Hello, many of you have heard a medical term "Osteoarthritis". Many elderly people can be seen complaining about their joints pain due to aging. Most of them were or are suffering from the disease called Osteoarthritis. So, in this blog I'm going to give an idea about osteoarthritis, what exactly it is, troubling our dear elderly people.
What is Osteoarthritis (OA)?
Osteoarthritis (OA) is a degenerative joint disease hat results from breakdown of joint cartilages and underlying bone. The etiology is multi-factorial, but commonly it is thought to be wear and tear of joints as on ages. The most common symptoms are joint pain and stiffness. Other symptoms include joint swelling, decreased range of motion. It can affect ones work and activities of daily living. Below, in the picture, one can see difference between healthy and osteoarthritic joint.
Types of Osteoarthritis
Primary OA:- This occur in old age, mainly in the weight bearing joints ( knees and hip). Primary OA is commoner than secondary OA.
Secondary OA:- This type of OA is caused by an underlying primary disease of the joint which leads to the degeneration of the joint, often in many years later. It may occur at any age after adolescence.
Causes of Secondary OA:-
- Joint Infection
- Congenital disorders of the joints
- Inflammatory diseases such as Perthes' disease, Lyme's disease, gout, Rheumatoid arthritis, costochondritis.
- Injury to joints or ligaments such as ACL or PCL injury as result of an accident.
- Ligamentous deterioration or instability may be a factor.
- Marfan syndrome
- Ehlers-Danlos Syndrome.
Signs and Symptoms
This disease occurs in elderly people, mostly in the major joints of the lower limb, frequently bilaterally. The main symptom is pain, causing loss of ability leading to joint stiffness. In beginning, pain occurs intermittently, but becomes constant over months or years. Initially, it is dull pain and comes on starting activity after a period of rest; but later it becomes worse and comes after activity. OA can cause a cracking noise called crepitus. Swelling of the Joint occurs due to the effusion caused by inflammation of the synovial tissues. Stiffness initially due to pain and muscle spasm, but laterally due to capsular contracture and incongruity of the joint surfaces.
Diagnosis is made on history and clinical examinations. X-ray may confirm the diagnosis. The following X-ray changes can be seen include:-
- Reducing joint spaces.
- Increased bone formation around the joint
- Subchondral cysts
- Osteophyte formation
- Loose bodies
- Deformation of the joint.
This disease once started, progresses gradually, there is no way to stop it. Lifestyle modification and analgesics are the mainstream treatment.
For overweight persons, weight loss may be an important factor. Patients education is helpful in self management of arthritis. Exercise should be included in daily lifestyle.
Analgecis are commonly used to suppress the pain. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are choice of use. But sometime steroidal therapy may be required.
Many dietary supplements are claimed to help in treating OA. Glucosamine and Chondritine Sulphate, are claimed to have results in repairing of the damaged cartilage.
Supportive Therapy:- Physiotherapy
Physiotherapy can play an important role in OA management. Electrotherapy modalities ( like TENS and IFT) are used by the therapist to control the pain. Heat therapy (like paraffin wax, hot packs) can be used to deal with pain, swelling and muscle spasm. Ultrasonic Therapy may help in reducing the tenderness and swelling, thus leading to pain relief.
Specific Joint related exercise are prescribed by the therapist to make the muscles strong and give support to the arthritic joint. Exercise plays the major role in treating or managing OA.
- Osteotomy: Osteotomy near a joint has been known to bring about relief in symptoms, especially in arthritic joints with deformities.
- Arthroscopic Procedures: Arthroscopic removal of loose bodies, degenerated meniscal tears and other such procedures have become popular because of their less invasive nature. In arthroscopic procedure, the degenerated, fibrillated cartilage is excised using a power-driven shaver under arthroscopic vision. Results are unpredictable.
- Joint Replacement: Advanced damaged osteoarthritic joints requires this. Total joint replacement operation has provided remarkable rehabilitation. These are commonly performed for the hip and knee. An artificial joint serves for about 10-15 years. Below, an X-ray taken after total knee joint replacement.
Well friends, hope you will like my blog about osteoarthritis. Questions regarding osteoarthritis, are most welcomed.