• Tue. Sep 27th, 2022

Osteoarthritis: its diagnosis and medical treatments

ByMadeleine J. Pierce

Jun 22, 2022

Osteoarthritis (OA) is the most common form of arthritis. According to the Centers for Disease Control and Prevention (CDC), over 32.5 million adults in the United States have this condition. It is considered a “wear and tear” disease of the joints of the body. It destroys the padding and slippery cartilage at the ends of bones. It mainly affects the back, hips, knees and sometimes the big toes, fingers and thumbs. Osteoarthritis is more common in older people and has no cure. Osteoarthritis can get worse over time, but there are treatments that relieve symptoms.

Osteoarthritis is a very different disease from rheumatoid arthritis. Osteoarthritis is a degenerative wear and tear disease. Rheumatoid arthritis (RA) is a disease that inflames the tissues of the joints. It is caused by a dysfunctional immune system that attacks healthy cells. Both Osteoarthritis and rheumatoid arthritis can cause pain, stiffness and swelling.

The most common targets of rheumatoid arthritis are feet, wrists and hands excluding the spine, hips and knees, which are primarily impacted by OA. Unlike osteoarthritis, rheumatoid arthritis can also affect organs such as the liver, heart, lungs and eyes. RA symptoms are more common. Rheumatoid arthritis can affect younger people, although it usually begins in a middle-aged person. About 8 in 100,000 young adults (ages 18 to 34) get RA. Conversely, osteoarthritis is a disease of aging.

With rheumatoid arthritis, the symptoms start quickly unlike the symptoms of osteoarthritis, which are gradual. With rheumatoid arthritis, the joints are sore and stiff in the morning, but osteoarthritis pain usually gets worse after activity. Rheumatoid arthritis affects the joints on both sides of the body while, in the case of osteoarthritis, the disease affects the joints on one side of the body. Doctors use X-rays to reveal other differences and treatments.

Symptoms of osteoarthritis:

  • Joint pain or aches during or after movement; with hip osteoarthritis, pain can occur in the buttocks and sometimes on the inside of the knee or thigh

  • Joint stiffness after inactivity or rest

  • Decreased flexibility and limited range of motion

  • Bone spurs, which are bony growths on the edge of bones like fingers

  • Grate, crackle, or pop when joint bends

  • Swelling, usually in the ankles and feet

  • Tenderness with slight pressure (most often in the big toes)

  • Joint buckling (often occurs in the knee)

Risk factors:

  • Advanced age – usually over 50

  • Female

  • Being overweight, which puts more pressure on the hips and knees. Fat cells produce proteins that cause joint inflammation.

  • Old injuries of all kinds can put you at increased risk for osteoarthritis.

  • Repetitive stress on the joint from sports and certain strenuous jobs, such as construction, dancing, textile work, music and teaching.

  • Genetics, since osteoarthritis can run in families

  • Malformed or misaligned bone or joint structures or defective cartilage

  • Certain metabolic diseases, such as diabetes, conditions that cause too much iron in the body, and hormonal disorders

  • Weak muscles, which do not properly support the joints

Diagnostic

Osteoarthritis is diagnosed by reviewing medical history, including symptoms and how the pain affects your self-care and other activities. You might need:

  • Physical exam, which involves looking at the joints and getting them moving.

  • Laboratory tests used to rule out other similar forms of osteoarthritis.

  • Joint aspiration, which is to check for infection or crystals that can rule out other medical issues.

  • X-rays to detect joint damage or changes.

  • Magnetic resonance imaging (MRI), which shows cartilage and other aspects of a damaged joint.

Treatment

Medications for pain and inflammation relief come in the form of pills, patches, gels, creams, syrups and injectables. These include:

  • Over-the-counter pain relievers like acetaminophen; you will need a prescription for drugs such as opioids.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen, and ibuprofen are for inflammation and pain. Those designed primarily for pain are over-the-counter, while those that treat both pain and inflammation require a prescription.

  • Over-the-counter products like capsaicin and lidocaine aggravate nerves to distract them from processing pain.

  • Prescription corticosteroids are taken by mouth or injected into the joint by your doctor.

  • Platelet-rich plasma is another injectable medication that can reduce inflammation and pain, but it is not currently FDA approved.

  • Antidepressants such as Cymbalta and Lyrica can also relieve pain; these drugs are FDA approved for this use.

Use the services of a physiotherapist. They can teach you a specific exercise program for your osteoarthritis. He will understand :

  • Strengthening exercises are a good way to reduce stress on painful joints by strengthening the muscles around them. Click here to find a core strengthening program.

  • Range of motion exercises and stretching are helpful ways to warm up the joints and maximize their flexibility. Click here to find a basic stretching program.

  • Aerobic or cardiovascular exercises help build endurance and lose weight.

  • Balance exercises are helpful in preventing falls by strengthening the small muscles in the lower legs.

Joint replacement surgery can be used to relieve pain while improving self-care, mobility and quality of life. The most common procedures are performed on the hips and knees. During a hip replacement, the damaged hip ball in the socket joint is removed and replaced with ceramic or metal which is bonded to a rod. This rod inserts into the thigh bone called the femur. Eventually, bone will grow out of the material that covers the new ball joint, called a prosthesis. Sometimes they use cement to attach the prosthesis to the bone. The joint socket is often a metal cup with a plastic liner, which snaps into place and allows the new ball to spin. The prostheses are individually designed for each person.

A knee replacement involves shaving a thin amount of bone along the underside of the femur and the underside of the kneecap. After shaping the bone surface, an implant is placed. Like hip replacements, knee replacements may use cement or a special coating in which the bone can grow. Total joint replacement surgery typically takes one to two hours with a one to two day recovery.

Conclusion

Osteoarthritis can be debilitating but can be easily diagnosed. Once diagnosed, many treatments are available to manage it, including medication, physiotherapy/exercise, and surgery.

Resources

https://www.arthritis.org/diseases/arthritis