
Unicondylar joint replacement can now be performed in which part of one of
the bone of the diseased joint is removed instead of a total joint replacement which
involved removal of part of both bones of a joint.
The choice of treatment depends on the stage of the disease and whether there are associated complication.
In general non-interventional methods are more suitable at the early stage of the illness and interventional modalities are more suitable for the later stage of Osteoarthritis.
What causes Osteoarthritis ?
----------------------------------
1. Genetics
has found to have role in the predisposition of Osteoarthritis.
Genes on chromosome 2q,4 & 16 have been linked with Osteoarthritis.
2. Aging
is a risk factor of Osteoarthritis.
More than 80% of those above 65 years suffer from Osteoarthritis.
3. Excessive physical activity is a potentially correctable cause of Osteoarthritis.
Activities like long distance running and other high endurance sports may place
the joints under high stress for prolonged periods resulting in overuse injuries and
accelerated wear and tear.
4. Gender plays a role in Osteoarthritis. Osteoarthritis is more common in men for a
cohort of under 50 years and more common in women in the cohort of 50-80 years.
5.Trauma is a common cause of Osteoarthritis in the younger age groups.
What are the symptoms of Osteoarthritis?
-------------------------------------------------
Most common symptom are pain and swelling:
Stiff,painful and swollen joints after a workout
Stiffness in the joints in the mornings which can last about half an hour
Loss of flexibility in one's joints
Bony lumps at the base of the thumb or on the middle of the end joints of the fingers
Pain in the joints after repeated use
Osteoarthritis is often associated with joint surgery or related injury
What are the complications of Osteoarthritis ?
-------------------------------------------------------
Osteoarthritis is the top cause of disability in older women and ranks second in older men.
Besides pain and swelling, quality of life suffers in patients with Osteoarthritis due to their loss of mobility and depression.
The loss of mobility is progressive with age.
Where does Osteoarthritis occur ?
----------------------------------------
It can affect the any joint of the body although the most commonly affected joints are the weight bearing joints:
knee
hip
ankle
spine.
Other non-weight bearing joints such as
shoulder ,
elbow,
fingers
can also be affected.
How do you treat Osteoarthritis ?
----------------------------------------
Osteoarthritis is not curable and the purpose of treatment is to:
1. improve functions and
2. reduce pain and discomfort.
Treatment of Osteoarthritis can be broadly classified into:
1. Non-interventional
a. non-pharmaceutical
Weight loss is an effective way to reduce the stress on the joints and minimise the pain
Walking sticks are useful ways to offload the stress on the affected weight bearing
joints such as hips or knee. The walking aids should be used on the opposite side.
It can be in the form of a sturdy umbrella instead of a crutch.
Hot packs are useful aids in the morning to soften a stiff arthritic joint whereas braces
and knee guards are useful supports to give some comfort to the knee.
Exercises that improve strength, agility and flexibility are useful to minimise
the disability of Osteoarthritis.
A range of motion exercises is useful to keep the joints supple and mobile .
Water based exercises are a good alternative form of aerobic workout by patients afflicted
by Osteoarthritis. The warm water especially is a good medium for joint mobility and
together with the buoyancy of water it helps to minimise the body weight impact
on the joints.
b. pharmaceutical
There are 2 main types of drugs:
1. symptom modifying drugs help to alleviate the symptoms but do not change the
natural history of the conditions.
Examples are Non-steroidal Anti-inflammatory Drugs(NSAIDs) like diclofenac.
2. disease modifying drugs such as glucosamine has been shown to slow down the
wear and tear of the cartilage but it does have the ability to grow new cartilage.
It has also being found to work better with chondroitin.
2. Interventional:
a. non-surgical
Joint aspiration is a procedure where fluid from the swollen joint is removed,
helping to decompress the tension and bring relief for a while .
Vasosupplementation is a procedure whereby a lubricant is injected into the affected
joint thus reducing the the frictional wear of the joint surfaces.
In addition the lubricant has anti inflammatory properties to reduce the inflammation in the
lining of the joints and may ease the pain for months in early osteoarthritic cases .
b.surgical
Surgical intervention is usually the last resort when all other above treatment fail and in
advanced cases:
Debridement is an arthroscopic (keyhole) procedure to clean the joint of torn cartilages,
loose pieces of bones, etc.
Its main use is to remove the worn out debris which may cause pain and can mechanically
cause friction.
High tibial Osteotomy is a procedure to correct the alignment of deformed legs which
then reduce the stress on the joint.
Prosthetic joint replacement is a procedure to replace the diseased portion of the joint
with a prosthesis or artificial joint allowing painless good range of movement.
It is more suitable for older patient because there is a shelf life to these implants.
Unicondylar joint replacement can now be performed in which part of one of
the bone of the diseased joint is removed instead of a total joint replacement which
involved removal of part of both bones of a joint.
The choice of treatment depends on the stage of the disease and whether there are associated complication.
In general non-interventional methods are more suitable at the early stage of the illness and interventional modalities are more suitable for the later stage of Osteoarthritis.
