This article deals with the various aspects of osteoarthritis treatment and management. Prevention is the best cure and it should start in early adulthood. Though we cannot stop aging, its important to stop premature and disabled aging.

Osteoarthritis is a degenerative form of arthritis occurring at middle age due to the wear and tear of the joints. It is a normal physiological part of the aging process.

Almost every person suffers from this type of arthritis in a milder or severe form depending upon the precipitating factors. Basically it means the loss of cartilage between the bones of the affected joints.

Obesity, overuse of the joints, age, genetics, gender (women are more likely to develop arthritis), trauma are considered to be some of the general risk factors. Common sites to be affected are knee, hip, spine and small joints of the hands. Pain and stiffness that increases with activity are the main symptoms of osteoarthritis. Swelling and joint instability may present in some cases.

The changes in the articular cartilage being irreversible, osteoarthritis can only be controlled and further thinning of cartilage can be arrested. In some cases pain-free condition can be achieved by a combination of treatments.

Treatment of Osteoarthritis

Arthritis Medications
Arthritis medications need to be individualized for every person. Analgesics, NSAID’s, and COX-2 inhibitors are the painkillers used for joint pain relief to ensure mobility in the aching joints. Calcium and mineral supplements can be used to reduce osteoporosis. Some nutritional supplements like glucosamine and chondroitin sulphate are used to minimize cartilage destruction.

Local Therapy
Topical creams and liniments can be used for pain relief. They provide temporary relief as they act superficially by relieving the pain in the muscle. Heat therapy is used for muscle relaxation and relieves the aching joints. Heat application is contra-indicated if the joints are swollen. Cold application helps to reduce the pain in such joints.

Intra-articular Treatments
Intra-articular corticosteroids can be administered in severe cases of joint pain and inflammation, but long term and repetitive use is not be encouraged.

Physiotherapy and Exercises
Physiotherapy helps in reducing pain, stiffness and improves muscle strength and mobility of joints. Muscle strengthening exercises need to be done stringently, to support the affected joint. Excessive stress on the joints should be avoided while exercising, as it might increase further degeneration of the cartilage.

Weight Loss
Weight loss is the most effective way to treat this condition. Overweight individuals tend to put a lot of pressure on the knee, back and hip joints; this further accelerates the degeneration of the cartilage. Taking off the extra kilos can significantly arrest the cartilage thinning process.

Living with Osteoarthritis
Patient education is a very important aspect of arthritis management. The patient needs to be educated about the do’s and dont’s in daily activities. Squatting, Kneeling, prolonged standing, sitting cross-legged, lifting heavy weights should be avoided. Regular Exercises, weight maintenance and medications need to be strictly followed. Different types of braces and aids for the knees and spine can be used for supporting the affected joints.

Surgical Management
Advanced Osteoarthritis needs surgical treatment like arthroscopy, osteotomy, or a total joint replacement surgery.

Prevention
Prevention is the best cure and it should start in early adulthood. Though we cant stop aging, its important to stop premature and disabling aging. Moderate muscle strengthening exercises should be done regularly. Healthy weight should be maintained with the help of exercises and a balanced diet to reduce undue stress on the joints. Sports injury and other minor injuries should be avoided.

By Dr. Meenaz M
Published: 9/14/2007

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Osteoarthritis, or degenerative joint disease, affects the elderly in parts of the body where it hurts the most. A person suffering from knee osteoarthritis will most likely equate it with cardiovascular disease because the breakdown of articular cartilage of knee joints restricts movement and the patient has to follow a set regimen affecting his lifestyle.

Knee osteoarthritis is due to injury, congenital disorder, or obesity. The deterioration of articular cartilage, a smooth and fibrous connective tissue that acts as a protective cushion, narrows the joint space between bones. In time, the cartilage becomes grooved and fragmented and surrounding bones thicken or sprout into spurs. Sometimes, there is additional swelling in the knees caused when synovium, a membrane producing a thick fluid to nourish the cartilage, becomes inflamed and produces additional fluid known as ‘water of the knee’. Changes occur due to constant rubbing of joint bones leading to deformity of joints that is equally painful.

Knee osteoarthritis is diagnosed through physical and pathological examinations of joints on either side of knee including hip joints, checking on posture, and gait. Once knee osteoarthritis is confirmed, a treatment is suggested depending on nature and extent of damage and on the personal physical history of patient.

