Log In

Medical Article

Relief from Osteoarthritis

Osteoarthritis is a disease affecting the joints, mostly cartilage. Cartilage is the slippery tissue that covers the end of bones in a joint. Healthy cartilage allows bones to glide over each other. Cartilage absorbs the shock movement and prevents friction between bones and when this friction is lost joint disorder occurs, due to this the bones rub together during movement. The rubbing causes pain, swelling, and loss of motion of joint. Over a period of time, this rubbing can permanently damage the joint.
Osteoarthritis can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe.
Osteoarthritis occurs most often in older people. Younger people sometimes get osteoarthritis primarily from an abnormal wear and tear in joint structure, repeated dislocation of the joint, infections, obesity or hyperthyroidism.
It is a chronic disease. There is no cure, but the pain can be managed and the joint function can be improved with the help of painkillers, exercise, weight control, alternative therapies and surgery.

Causes of Osteoarthritis
The cause of osteoarthritis is unknown, but it is believed to be caused by the wear and tear of joints over time. The factors that might cause it include:

Joint injury : Repetitive movements or injuries to joints (such as fracture, surgery or  ligament tears) can lead to osteoarthritis. Certain careers that require standing for long periods of time, repetitive bending, heavy lifting or other movements can make cartilage wear and tear. If you were born with abnormalities or develop them during childhood, it can lead to earlier and more severe osteoarthritis than usual.

Weight :  overweight puts additional pressure on hips and knees. Studies show that excess fat tissue produces inflammatory chemicals that can damage the joints. Carrying extra pounds for long time can cause the cartilage and the cushions joints break down faster.

Age and Gender : Osteoarthritis starts at late 40s. It may be due to muscle weakening with age and the body being less able to heal itself, or the joint slowly wearing out over time. Osteroarthritis is more common and severe in women.
Genetic factors: Nodal osteoarthritis, which particularly affects the hands of middle-aged women, runs strongly in families. Some rare forms of osteoarthritis which start at an earlier age are linked with genes that affect collagen. Genetic factors play important role in osteoarthritis of the hip and knee.

Osteoarthritis symptoms
Osteoarthritis symptoms develop slowly and worsen over time. The most common symptoms are pain and stiffness, particularly in the morning or after rest.

Symptoms of osteoarthritis include:

Stiffness - Sore or stiff joints affect particularly the hips, knees, and lower back, due to inactivity or overuse. Severe pain while moving the joint.  Mild swelling around a joint, an abnormal rubbing, grating, or cracking sound can be heard on moving the joint. 
Loss of flexibility-  You may not be able to move your joint through its full range of motion,

Hips -  Osteoarthritis in hips often create difficulty in moving hip joints. Pain is felt in the groin area or buttocks and sometimes on the inside of the knee or thigh. It can also affect you when you are resting or sleeping.

Knee - Your knees may be most painful when you walk, particularly when walking up or down hills or stairs. Sometimes you may feel difficulty to straighten your legs. A grating or scraping sensation occurs when moving the knee.

Hand -  Osteoarthritis often affects three main areas of hand, the thumb, the joints closest to your fingertips and the middle joints of fingers. The fingers may become stiff, painful and swollen and develop bumps on your finger joints. There may be pain at the base of the thumb. You may find it difficult to write, open bottles etc.

Osteoarthritis Diagnosis
Doctors usually examine joints and diagnose symptoms and the physical signs of osteoarthritis. He/she will check joint tenderness, cracking of grating sounds, bony swelling, excess fluid, reduced movement, joint instability, muscle thinning etc.

Tests for Osteoarthritis

X-rays -  X-ray is the most useful test to confirm osteoarthritis. Cartilage doesn’t show up on X-ray images, but cartilage loss is revealed. X-ray can show damage and other changes related to osteoarthritis to confirm the diagnosis. It can also show changes such as bony spurs or narrowing of the space between your bones, whether any calcium is settled in your joint etc.  Simple X-ray testing can be very helpful to exclude other causes of pain in a particular joint as well as assist with decision making as to when surgical intervention should be considered.

Magnetic resonance imaging (MRI) - Magnetic resonance imaging are more expensive than X-rays. This will show the soft tissues like cartilage, tendons, muscles and changes in your bone that can’t be seen on a standard X-ray.  It is helpful to detect early abnormalities in typical osteoarthritis cases.

