Osteoarthritis, also known as degenerative arthritis, is a type of arthritis that is most common among adults 50 years of age or older. This happens when joints become painful and swollen due to the breakdown and loss of cartilage, a protein substance that serves as a cushion between bones.
Osteoarthritis happens when the cartilage that acts as a cushion between bones gets worn out over time. Eventually, when the cartilage gets completely eroded, bone will rub on bone, causing pain and inflammation of the affected joints. This most commonly affects joints in the hands, knees, hips, and spine. There are various factors which can increase the risk for osteoarthritis: • Aging • Obesity • Repeated injury or surgery to joints • Congenital abnormalities • Certain metabolic diseases, like diabetes mellitus • Hormone disorders
Damage to the cartilage can occur because of (1) mechanical overload associated with certain occupations or with obesity, (2) weak muscles due to lack of exercise, deconditioning, or muscle disease, (3) an imbalance in loading of the joint due to congenital anomalies like knock-knee or bowlegs, (4) instability from torn ligaments or tendons resulting from injuries, or (5) abnormal nerve supply as can be seen in diabetic neuropathy. Recurrent or persistent inflammation of the joint due to gout, rheumatoid arthritis, or infection can also lead to cartilage damage.
OA is more common in older people because with ageing, there is reduced capacity for repair and decrease in the amount and quality of the lubricants in joint (synovial) fluid. However, OA is a disease and is not just an inevitable part of aging. The risk for OA can also be inherited.
Osteoarthritis may produce the following symptoms: • Pain and stiffness in the affected joint/s • Swelling, warmth, and creaking of the affected joint/s • Loss of flexibility
Osteoarthritis can affect almost any joint, but most commonly involves the hands, knees, hips, cervical and lumbar spine. The main symptom of OA is pain that is worse with activity and relieved by rest. Typically, the patient feels short-lived pain and stiffness of the involved joint when moving after a prolonged period of rest. This discomfort disappears as movement is continued but it reappears when activity, like standing or walking, is prolonged. Swelling due to increased joint fluid or enlargement of the bone may occur. Cracking or grating sound or sensation during movement, reduced joint motion, and changes in the shape of the affected joints can also occur.
Osteoarthritis can be diagnosed after interviewing and examining an individual; in more complicated cases, imaging studies like an X-ray and magnetic resonance imaging (MRI) may offer additional information to help manage the individual’s condition.
There is currently no cure to either stop cartilage degeneration or to repair damaged cartilage. However, individuals with the disease can undergo various treatments to help relieve pain and to manage any resulting disability.
Initial treatments are nonsurgical, including:
If a person doesn’t respond to the above treatments, and develops significant disability, he/she may be advised to undergo surgery (like joint replacement) depending on his/her condition.
The following interventions may help prevent osteoarthritis:
These measures may also help prevent the development of OA among those at risk for the disease (older age, with family history of OA, congenital deformity, obesity, weak muscles, previous injury or surgery to the joint). We may also consult a musculoskeletal disease specialist to inquire on how best to take care of our joints and reduce the risk of OA.