Osteoarthritis

What causes osteoarthritis?

Osteoarthritis is classified into two types: primary and secondary. Primary osteoarthritis has no known cause, while secondary osteoarthritis is usually caused by other conditions such as infections, injuries, or deformities. Osteoarthritis begins with the breakdown of cartilage inside the joint. As this cartilage wears down, the ends of the bones become thickened and inflamed, often resulting in the formation of bony growths called spurs. These bone spurs interfere with joint movement and cause additional pain. Furthermore, fragments of bone and cartilage may float in the joint space, and fluid-filled cysts may form within the bone, further limiting joint movement.

What Patients are at risk for osteoarthritis?

Risk factors of osteoarthritis include:

Family History and Genetics: Small joint defects and/or double-jointedness creating laxity can contribute to osteoarthritis.
Obesity: Being overweight or obese puts stress on these knees over time with pressure caused by the excess weight causing faster deterioration of the cartilage.
Injury or overuse: Serious injury to a joint, such as the knee, can lead to early osteoarthritis. Injuries can also result from overuse or misuse over time.

Symptoms of osteoarthritis?

Pain is the most common symptom of osteoarthritis after overuse or inactivity of a joint. The pain usually develops slowly over the years. However, symptoms can occur a bit differently in each person, and may include:

Joint pain only when standing or walking
Joint stiffness after sleep or inactivity
Less movement in the joint as time goes on.
A feeling of grinding of the joint when moved, as the cartilage wears away, especially in more advanced stages of the disease.

However, be cautious as the symptoms of osteoarthritis can look like other health conditions. It’s important to see your healthcare provider for an accurate diagnosis.

How is osteoarthritis diagnosed?

This starts with a medical history and a physical exam performed by your provider. This will usually start with having some X-rays. This test gives information on what the joint looks like and how much the gap created by the eroding cartilage is getting narrowed.

How is osteoarthritis treated?

Treatment will depend on the pain and stability of the joint, the age of the patient, and general health and risk of having surgeries. It will also depend on how severe the condition is and how it is affecting the patient’s lifestyle. All treatment goals are to to reduce joint pain and stiffness, and improve joint movement.

Treatment for Osteoarthritis includes:

Regular Exercise: This may include stretching and strengthening, which may help reduce pain and other symptoms.
Heating treatment: Treating affected joints with heat may help reduce pain.
Physical and Occupational Therapy: PT and OT therapy may help to reduce joint pain, improve joint flexibility, and reduce joint strain. Braces and other assistive devices can also be used.
Weight Reduction: Keeping a healthy weight or losing weight if needed can help to prevent or reduce symptoms.
Medication: These may include pain relievers and anti-inflammatory medicines such as Ibuprofen and oral steroids. These may be taken by mouth as a pill or rubbed on the skin as a topical cream.
Injections of certain types of thick liquids that mimic cartilage into the joints. These liquids can be a good temporary solution making it feel like normal joint fluid.
Replacement joint surgery: Surgery may be required to repair or replace a severely damaged joint.

Remember, it is important to talk with your healthcare providers about the risks, benefits, and possible side effects of all medications and surgeries.

Complications from osteoarthritis?

Osteoarthritis causes joints to degenerate over time which can cause significant disability. In addition, It can cause pain and movement problems that can make a person less able to do normal daily activities and tasks.

Osteoarthritis and Activities of Daily Living

There is no cure for osteoarthritis, however, to help keep joints functioning, it is important to work on reducing pain and inflammation. Thus, working on a treatment plan with your healthcare provider that includes medication and therapy is very important. This involves working on lifestyle changes that can improve your quality of life. Lifestyle changes to work on: Weight Reduction: Extra weight puts more pressure on weight-bearing joints, such as the hips and knees. Exercise: Some muscle strengthening exercises may help reduce joint pain and stiffness by reducing the amount of pressure coming onto the joints. These would include swimming, walking, low-impact aerobic exercise, and range-of-motion exercises. Stretching exercises can also help keep the joints flexible. Alternating activity and resting: To reduce stress on the joints, alternate between activity and resting. This can help protect your joints by keeping inflammation under control and lessening your symptoms. Using Medical Assist Devices: Canes, crutches, and walkers can help to keep pressure off of weight-bearing joints and improve balance. Using Convenience Tols: Claw reachers and grabbers allow people to extend their reach and reduce straining. Dressing aids can also help people get dressed more easily. Optimizing the use of medications: Using the right amounts as long-term use of some anti-inflammatory medicines can lead to stomach ulcers and bleeding. Always consider talking with your healthcare provider to develop a plan that reduces this risk.

Should I call my healthcare provider if things get worse?

When your symptoms get worse or you have new symptoms, let your healthcare provider know as soon as possible

Key takeaways about Osteoarthritis

Osteoarthritis is a chronic disease of the joints. It usually affects middle-aged and older adults.
It starts with the breakdown of joint cartilage which is like the shock absorber
Risk factors include genetics, obesity, injuries, and overuse.
Symptoms commonly include pain, stiffness, and limited movement of joints.
Treatment goals are to reduce joint pain and stiffness and improve joint mobility.
Treatment may include medications, exercise therapy, heat, and joint injections.
Surgery may be needed to replace a joint in the most severe cases

Rheumatoid arthritis can also affect the knees by causing the joint to become inflamed and by destroying the knee cartilage. Rheumatoid arthritis often affects persons at an earlier age than osteoarthritis.

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How is knee pain diagnosed?

A complete medical history and physical examination, as well as other diagnostic imaging tests for knee problems, may include:

Diagnosis involves a thorough medical history, neurological examination, and various diagnostic tests, including nerve conduction studies, electromyography, blood tests, and imaging studies (e.g., MRI) to identify the underlying cause and assess the extent of nerve damage.

X-ray This imaging study uses invisible electromagnetic energy beams to create images of internal structures, such as bones, on film. Magnetic resonance imaging (MRI). This imaging study uses large magnets, radio frequencies, and a computer to make detailed images of organs and structures within the body which can often determine damage or disease to a surrounding ligament or muscle. Computed tomography scan (also called a CT or CAT scan). This imaging study uses X-rays and computer technology to make horizontal, or axial, images called “slices” of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays. Arthroscopy. This is a minimally invasive diagnostic scope procedure and treatment procedure used for ligament-type injuries of a joint. This procedure uses a small, lighted, optic tube called an arthroscope, which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are then seen on a TV screen and used to evaluate any degenerative changes in the joint. It can also be used; to detect bone diseases and tumors and to determine the cause of bone pain and inflammation. Radionuclide bone scan. A nuclear imaging test uses a very small amount of radioactive material, that is injected into the patient’s bloodstream and that which can be detected by a special camera-type scanner. This test can show blood flow to the bone and cell activity within the bone which can be very high with pain and inflammation in the joint.