Women over 60 years of age are high risk factors for knee osteoarthritis as they spend major portion of their lives doing physically demanding work that has direct relationship with knee osteoarthritis. Wearing high heeled shoes also aggravates the pain. In youngsters, knee osteoarthritis is hereditary or due to some injury.

Precautions such as weight reduction, changing work routine, postures, diet, avoiding injuries, participating in physiotherapy, and exercise are advised. Other methods of relief such as acupuncture, ointments, prescription drugs, magnetic pulse therapy, vitamin regimes, and topical pain relievers are temporary. Using prescription drugs and surgery should be a mutual decision between patient and doctor.  Another method worth considering if you are searching for osteoarthritis relief is the use of natural supplements instead of regular osteoarthritis medication.  These have no side effects and if you can find a good effective supplement to add to your diet that will work for you, then your days of joint pain could be over.

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The most common type of arthritis is osteoarthritis (OA). This type of arthritis is commonly referred to as wear and tear arthritis or degenerative arthritis.

While this condition probably begins in the early teen years, it does not become symptomatic until a person reaches their 40’s. Osteoarthritis affects cartilage, the slippery elastic tissue that covers the ends of long bones. Cartilage functions to absorb shock from movement and also to provide a gliding surface for the joints.

With OA, the cartilage begins to wear away and the underlying bones begin to rub against each other. This leads to pain. As OS progresses, it causes swelling and loss of motion. Bone spurs develop and the joint starts to deform. Microscopic particles of cartilage and bone flake off and cause irritation of the joint lining leading to more inflammation which leads to pain and more damage.

Symptoms of OA include pain or stiffness in a joint particularly after getting out of bed or after sitting for a prolonged period of time. Some people have ‘flares’ of their symptoms with weather changes. Stiffness and pain in the joints with movement may occur as may ‘crunchiness’.

Some people report no symptoms. One study done at the National Institutes of Health showed that one third of patients with osteoarthritis on x-ray had no symptoms.

While any joint may be affected, the most common areas of involvement are weight-bearing parts of the skeleton such as the neck, low back, hips, and knees. The great toe and the base of the thumb are also common locations. In older women the last row of finger joints and the next to last row of finger joints may be affected. Less common sites are the shoulders, elbows, ankles, and jaws.

Many factors can cause OA, including the way people use their joints. Occupational experiences also play a role. For instance, miners and dockworkers may develop knee OA while farmers have a higher incidence of OA of the hip. Ballet dancers can also develop OA in the feet, ankles, and hips. Athletes also fall into a high risk category with women soccer players being more likely to develop knee OA as a result of prior injury. Other athletic activities which cause joint trauma also can be a trigger for the development of OA.

Obesity is a major risk factor for OA of the hips and knees. The famous Framingham study showed that obese women had the most severe OA.

People with other types of arthritis such as rheumatoid arthritis or gout are at increased risk for developing OA also.  Probably the most significant risk factor is genetic. Patients with a strong family history of OA are at high risk themselves for developing OA. This is most likely a result of defects in cartilage metabolism which hastens wear and tear.

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Osteoarthritis and rheumatoid are two of the most prevalent forms of arthritis, and knowing the difference between the two is important.

Rheumatoid Arthritis (RA)
Rheumatoid Arthritis (RA) is more prevalent, afflicting numerous people across the globe. Rheumatoid Arthritis is chiefly an inflammatory condition affecting the tissue of the joints. After a while, the inflammation can extend to the major organs of the human body and may even progress into a debilitating condition.

In the past, medical research has tried to discover the cause of this condition, but the specific cause has not been identified. At present, it is speculated that the cause is a genetic factor which predisposes a patient to this disease. Certain environmental factors are also deemed to set off its symptoms.

Rheumatoid arthritis (RA) can be treated with certain drugs, such as NSAIDs or non-steroidal anti-inflammatory drugs, and DMARDs (disease modifying anti-rheumatic drugs), both of which can be prescribed by your doctor. Examples of such drugs are Enbrel, Methotrexate, Celebrax, Arava, among others. While these medications have been proven to be effective, it is also imperative to remember that these drugs will at times cause adverse side effects that can exacerbate rather than improve a patient’s overall condition.

