Arthritis – Osteoarthritis (OA)

Osteoarthritis (OA) is often called “wear and tear” arthritis; Osteoarthritis (OA) is the most common form of Arthritis. In most cases, over time, cartilage in joints breaks down, and Osteoarthritis (OA) symptoms begin to occur. Osteoarthritis (OA) is most commonly found in the:-

Osteoarthritis (OA)
  • Knees
  • Hips
  • Hands and fingers
  • Spine

Wrists, elbows, shoulders, and ankles can also be affected by Osteoarthritis (OA), but this occurs less frequently. When Osteoarthritis (OA) is found in these joints, there may have been a history of injury or stress to that joint.

Symptoms of Osteoarthritis (OA)

Typically, Osteoarthritis (OA) comes on slowly. For many, the first signs are joints that ache after physical work or exercise. As the disease progresses, other most common symptoms include:

  • Pain in a joint
  • Swelling or tenderness in one or more joints
  • Stiffness after periods of inactivity, such as sleeping or sitting
  • Flare-ups of pain and inflammation after use of the affected joint
  • Crunching feeling or sound of bone rubbing on bone (called crepitus) when the joint is used

Osteoarthritis (OA)  most often occurs in the following areas:

  • Knees. Because knees are primarily weight-bearing joints, they are very commonly affected by Osteoarthritis (OA). If you have Osteoarthritis (OA) in your knees, you may feel that these joints are stiff, swollen, and painful, making it hard to walk, climb, and get in and out of chairs and bathtubs.
  • Hips. Osteoarthritis (OA) in the hip can cause pain, stiffness, and severe disability. Hips both support the weight of the body and enable movement of your lower body. When you have Osteoarthritis (OA) in your hips, you may also feel the pain in your groin, inner thigh, or knees. Osteoarthritis (OA) in the hip can lead to difficulty moving, bending, and walking.
  • Fingers and Hands. When Osteoarthritis (OA) occurs in hands and fingers, the base of the thumb joint is commonly affected and people experience stiffness, numbness, and aching. Other symptoms of hand and finger Osteoarthritis (OA) include:
  1. Heberden’s nodes: small bony knobs that appear on the end joints of fingers
  2. Bouchards’s nodes: small bony knobs that appear on the middle joints of fingers
  • Spine. If you have Osteoarthritis (OA) of the spine, you may experience stiffness and pain in the neck or in the lower back. Sometimes arthritis-related changes in the spine can put pressure on the nerves, causing weakness or numbness in your arms or legs.
Osteoarthritis (OA)

Causes of Osteoarthritis (OA)

While the exact cause of OA is unknown, joint damage can be due to repetitive movement (also known as “wear and tear”). It can also begin as the result of an injury. Either way, with OA there’s erosion of the cartilage, the part of the joint that covers the ends of the bones.

  • Cartilage acts as a shock absorber, allowing the joint to move smoothly.
  • As cartilage breaks down, the ends of the bones thicken and the joint may lose its normal shape.
  • With further cartilage breakdown, the ends of the bones may begin to rub together, causing pain.
  • In addition, damaged joint tissue can cause the release of certain substances called prostaglandins, which can also contribute to the pain and swelling characteristic of the disease.

Risk Factors of Osteoarthritis (OA)

Here are some factors that may increase your risk of developing Osteoarthritis (OA):-

Age
Age is the strongest risk factor for Osteoarthritis (OA). Although Osteoarthritis (OA) can start in young adulthood, in these cases, it is often due to joint injury.

Gender
Osteoarthritis (OA) affects both men and women. However, before age 45, Osteoarthritis (OA) occurs more frequently in men; after age 45, OA is more common in women.

Joint injury or overuse caused by physical labor or sports
Traumatic injury to joint increases your risk of developing Osteoarthritis (OA) in that joint. Joints that are used repeatedly in certain jobs may be more likely to develop Osteoarthritis (OA) because of injury or overuse.

