Osteoarthritis
Definition:
Osteoarthritis (OA) is the most prevalent chronic disease affecting the musculoskeletal system. Over the past two decades, the definition of osteoarthritis has evolved to encompass a complex interplay of clinical, pathophysiological, biochemical, and biomechanical changes with multiple etiologies. The disease affects the articular cartilage and the entire joint, including the subchondral bone layer, ligaments, joint capsule, synovium, and periarticular muscles. OA can impact a wide range of joints, including the hip, knee, ankle, shoulder, elbow, wrist, interphalangeal, metacarpophalangeal, or spine joints. This widespread impact underscores the severity of the disease. Knee osteoarthritis, also known as gonarthrosis, is particularly debilitating, leading to pain, stiffness, swelling, and decreased mobility in the affected joints.
Global Prevalence:
Osteoarthritis is a leading cause of disability worldwide. According to the World Health Organization (WHO), approximately 9.6% of men and 18.0% of women aged 60 years and older have symptomatic OA. The prevalence is expected to rise due to increasing life expectancy and the global obesity epidemic.
Types:
- Primary Osteoarthritis: Age-related, usually affecting multiple joints due to natural wear and tear of cartilage.
- Secondary Osteoarthritis: Results from an underlying condition such as injury, obesity, congenital joint abnormalities, or diseases like rheumatoid arthritis.
Age Group:
Osteoarthritis is a condition that can affect individuals of any age, but it is most associated with older adults. The risk of developing OA increases significantly after the age of 50, a fact that underscores its inevitability and commonality in our ageing population. Understanding this can help individuals feel validated in their experiences and better prepared for potential health challenges.
Causes and Risk Factors:
- Age: Risk increases with age, generally appearing in people over 50.
- Gender: Women are more likely to develop OA, particularly after menopause.
- Joint Injury: Injuries like fractures or ligament tears can lead to OA.
- Overuse: Repetitive use of the same joints in jobs or sports.
- Obesity: Excess weight adds stress to joints and promotes inflammation.
- Musculoskeletal Abnormalities: Misalignment of bone or joint structures.
- Weak Muscles: Inadequate joint support can lead to poor alignment and OA.
- Genetics: A family history of OA increases risk.
- Environmental Factors: Occupation, physical activity level, joint injury, obesity, diet, sex hormones, and bone density.
Affected Body Parts:
As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:
- Hips: Pain in the groin or buttocks, sometimes radiating to the knee or thigh.
- Knees: A grating or scraping sensation when moving the knee.
- Fingers: Bony growths causing swelling, tenderness, and redness, often with pain at the thumb's base.
- Feet: Pain and tenderness in the big toe, with possible ankle or toe swelling.
Potential Consequences:
- Obesity, Diabetes, and Heart disease: Painful joints make exercise difficult, increasing the risk of obesity, high cholesterol, type 2 diabetes, heart disease, and high blood pressure.
- Falls: People with OA experience more falls and fractures due to decreased function, muscle weakness, and balance issues, especially in those with knee or hip OA. Pain medications may also contribute to falls due to side effects like dizziness.
Signs and Symptoms:
Signs and symptoms of osteoarthritis include:
- Pain: Affected joints may hurt during or after movement.
- Stiffness: Joint stiffness is often most noticeable upon waking or after periods of inactivity.
- Tenderness: The joint may feel tender when light pressure is applied to or around it.
- Loss of Flexibility: You may have difficulty moving the joint through its full range of motion.
- Grating Sensation: You might experience a grating feeling when using the joint and sometimes hear popping or crackling sounds.
- Bone Spurs: These extra bone formations, which can feel like hard lumps, may develop around the affected joint.
- Swelling: This can occur due to soft tissue inflammation around the joint.
Diagnosis:
Diagnosis involves a medical history review, physical examination, and lab tests:
- Joint Aspiration: Fluid is drawn from the joint to check for infection or crystals.
- X-ray: Reveals joint or bone damage and changes related to OA.
- MRI: Provides a detailed view of cartilage and other joint structures.
Treatment Options:
While there is no cure for OA, various treatments can help ease pain and improve function:
- Medications: Pain relievers (acetaminophen, opioids), NSAIDs (aspirin, ibuprofen, naproxen), counterirritants (capsaicin, menthol), corticosteroids, PRP injections, and other drugs like duloxetine and pregabalin.
- Regenerative Orthopaedics: Includes platelet-rich plasma (PRP) injections, stem cell therapy, and prolotherapy.
- Lifestyle Modifications: Regular exercise, healthy weight, hot and cold therapy, and staying active.
Living with Osteoarthritis:
Managing OA involves combining treatments and lifestyle changes:
- Exercise Regularly: Engage in low-impact activities like swimming, walking, and cycling.
- Maintain a Healthy Weight: Reduces stress on joints.
- Hot and Cold Therapy: Helps reduce pain and stiffness.
- Stay Active: Prevents joint stiffness and maintains function.
- Educate Yourself: Understanding the condition aids in effective management.
Care to be Taken:
- Regular Check-ups: Monitor progression and adjust treatments.
- Follow Treatment Plans: Adhere to medication schedules and physical therapy exercises.
- Joint Protection Techniques: Use proper body mechanics and ergonomic tools.
- Healthy Diet: Include anti-inflammatory foods and supplements like omega-3 fatty acids.
Conclusion:
Understanding and managing osteoarthritis requires a comprehensive approach involving medical treatment, lifestyle modifications, and supportive therapies. Advances in regenerative orthopaedics offer promising options for reducing pain and improving joint function in individuals with OA.