Osteoarthritis is a type of arthritis that is caused by the breakdown and eventual loss of the cartilage of one or more joints. Cartilage is a protein substance that serves as a “cushion” between the bones of the joints. Osteoarthritis is also known as degenerative arthritis.
Osteoarthritis commonly affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees. Most cases of osteoarthritis have no known cause and are referred to as primary osteoarthritis. When the cause of the osteoarthritis is known, the condition is referred to as secondary osteoarthritis
- With aging, the water content of the cartilage increases and the protein makeup of cartilage degenerates. Repetitive use of the joints over the years irritates and inflames the cartilage, causing joint pain and swelling. Eventually, cartilage begins to degenerate by flaking or forming tiny crevasses. In advanced cases, there is a total loss of the cartilage cushion between the bones of the joints. Loss of cartilage cushion causes friction between the bones, leading to pain and limitation of joint mobility.
- Inflammation of the cartilage can also stimulate new bone outgrowths (spurs) to form around the joints.
- Osteoarthritis occasionally can be found in multiple members of the same family, implying an heredity (genetic) basis for this condition.
The most common symptom of osteoarthritis is pain in the affected joint(s) after repetitive use. Joint pain is usually worse later in the day.
- There can be swelling, warmth, and creaking of the affected joints.
- Pain and stiffness of the joints can also occur after long periods of inactivity,
- In severe osteoarthritis, complete loss of cartilage cushion causes friction between bones, causing pain at rest or pain with limited motion.
- Symptoms of osteoarthritis vary greatly from patient to patient. Some patients can be debilitated by their symptoms. On the other hand, others may have remarkably few symptoms in spite of dramatic degeneration of the joints apparent on x-rays.
- Symptoms also can be intermittent. It is not unusual for patients with osteoarthritis of the hands and knees to have years of pain-free intervals between symptoms.
- Osteoarthritis of the knees is often associated with obesity or a history of repeated injury and/or joint surgery. Progressive cartilage degeneration of the knee joints can lead to deformity and outward curvature of the knees referred to as “bow legged.”
- Patients with osteoarthritis of the weight bearing joints (like the knees) can develop a limp. The limping can worsen as more cartilage degenerates. In some patients, the pain, limping, and joint dysfunction may not respond to medications or other conservative measures.
- Osteoarthritis of the spine causes pain in the neck or low back. Bony spurs that form along the arthritic spine can irritate spinal nerves, causing severe pain, numbness, and tingling of the affected parts of the body.
- Osteoarthritis causes the formation of hard bony enlargements of the small joints of the fingers. Classic bony enlargement of the small joint at the end of the fingers is called a Heberden’s node, named after a very famous British doctor. The bony deformity is a result of the bone spurs from the osteoarthritis in that joint. Another common bony knob (node) occurs at the middle joint of the fingers in many patients with osteoarthritis and is called a Bouchard’s node.
- X-rays of the affected joints can suggest osteoarthritis. The common x-ray findings of osteoarthritis include loss of joint cartilage, narrowing of the joint space between adjacent bones, and bone spur formation. Simple x-ray testing can be very helpful to exclude other causes of pain in a particular joint as well as assist the decision-making as to when surgical intervention should be considered.
- Arthrocentesis is often performed in the doctor’s office. During arthrocentesis, a sterile needle is used to remove joint fluid for analysis. Joint fluid analysis is useful in excluding gout, infection, and other causes of arthritis. Removal of joint fluid and injection of corticosteroids into the joints during arthrocentesis can help relieve pain, swelling, and inflammation.
- Arthroscopy is a surgical technique whereby a doctor inserts a viewing tube into the joint space. Abnormalities of and damage to the cartilage and ligaments can be detected and sometimes repaired through the arthroscope. If successful, patients can recover from the arthroscopic surgery much more quickly than from open joint surgery
Physioline Management includes
- Aside from weight reduction and avoiding activities that exert excessive stress on the joint cartilage, there is no specific treatment to halt cartilage degeneration or to repair damaged cartilage in osteoarthritis.
- The goal of treatment in osteoarthritis is to reduce joint pain and inflammation while improving and maintaining joint function.
- conservative measures such as rest, exercise, weight reduction, physical and occupational therapy, and mechanical support devices. These measures are particularly important when large, weight-bearing joints are involved, such as the hips or knees. In fact, even modest weight reduction can help to decrease symptoms of osteoarthritis of the large joints, such as the knees and hips.
- Medications are used to complement the physical measures described above. Medication may be used topically, taken orally, or injected into the joints to decrease joint inflammation and pain.
- Resting sore joints decreases stress on the joints, and relieves pain and swelling. Patients are asked to simply decrease the intensity and/or frequency of the activities that consistently cause joint pain.
- Exercise usually does not aggravate osteoarthritis when performed at levels that do not cause joint pain. Exercise is helpful in osteoarthritis in several ways. First, it strengthens the muscular support around the joints. It also prevents the joints from “freezing up” and improves and maintains joint mobility. Finally, it helps with weight reduction and promotes endurance.
- Applying local heat before and cold packs after exercise can help relieve pain and inflammation.
- Swimming is particularly suited for patients with osteoarthritis because it allows patients to exercise with minimal impact stress to the joints.
- Other popular exercises include walking, stationary cycling, and light weight training.
- Physical therapists can provide support devices, such as splints, canes, walkers, and braces. These devices can be helpful in reducing stress on the joints.
- Finger splints can support individual joints of the fingers. Paraffin wax dips, warm water soaks, and nighttime cotton gloves can help ease hand symptoms.
- Spine symptoms can improve with a neck collar, lumbar corset, or a firm mattress, depending on what areas are involved.
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