Obesity
The chances of getting Osteoarthritis (OA) generally increase with the amount of weight the body’s joints have to bear. The knee is particularly affected because it is a major weight-bearing joint.

Joint Alignment
People with joints that don’t move or fit together correctly, like bowlegs, dislocated hips, or double-jointedness, are more likely to develop Osteoarthritis (OA) in those joints.

Heredity
An inherited defect in one of the genes responsible for manufacturing cartilage may be a contributing factor in developing Osteoarthritis (OA).

Diagnosis of Osteoarthritis (OA)

If you experience joint pain, stiffness, and/or swelling that won’t go away; you should make an appointment to see your doctor. You may also need other tests to help confirm the diagnosis of OA and determine the extent and severity of joint damage. Some of these may include:

  • X-rays. X-rays can help the doctor determine whether you have OA or rheumatoid arthritis (RA). A series of X-rays obtained over time can show how fast joint damage is progressing. X-rays of the affected joints can show cartilage loss, bone damage, and extra bone growth (known as bone spurs) that can develop on the surface of normal bones.
  • Joint Aspiration. If your doctor is still uncertain about the diagnosis or suspects that you may have an infection, he or she may perform joint aspiration. In this procedure, your doctor withdraws and examines synovial fluid (a liquid that lubricates the joint) from affected joints using a needle.

Treatment of Osteoarthritis (OA)

Arthritis-Osteoarthritis
  • Physical Therapy. Physical Therapy and occupational therapy help maintain joint mobility and range of motion. How much therapy you need, and what kind of therapy will depend on many factors, such as the severity and type of arthritis you have, your age, and your general state of health. This has to be decided by you with your physician and physical or occupational therapist
  • Medication of  Osteoarthritis (OA)
    • NSAIDs .NSAIDs (nonsteroidal anti-inflammatory drugs) are the most commonly prescribed drugs for arthritis patients. These may be either prescription or over-the-counter (OTC).
    • Traditional NSAIDs – these are the largest subset of NSAIDs. As is the case with most drugs, they do carry a risk of side-effects, such as stomach upset and gastrointestinal bleeding. The risk of side effects is significantly higher if the patient is over 60. A patient should take this type of drug at high doses under the supervision of a doctor.
    • COX-2 inhibitors – these also reduce pain and inflammation. However, they are designed to have fewer stomach and gastrointestinal side-effects. In 22004/2005 Vioxx and Bextra were taken off the market after some major studies showed Vioxx carried increased cardiovascular risks, while Bextra triggered serious skin reactions. Some other COX-2 inhibitors are also being investigated for side-effects. The FDA asked makers of NSAIDs to highlight warnings on their labels in a black box.
    • Salicylates – includes aspirin which continues to be the preferred medication of many doctors and patients. Patients need to consult their doctor if they plan to take aspirin more than just occasionally. Long term high dosage usage of aspirin carries with it a significant risk of serious undesirable side effects, such as kidney problems and gastrointestinal bleeding. For effective control of arthritis pain and inflammation frequent large doses are needed.
    • Glucocorticoids are anti-inflammatory steroids and are very effective at combating inflammation and can be extremely helpful when used properly. The patient needs to consider the potential for undesirable side-effects with this type of drug.
    • Anti-malarials, such as hydroxychloroquine and chloroquine are commonly used for treating mild inflammatory arthritis.
    • Minocycline – an antibiotic that is sometimes used as antibiotic therapy for rheumatoid arthritis. Its use is controversial.
    • Sulfasalazine – commonly used for many types of inflammatory arthritis. Sulfasalazine is a sulfa derivative.
    • Methotrexate – works by blocking the metabolism of rapidly dividing cells. It is commonly used for treating more serious types of inflammatory arthritis.
    • Azathioprine – used for severe forms of inflammatory arthritis. Azathioprine also blocks the metabolism of rapidly dividing cells.
    • Leflunomide – used to treat rheumatoid arthritis and psoriatic arthritis. It also blocks cell metabolism. However, biologic therapy is gradually taking over.
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