Treating Osteoarthritis

There is no cure for osteoarthritis. There are a number of treatments available for pain relief.  The main treatment suggested for osteoarthritis is to maintain a healthy weight and regular exercise. Medication to relive pain and supportive therapies help to make everyday activities easier. If condition get worse over time surgery to repair, strengthen or replace damaged joint can be considered.

Exercise - Exercise is the most effective treatment for osteoarthritis. It will help to strengthen muscles and exercise can improve the general fitness. Exercise will help to relive pain and stiffness caused by osteoarthritis. Regular exercise will keep you active, mobile and build up muscle, thereby strengthening the joints and improve the symptoms. It will also help to lose weight, improve posture and relieve stress. But too much exercise all of a sudden or wrong sort of exercise will damage your joint, so take advice of a physiotherapist, about the exercise programme that you can follow at home.

Weight Lose -  obesity cause more strain to joints.  Physical activity and eating  healthier diet will help you to reduce over weight.  A physiotherapist can suggest suitable exercise programme according to your age.

Medications

Symptoms of osteroarthritis can be effectively managed with lifestyle changes, physical and other therapies, medications, and surgery. The health status of the patient is assessed and oral medicines are given to reduce pain and swelling.  Available medicines for osteoarthritis are pills, syrups, creams or lotions, or they are injected into a joint.
Acetaminophen : Most doctors prescribe acetaminophen for pain relief.  Taking more than the recommended dosage of acetaminophen can cause liver damage.

Nonsteroidal anti-inflammatory drugs(NSAIDs) :  If pain continues doctors prescribe Nonsteroidal anti-inflammatory drugs(NSAIDs), like ibuprofen and naproxen sodium. It helps to relieve osteoarthritis pain. It can cause stomach upset, cardiovascular problems, bleeding problems and liver and kidney damage.

Duloxetine: it is used as an antidepressant, this medication also approved for the treatment of osteoarthritis pain.
Hydrocortisone injections are also given into the joints for reducing pain and swelling. In case of calcium deficiency calcium supplements are also prescribed.

Therapy

Physical therapy : Physiotherapy reduces and relieves pain, joint stiffness and muscles tightness. A physical therapist can work with you to create an individualized exercise programme to strengthens your weak muscles and help in improving the mobility. Regular exercise like swimming or walking can be equally effective.
Physiotherapy reduces and relieves pain, joint stiffness and muscle tightness. It also strengthens the weak muscles and helps in improving the mobility.

Occupational therapy : An occupational therapist can help you discover ways to do everyday tasks or do your job without putting extra stress on your painful joint.

Tai chi and Yoga : Research suggest that tai chi and yoga training led by a knowledgeable instructor, help to reduce osteoarthritis pain. These movement therapies involve gentle exercises and stretches combined with deep breathing.

Surgical procedures

If the disease is severe and conservative treatments don’t help, you may want to consider procedure such as:

Cortisone injections : These medications relieve pain in your joint. During this procedure thedoctor numbs the area around the joint, then places a needle into the space within your joints and injects medication. Each year you can receive three or four injections, more than this can worsen joint damage over time.

Lubrication injections : Injection of hyaluronic acid, it is similar to the component normally found in your joint fluid, gives pain relief by providing some cushioning in knee.

Realigning bones : If one side of your knee is damaged more than the other, osteotomy can be helpful, wherein; the surgeon cut across the bone either above or below the knee, and then removes or adds a wedge of bone. This shifts the body weight away from the worn-out part of your knee.

Joint replacement: In this surgery your surgeon removes damaged joint surfaces and replaces with plastic and metal parts. These artificial joints can wear out or come loose and may need to be replaced eventually.

Alternative therapies
Various complementary therapies and alternative medicine usually adopted to comfort the patient.

Wax bath: warm cloth dipped in a paraffin wax is placed on the ailing joint to reduce the pain and stiffness.

Hot packs : A specialized fabric pack immersed in hot water is placed on the joint to give relief to the patient. Care should be taken so that the warmth is bearable to the patient.

Ice application: Ice packs are applied over the affected area to relieve pain and loosen the tight muscles.

Short wave diathermy : The warmth obtained from short wave diathermy current is effective in reducing arthritic pain and muscle tightness.

Acupunture : Research indicates that acupuncture can relieve pain and improve function in people who have knee osteoarthritis. In this procedure hair-thin needles are inserted into your skin at precise spots on your body.

Avocado-soybean unsaponifiables : In Europe to treat the knee and hop osteoarthritis, nutritional supplements like avocado and soybean oils is widely used.  It acts like an anti-inflammatory and relieve pain.