OSTEOARTHRITIS
What is osteoarthritis?
Osteoarthritis is the most common type of arthritis. Whilst it is often associated with advancing age, this is not always the case. Loss of cartilage (as opposed to immune associated inflammation which is the underlying problem in rheumatoid arthritis) results in pain, stiffness and reduced range of movement.
The reduction in the cartilage may occur as a primary problem (no underlying injury or disease) or as a secondary problem (usually as a result of prior trauma to the joint e.g. dislocations, fractures and meniscus tears). A number of other factors may increase the risk of developing the condition. These include genetics, particularly in women, and obesity. While there is no cure for osteoarthritis, supervised exercise and maintaining a healthy body weight, can help to slow its progression.
The most common symptoms of osteoarthritis include pain, stiffness and bony swelling, also known as nodules, in the joints. Pain in the joints typically develops during or after movement, and you may feel some tenderness when you apply pressure to the affected area. Many patients report reduced flexibility and joint stiffness in the mornings or after a period of inactivity. In most cases, the symptoms of osteoarthritis develop slowly and get more severe over time.
How is it diagnosed?
Diagnosis involves a full physical examination, in which your affected joints are closely examined. A number of imaging tests may be performed, including x-rays to check for cartilage loss and bone spurs that may have developed around a joint. MRI may be used to produce detailed images of the bones and tissue in complex cases of the condition.
Blood tests will not confirm osteoarthritis but can rule out other possible causes of joint pain. Joint fluid analysis may be recommended to check for inflammation, gout and infection.
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How can it be treated?
The goals of treatment are to reduce symptoms and to improve function. The options include pharmacologic treatment with medication and non-pharmacologic treatment (e.g. physiotherapy / occupational therapy), surgery and complementary or alternative therapy.
Among the medications that may be prescribed for osteoarthritis are paracetamol; nonsteroidal anti-inflammatory drugs; and duloxetine. All of these may be helpful in relieving some of the pain caused by the condition.
Cortisone injections may also be recommended. These are particularly helpful for one or two particularly inflamed joints or in those in whom surgery is not an option.
Weight reduction, supervised exercise, healthy diet and attention to other associated problems may also aid in improving symptoms. Aqua therapy may be particularly helpful for osteoarthritis of the hips and knees.
Glucosamine and chondroitin sulfate, alone or in combination, are used worldwide by individuals suffering from osteoarthritis pain. Various studies looking at the use of these agents have shown different outcomes. They may provide pain relief and are generally regarded as safe, but their effect on slowing down cartilage loss is still debated and additional studies are needed. The American College of rheumatology does not endorse the use of Glucosamine and Chondroitin.
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