OSTEOARTHRITIS - Watsons Health

OSTEOARTHRITIS

Osteoarthritis (OA) is sometimes called a degenerative joint disease or “wear and tear” disease, because it is associated with increasing age and the degeneration of the protective cartilage in the joints. In osteoarthritis, the slick surface of the cartilage becomes rough. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone.It most commonly affect the joint of the hips, hands, knees and spine.

Osteoarthritis has no specific cause, and may include:

  • Endocrine: People with diabetes may be prone to osteoarthritis. Other endocrine problems also may promote osteoarthritis development, including acromegaly, hypothyroidism, hyperparathyroidism, and obesity.
  • Post traumatic: Traumatic causes can be further divided into macrotrauma or microtrauma. An example of macrotrauma is an injury to the joint such as a bone break, causing the bones to line up improperly (malalignment), lose stability, or damage cartilage. Microtrauma may occur over time (chronically). An example of this would be repetitive movements or the overuse noted in several occupations.
  • Inflammatory joint diseases: This category would include infected joints, chronic gout, and rheumatoid disease.
  • Metabolic: Diseases causing errors of metabolism may cause osteoarthritis. Examples include Paget’s disease and Wilson disease.
  • Congenital or developmental: Abnormal anatomy such as unequal leg length may be a cause of osteoarthritis.
  • Genetic: A genetic defect may promote breakdown of the protective architecture of cartilage. Examples include collagen disturbances such as Ehlers-Danlos syndrome.
  • Neuropathic: Diseases such as diabetes can cause nerve problems. The loss of sensation may affect how the body knows the position and condition of the joints or limbs. In other words, the body can’t tell when it is injured.
  • Other: Nutritional problems may cause osteoarthritis. Other diseases such as hemophilia and sickle cell are further examples.

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

  • Pain. Your joint may hurt during or after movement.
  • Tenderness. Your joint may feel tender when you apply light pressure to it.
  • Stiffness. Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity.
  • Loss of flexibility. You may not be able to move your joint through its full range of motion.
  • Grating sensation. You may hear or feel a grating sensation when you use the joint.
  • Bone spurs. These extra bits of bone, which feel like hard lumps, may form around the affected joint.

During the physical exam, your doctor will closely examine your affected joint, checking for tenderness, swelling or redness, and for range of motion in the joint. Your doctor may also recommend imaging and lab tests.

Imaging tests

Pictures of the affected joint can be obtained during imaging tests. Examples include:

  • X-rays. Cartilage doesn’t show up on X-ray images, but cartilage loss is revealed by a narrowing of the space between the bones in your joint. An X-ray may also show bone spurs around a joint. Some people may have X-ray evidence of osteoarthritis before they experience any symptoms.
  • Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce detailed images of bone and soft tissues, including cartilage. MRI isn’t commonly needed to diagnose osteoarthritis but may help provide more information in complex cases.
  • Lab tests. Analyzing your blood or joint fluid can help pinpoint the diagnosis.
  • Blood tests. Blood tests may help rule out other causes of joint pain, such as rheumatoid arthritis.
  • Joint fluid analysis. Your doctor may use a needle to draw fluid out of the affected joint. Examining and testing the fluid from your joint can determine if there’s inflammation and if your pain is caused by gout or an infection.

 

RECOMMENDED MEDICATIONS

Medicine can help reduce your symptoms of osteoarthritis and allow you to do your daily activities.

The type of medicine depends on how bad your pain is. For instance:

  • For mild to moderate pain, you can try over-the-counter pain medicine, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.
  • For moderate to severe pain, you may need stronger pain medicine such as opioids.

Exercising and achieving a healthy weight are the best and most important ways to treat osteoarthritis. Your doctor also may suggest:

  • Physical therapy. A physical therapist can work with you to create an individualized exercise program that will strengthen the muscles around your joint, increase your range of motion and reduce pain.
  • Occupational therapy. An occupational therapist can help you discover ways to do everyday tasks or do your job without putting extra stress on your already painful joint.
  • Braces or shoe inserts. These devices can immobilize or support your joint to help take pressure off it.

If conservative treatments don’t help, you may want to consider procedures such as:

  • Cortisone shots. Injections of corticosteroid medications may relieve pain in your joint.
  • Lubrication injections. Injections of hyaluronic acid may offer pain relief by providing some cushioning in your knee. Hyaluronic acid is similar to a component normally found in your joint fluid.
  • Realigning bones. During a surgical procedure called an osteotomy, the surgeon cuts across the bone either above or below the knee to realign the leg. Osteotomy can reduce knee pain by shifting your body weight away from the worn-out part of your knee.
  • Joint replacement. In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surfaces and replaces them with plastic and metal parts. The hip and knee joints are those most commonly replaced.

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