Osteoarthritis (OA) is a type of arthritis. It is also known as Degenerative Arthritis, and it is the most common type of arthritis. It commonly affects the hands, hips, and knees. The knee arthritis affects the joints on the knees and thus causes pain that can lead to disability. There are different stages in OA, with 0 being a normal stage and 4 being the most severe stage of OA. According to the Center for Disease and Prevention, the number of people suffering from OA is increasing steadily. This has dramatically affected workforce productivity and economic costs.
Epidemiology
Osteoarthritis is a common joint condition in America. However, it is likely to affect men more than women. The risk of developing the disorder also increases with age. Similarly, obesity increases a person’s vulnerability.
Predisposing factors
Primary Osteoarthritis is often a result of aging. As one gets older, the cartilage’s water content increases. This results in the degeneration of the cartilage’s protein make-up. Thus, as repetitive uses of the joint continue, the cartilage is damaged, these damages cause joint pains and swelling. There are some cases where multiple people from the same family may have OA, and this indicates, there is a genetic basis for the disease.
Secondary osteoarthritis results from another disease. It is caused by conditions such as obesity, which increases the mechanical stress on the cartilage, and it causes early OA in the knees. Similarly, it can be caused by repeated surgery on the joint tissues, and this is common among soccer players and long-distance runners. Gout is also a predisposing factor to OA. The crystal deposits on the cartilage will cause its degeneration. The uric crystals cause this in gout. Rheumatoid arthritis damages the joints and could lead to OA as the cartilage degenerates. Congenital abnormalities put a person at risk of OA. These people are susceptible to mechanical wear at an early age and commonly suffer from hip osteoarthritis. Finally, hormonal disturbances also cause early mechanical wear to the cartilage and thus causing OA.
Signs and Symptoms
The main symptom of osteoarthritis is pain in the hip, hand, and knee joints. This can be coupled with swelling and creaking of the affected joints. Likewise, there can be warmth on the joints. In severe cases of OA where the cartilage is completely lost, a patient would experience pain with limited movement.
Normal Physiology
In a healthy individual, the cartilage is often a tough tissue. However, it is also smooth and slippery. It is found on the bones’ surface and ensures that the bones can move freely.
Pathophysiology
As one gets older, the cartilage’s water content increases. This results in the degeneration of the cartilage’s protein make-up. Thus, as repetitive uses of the joint continue, the cartilage is damaged, these damages cause joint pains and swelling. Ultimately, the cartilage degenerates and start flaking and forming tiny gaps. In extreme cases, the cartilage cushion is lost. The lack of cartilage between the joints in the ones causes friction that results in pain and reduced mobility. Similarly, damaged cartilage may cause new bone
Outgrowths around the joints.
Biopsychosocial impact
As the cartilage progressively degenerates in the knee, joints can result in bow-legged. This is a condition in which the knees curve outwards. In people with obesity, OA can cause the patients to acquire a limp that would worse with increased degeneration. On the fingers, it results in the development of hard body enlargements, a condition known as Heberden’s node. If the node is on the fingers middle joint, then it a Bouchard’s node. The two conditions might not be painful, but the limit movement within the fingers.
Diagnosis
The pain from OA can be identified through its common symptoms or common diagnosis. A blood test is carried on patients with OA to eliminate conditions that result in secondary osteoarthritis and other arthritis diseases that have similar symptoms. OA is mainly identified through X-rays. These X-rays will show loss of joint cartilage, increase in the joint spaces in the bones, and any formation of bone spurs. Similarly, X-rays can be used to eliminate other conditions that may cause pain to the joints. Nevertheless, there are some people with large OA but only show minor variations in an X-ray. Hence there is a need to concentrate more on the symptoms and not only the X-rays.
Additionally, for an OA patient, an arthrocentesis has to be performed in which the joint fluid is removed for analysis to eliminate certain conditions such as gout and inflammatory arthritis. Diagnosis is also made through arthroscopy in which a viewing tube is inserted into the joint space. The arthroscope detects and repairs the abnormalities in the cartilage.
Finally, the doctor has to know the precise location of the joint pain. Also, information about the duration and the properties, and the appearance of the joint symptoms can help in diagnosis.
Treatment or Management
It is not possible to reverse osteoarthritis. The available treatments are to help in reducing the patient and help the patient with better movement. Several medications are used to relieve pain. These include Acetaminophen for mild and moderate pain. Similarly, there are non-steroidal anti-inflammatory drugs (NSAIDs) that can be bought over the counter. They include ibuprofen and naproxen sodium. Stronger NSAIDs require a prescription before they can be dispatched. The final drug is Duloxetine that is used to relieve chronic pain.
Therapy can also be used to help with OA. Physical therapy helps in strengthening the muscles. Additionally, it increases the patient’s flexibility and helps reducing pain. On the other hand, occupational therapy is used to help the patient to carry out his various activities without applying much pressure on the painful joints.
Finally, surgical and various procedures can be used in osteoarthritis treatments. The first one is cortisone injections in which the doctor numbs the affected joint and then injects medication in the space. Likewise, lubrication injections can be used. Hyaluronic acid is used to cushion the knee. Additionally, the bones can be realigned through osteotomy. In this procedure, a wedge of bone is added or removed either above or below the knee. Thus, the bodyweight is shifted from the damaged area. The final surgical procedure is a joint replacement in which the damaged joints are replaced with a plastic or metal parts.
Additionally, lifestyle remedies can help with osteoarthritis. Low impact exercise can help in increasing endurance while strengthening the muscles in the joins and increasing joint stability. It is also essential to losing weight if the patient is obese to relive some pressure from the joints and thus reduce pain.
Prognosis
Each of the mentioned treatments has its side effects if not used effectively. Thus, it would be useful it the patient lost some weight if obese, and carry out low impact exercises. This can be could with movement therapies such as yoga. Hence, there will be a moderation in the use of pain-killers.