Osteoarthritis

From WikiMD

X-ray of knee with osteoarthritis.

Osteoarthritis normally affects older people: it is a disease where joints wear out. As the joint surface wears away, it sheds particles which stimulate the joint lining to produce fluid. This causes the joint to swell. When the joint cartilage wears away, the core of the bone becomes exposed. The exposed bone rubs against other exposed bone.

Incidence

  • It is the most common type of arthritis and is more common in older people.
  • People with osteoarthritis usually have joint pain and, after rest or inactivity, stiffness for a short period of time. The most commonly affected joints include the:
  • Hands.
  • Knees.
  • Hips.
  • Neck.
  • Lower back.
Osteoarthritis of the knee
Osteoarthritis of the knee

Severity

  • Osteoarthritis affects each person differently.
  • For some people, osteoarthritis is relatively mild and does not affect day-to-day activities.
  • For others, it causes significant pain and disability.

Pathophysiology

Joint damage usually develops gradually over years, although it could worsen quickly in some people.

While the exact cause is not fully know, OA causes damage to all the areas of the joint, including: Cartilage, the tissue that covers the ends where two bones meet to form a joint.

  • Tendons and ligaments.
  • Synovium, the lining of the joint.
  • Bone.
  • Meniscus in the knee.
Osteoarthritis of hands
Osteoarthritis of hands

Symptoms of Osteoarthritis

The symptoms of osteoarthritis often begin slowly and usually begin with one or a few joints. The common symptoms of osteoarthritis include:

  • Pain when using the joint, which may improve with rest. For some people, in the later stages
  • of the disease, the pain may be worse at night. Pain can be localized or widespread.
  • Joint stiffness, usually lasting less than 30 minutes, in the morning or after resting for a period
  • of time.
  • Joint changes that can limit joint movement.
  • Swelling in and around the joint, especially after a lot of activity or use of that area.
  • Changes in the ability to move the joint.
  • Feeling that the joint is loose or unstable.

Cause of Osteoarthritis

Osteoarthritis happens when the cartilage and other tissues within the joint break down or have a change in their structure. This does not happen because of simple wear and tear on the joints. Instead, changes in the tissue can trigger the breakdown, which usually happens gradually over time. Certain factors may make it more likely for you to develop the disease, including:

  • Aging.
  • Being overweight or obese.
  • History of injury or surgery to a joint.
  • Overuse from repetitive movements of the joint.
  • Joints that do not form correctly.
  • Family history of osteoarthritis.
X-ray of osteoarthritis of the shoulder
X-ray of osteoarthritis of the shoulder

Diagnosis of Osteoarthritis

There is no single test for osteoarthritis. Diagnosing the condition may include the following: Providing to a doctor a medical history that includes your symptoms, any other medical problems you and your close family members have, and any medications you are taking. Having a physical exam to check your general health, reflexes, and problem joints. Having images taken of your joint using:

  • X-rays, which can show loss of joint space, bone damage, bone remodeling, and bone spurs. Early joint damage does not usually appear on x-rays.
  • Magnetic resonance imaging (MRI), which can show damage to soft tissues in and around the joint. Generally, MRI helps to evaluate a joint that is locking or giving out.
  • Having blood tests to rule out other causes for symptoms.
  • Taking joint fluid samples to look for other causes of joint pain, such as infection or gout.
Hip replacement
Hip replacement

Treatment of Osteoarthritis

  • The goals of your treatment for osteoarthritis include: Reducing pain and other symptoms.
  • Improving joint function.
  • Stopping the disease from progressing.
  • Maintaining a health-related quality of life to help prevent disability.

Treatment modalities

Treating osteoarthritis usually begins with: Learning about osteoarthritis. Your doctor may recommend classes that you can attend or online programs you can join.

  • Exercising, which can reduce joint pain and stiffness and increase flexibility, muscle strength, and endurance. Remember to start any exercise program slowly and take the time to adjust to the new level of activity. You should speak to your doctor or physical therapist about a safe, well-rounded exercise program, which may include: Range-of-motion and stretching activities to keep your joints limber.
  • Strengthening exercises performed with weights or exercise bands to strengthen muscles that support joints affected by arthritis.
  • Exercises in the water to help lower the stress on the joints while exercising.
  • Balance and agility exercises to help you maintain daily living skills.
New Compact Ultrasound-delivering Device
New Compact Ultrasound-delivering Device
  • Low-impact activities that give you a moderate level of activity without putting stress on the joints such as walking, cycling, swimming, tai chi, water aerobics, or a lowimpact aerobics class.

  • Managing your weight can help reduce the stress on joints.
  • Using braces or orthotics that your doctor
Osteoarthritis of the knee
Osteoarthritis of the knee
  • Some people may need medications to help manage the symptoms of osteoarthritis, including: Oral pain relievers.
  • Oral anti-inflammatory medications to treat pain and inflammation.
  • Topical creams, rubs, or sprays that you apply to the skin over sore joints to relieve pain.
  • Corticosteroids, strong inflammation-fighting drugs that are usually injected into the joint to temporarily relieve pain.
  • Hyaluronic acid substitutes (viscosupplements), which are injected into the knee to replace a normal component of the joint involved in lubrication and nutrition are sometimes recommended for knee osteoarthritis.
  • Selective serotonin and norepinephrine reuptake inhibitors that you take orally to help control chronic (long-term) pain.
  • If other treatments are not helping and if the joint damage is extensive, some people may have surgery.
  • Partial or total joint replacement surgery: Removal of part of all of the damaged joint and replacing it with a new joint made of plastic, metal, or ceramic.
  • Other therapies such as massage can increase blood flow and bring warmth to the area.
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