CONDITIONS

Osteoarthritis

Osteoarthritis

Osteoarthritis is a widespread and very common problem, and it is the most frequent joint disease with a prevalence of 22% to 39% in India. Osteoarthritis occurs over a period when the protective cartilage that cushions the ends of the bones wears down. Osteoarthritis most commonly affects joints in your hands, knees, hips, and spine.

What are the symptoms of Osteoarthritis?

Signs and symptoms of osteoarthritis are:

  • Pain in affected joints that may hurt during normal day to day movements or in case of excessive movement.
  • Stiffness – Most noticeable in the morning after waking up or after being inactive.
  • Tenderness – Joints may feel tender.
  • Loss of flexibility – a person may be able to move the joint in full capacity.
  • Grating sensation
  • Swelling might be seen because of soft tissue inflammation around the joint.

What are the causes and risk factors of Osteoarthritis?

Several factors increase the risk of OA as follows:

  • Older age: Risk of osteoarthritis increases with age.
  • Sex: Women are more likely to develop osteoarthritis
  • Obesity: The more you weigh, the greater your risk of OA as more weight adds stress to weight-bearing joints.
  • Joint injuries that occur while playing sports or from an accident may increase chances of development of osteoarthritis.
  • Repeated stress on the joint: A job which includes repetitive stress on a joint, or a sport played by people such as squash, etc. might eventually develop osteoarthritis.
  • Hereditary: Some people have genetic defect in making the cartilage required, which may lead to rapid degeneration of joints.

How is Osteoarthritis diagnosed?

The doctor conducts a physical exam, and checks the joint for tenderness, swelling, stiffness, redness and flexibility.

Some imaging tests to get clarity may be conducted as follows:

Imaging tests

  • X-rays to assess the space between the bones in the joint and to check for cartilage damage.
  • Magnetic resonance imaging (MRI): An MRI produces detailed images of bone and soft tissues, including cartilage by using radio waves and a strong magnetic field

Lab tests like –

  • Blood test : No tests for OA but to rule out Rheumatoid arthritis, these tests are done.
  • Joint fluid analysis: Fluid is drawn from affected joint to check for cause of the inflammation.

What are the treatment options of Osteoarthritis?

OA cannot be reversed but several therapies and medications help in slowing down progression and managing symptoms. These are:

Medicines: To relieve the pain, paracetamol and painkillers (NSAIDs) are given.

Physical therapy: A physiotherapist shows exercises to strengthen the muscles around the joint, increase flexibility and reduce pain. Regular gentle exercise such as swimming or walking, may be equally effective.

Occupational therapy: An occupational therapist helps discover ways to do regular tasks without putting extra stress on the arthritic joint. For example, a bench in the shower helps relieve the pain of standing in case of knee osteoarthritis.

Transcutaneous electrical nerve stimulation (TENS): Uses a low-voltage electrical current to relieve pain providing short-term relief in some people with knee and hip osteoarthritis.

Surgical and other procedures

  • Cortisone injections given in the joint to relieve pain for a few weeks. Consult the doctor and only upon his suggestion are few injections given in the entire year.
  • Lubrication injections such as that of hyaluronic acid might relieve pain by providing some cushioning knee. though some research suggests that these injections offer no more relief than a placebo. Hyaluronic acid is similar to a component normally found in your joint fluid.
  • Realigning bones – A knee osteotomy,
  • Joint replacement – in this, the damaged joint surfaces are removed and replaced with plastic and metal parts.

How Can Osteoarthritis be managed properly?

  • Exercise
  • Lose weight
  • Movement therapies like tai chi and yoga involve gentle exercises and stretches combined with deep breathing
  • Heat and cold pack
  • Braces or shoe inserts. Shoe inserts or other devices might help reduce pain when you stand or walk.
  • Assistive devices to relieve the stress on the joints such as a cane or walker take weight off the knee or hip

References

  1. Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian J Orthop. 2016 Sep;50(5):518-522.
  2. Osteoarthritis. WebMD. March 2024. https://www.webmd.com/osteoarthritis/osteoarthritis-basics
  3. Osteoarthritis. Mayo Clinic. March 2024. https://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/drc-20351930

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