Osteoarthritis (OA)
Osteoarthritis is more common among older people, as OA is caused primarily by joint “wear and tear” triggered by the aging process. In osteoarthritis, the cartilage’s water component rises, whereas its protein component diminishes.

Persistent stress or use of the joints, like being overweight or contracting joint injury, can also cause this condition.  Similarly, certain factors as joint infections, diabetes, pregnancy, hormonal disorders, among others, can bring about osteoarthritis. Treatment can vary from localized injections of hyaluronan and glucocorticoid to surgical joint replacement procedures.

Signs & Symptoms of Rheumatoid Arthritis & Osteoarthritis
Knowing the symptoms of Rheumatoid Arthritis & Osteoarthritis may help you learn the distinction between these two forms of arthritis.

If two sides of the joint are affected, plus there is joint swelling or reddening (i.e. inflammation), it is most probably RA. In such cases, the person usually experiences some fever, fatigue, and a sensation of stiffness throughout the entire body for fifteen minutes or more. Some forms of vasculitis, a condition affecting the veins and arteries, may also develop in response to RA. Further, rheumatoid arthritis patients have greater risk for heart attack or a stroke.

Also prevalent among rheumatoid arthritic sufferers are fibrosis of the lungs and renal amyloidosis. Inflammations of the lungs and the kidney are direct or indirect targets of RA.

On the other hand, osteoarthritis does not affect your body’s major organs. In the majority of cases, OA only develops as a consequence of old age.

It is imperative for arthritic patients to distinguish between these two most common types of arthritis. Knowing which type of arthritis you suffer from will allow you to to get the right treatment for your condition. As always, discussing this with a a qualified physician is recommended for an accurate diagnosis and ensuing treatment. Your physician has the ability to prescribe the appropriate therapy and therefore lead you to recovery. If you feel some side effects from using prescription drugs, contact your doctor at once.

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Osteoarthritis is also called degenerative joint disease or osteoarthrosis. It is the most common form of arthritis. People with osteoarthritis usually have joint pain and some movement limitations.

Unlike some other forms of arthritis, such as rheumatoid arthritis, osteoarthritis affects only joint function and does not affect skin tissue, the lungs, the eyes, or the blood vessels as many think about this illness.

Among the over 100 different types of arthritis conditions, osteoarthritis is the most common, affecting over 20 million people in the United States. The risk of developing the condition increases with age. It mainly affects people over the age of 40, and is most common among those over the age of 65.

Causes

It is caused by the breakdown of cartilage. Cartilage is the tough elastic material that covers and protects the ends of bones. Bits of cartilage may break off and cause pain and swelling in the joint between bones. This pain and swelling is called inflammation. People with diabetes may be prone to osteoarthritis. Other endocrine problems also may promote development, including acromegaly, hypothyroidism, hyperparathyroidism, and obesity. A major injury or operation on a joint may lead to osteoarthritis at that site in later life. There are some abnormalities of the joint that you can be born with or which develop when you are a child, such as Perthes’ disease of the hips, which also lead to osteoarthritis in later life.

Symptoms

The symptoms of OA can vary significantly from person to person, and can range from mild and barely noticeable, to severe and disabling. Without cartilage, bones rub directly against each other when you move, causing pain and inflammation. Joint pain usually develops gradually and may feel dull or aching. Pain may be worse in the morning and feel better with activity. Vigorous activity may cause pain to flare up. As osteoarthritis becomes more severe, symptoms may include a total loss of function in the affected joints.

Treatment

There is no blood test for osteoarthritis, but blood may be taken to exclude to check for other types of arthritis. The most useful test for osteoarthritis is an X-ray. This can show the narrowed space between the bones in a joint that is due to cartilage loss. It can also identify any calcification.

If you are overweight, try to lose some weight as the extra burden placed on back, hips, and knees can make symptoms worse. Even a modest amount of weight loss can make quite a difference.

Other treatment choices for osteoarthritis are the dietary supplements glucosamine and chondroitin. Glucosamine may decrease pain in some people with mild to moderate symptoms.

Some hyaluronic acid is already in the fluid in your joints. In people with osteoarthritis, the hyaluronic acid gets thinner. When this happens, there isn’t enough hyaluronic acid to protect the joint. Injections can put more hyaluronic acid into your knee joint to help protect it.

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