What Is Osteoarthritis?
Table of Contents
Osteoarthritis is normally confined to joints, whereas the symptoms of some other types of arthritis may extend to other tissues such as organs. This condition is most prevalent in adults aged 60 years or more. Cases of osteoarthritis in younger individuals is also possible, but is normally related to direct damage to a joint through injury or similar events. This increases the risk of early-onset osteoarthritis.
The symptoms of osteoarthritis may differ greatly from patient to patient. Typical signs of this condition may include reduced flexibility or motion in the joint or joints affected, and joint pain. In most cases, these symptoms intensify over time. They may also recede for a time and then return in force.
Other characteristics associated with osteoarthritis may include Heberden’s nodes, or the accumulation of additional tissue around the joints of the digits (fingers or toes), forming protuberances. These may be clearly visible through the skin and appear as a swelling of the bone at the end of the digit. Heberden’s nodes are associated with reduced mobility and possible pain of the affected joint.
Causes Of OsteoarthritisOsteoarthritis, as outlined above, is a chronic disorder of joint cartilage. Cartilage is present around the joint surfaces (where two bones meet and interface for normal movement of the joint). It is a resilient, flexible material that protects the bones from shock, damage, and wear. It also prevents the bone surfaces from coming into direct contact with one another.
Osteoarthritis is associated with the gradual loss of cartilage from the joint. This occurs naturally over time, and may be referred to as age-related wear and tear. Severe degeneration (or loss) of cartilage may lead to direct bone-on-bone contact that could result in decreases in the normal range of motion and function of the joint, and may be associated with pain. The loss of cartilage is also associated with inflammation, which is the release of molecules that may cause pain or tissue damage. Damaged cartilage may also impact or otherwise damage the sac of synovial fluid, which is another source of protection and cushioning within some joints.
Osteoarthritis typically affects a number of joints in the body. These may include:
- Finger joints
- Toe joints
- Knee joints
- Hip joints
- Spinal joints
Osteoarthritis often has a mild onset and then intensifies slowly over time. Many cases of this disorder are related to simple age-related degeneration. On the other hand, some variables or attributes are associated with an increased risk of osteoarthritis.
Some of these risk factors include:
- Increased bodyweight
- Advancing age
- Injury or damage to joints
- Structural joint abnormalities or disorders of joint development
- Genetic factors concerning cartilage formation
- Occupational hazards that increase stress on joints (e.g. repetitive athletic movements or repetitive motions at work)
Treatments For OsteoarthritisCurrently, there are no outright cures for osteoarthritis available. Therefore, treatment goals for this condition concern the prevention and management of pain and other symptoms such as reduced mobility.
Non-steroidal anti-inflammatory drugs (NSAIDs) are typically recommended for new-onset or mild osteoarthritis. These medications are conventional over-the-counter or prescription painkillers, such as aspirin or indomethacin. These function through the inhibition of the formation of inflammatory molecules in the body, thus reducing the pain they may cause. Corticosteroids also inhibit inflammation, and are also often prescribed in oral form to patients with mild to moderate osteoarthritis.
Non-drug therapies are also often recommended to restore motion, flexibility, and function to the joint. These may include physical therapy, which involves a program of targeted exercise to relieve symptoms in an affected body part.
Potential improvements in osteoarthritis are also associated with dietary modifications that include switches to more healthy foods and balanced eating patterns. These may include an increased intake of fresh vegetables and fruits. In addition, a diet containing fish rich in omega-3 fatty acids and reduced quantities of red meat has been shown to elicit some improvements in early-stage osteoarthritis.
Patients with moderate to severe pain associated with osteoarthritis may consider procedures that can be performed in a pain clinic. These include the injection of corticosteroids (which may be combined with local anesthetics to further relieve pain) directly into the joint. Examples of these procedures linked to improvements in osteoarthritis pain include hip joint injections and knee joint injections. These may result in the alleviation of pain of moderate duration.
These joint injections may be repeated according to a regular schedule, depending on the individual response of the patient. A full discussion of the risks, benefits, and expected outcomes of joint injections with a physician or pain specialist, before undergoing this procedure, is recommended.
Biofeedback training, in which a patient learns to employ relaxation and coping techniques in response to pain or other symptoms, is associated with improvement in some cases of osteoarthritis. This therapy often includes the training of patients in how to read biometrics in order to apply their new skills to pain-related changes. Biofeedback training may be conducted in the clinic and then practiced at home.
Some other forms of alternative treatment, such as acupuncture, may also be of some benefit in conjunction with other treatments for pain.
ConclusionOsteoarthritis is a chronic degeneration of the cartilage around and within various joints in the body. It often has a mild onset and progresses in symptom severity over time. Osteoarthritis is often associated with pain, increasing loss of flexibility and mobility, and damage in the joint. The degeneration of cartilage is linked to age-related wear and tear, but may also be associated with risk factors such as occupational joint stress, increased weight, and joint injury.
Osteoarthritis treatment focuses on the management of pain and other symptoms. These may include oral medications, physical therapy, or joint injections. Those who are in chronic pain associated with osteoarthritis may benefit from a full discussion with their pain specialist or doctor about their treatment options and what may be best for their particular case.
- Akasaki Y, Hasegawa A, Saito M, Asahara H, Iwamoto Y, Lotz MK. Dysregulated FOXO transcription factors in articular cartilage in aging and osteoarthritis. Osteoarthritis Cartilage. Nov 2013;[Epub ahead of print].
- Brand E, Nyland J, McGinnis M. Arthritis self-efficacy scale pain subscale scores in patients with knee osteoarthritis: A systematic review comparing intervention methods. J Orthop Sports Phys Ther. Oct 2013;[Epub ahead of print].
- Henrotin Y, Lambert C, Richette P. Importance of synovitis in osteoarthritis: Evidence for the use of glycosaminoglycans against synovial inflammation. Semin Arthritis Rheum. Oct 2013;[Epub ahead of print].
- Jones G. Osteoarthritis: Where are we for pain and therapy in 2013? Aust Fam Physician. 2013;42(11):766-9.
- Lee S, Kim TN, Kim SH. Knee osteoarthritis is associated with increased prevalence of vertebral fractures despite high systemic bone mineral density: A cross-sectional study in an Asain population. Mod Rheumatol. 2014;24(1):172-81.
- Roubille C, Pelletier JP, Martel-Pelletier J. New and emerging treatments for osteoarthritis management: Will the dream come true with personalized medicine? Expert Opin Pharmacother. 2013;14(15):2059-77.
- Trigkilidas D, Anand A. The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain. Ann R Coll Surg Engl. 2013;95(8):545-51.