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Osteoarthritis

April 16, 2012

K. Faaborg

As we get age we seem to have more health related complications. One of these complications is osteoarthritis, which is the most common joint disorder and is a degenerative disease. It is due to aging and wear and tear of joints. Osteoarthritis is also known as degenerative arthritis and almost everyone has symptoms by the time they are 70, although some maybe be more severe than others. The cartilage in joints tends to break down as you age and the bones will start rubbing together causing discomfort and pain. In this post I will go over the cause, the signs, how OA can be diagnosed, and its treatment.

Pathogenesis

Osteoarthritis is a degenerative disease that causes pain in the joints. As we age the pressure that we have put on joints starts to catch up with us. Everything from walking to playing sports causes wear and tear on the cartilage in our joints, which allows bones to glide over one another. As we age the cartilage starts to break down and then the bones rub against one another. This can cause ligaments and muscles around the joint to become stiff.  The most common symptom of OA is stiffness and pain in joints especially after exercise. As it progresses your joints may seem to hurt most of the time even when you are resting and may even wake you at night. The signs of osteoarthritis are cracking or grating during joint movement, swelling of joints, and limited range of motion. Osteoarthritis does not resolve although some days may be better than others, the cartilage that is lost is unable to replace itself.

Etiology

The cause of osteoarthritis is unknown but is linked with aging and some investigators believe that mechanical stress on joints underlies all OA.  There are factors that can increase your risk of osteoarthritis such as genetics. Studies have shown that there is a greater prevalence of the disease in siblings and identical twins showing that it runs in families. Being overweight also causes an earlier on set of OA due to the extra pressure put on the joints. Fractures or other injuries to joints can also increase risk. Jobs that involve kneeling or squatting for more than an hour a day put you at a high risk, also playing sports that involve direct impact on joints such as football and basketball.

Diagnosis

Many times a physician will do a physical exam and will check for cracking when a joint is moved, this is called crepitation.  They will also check for joint swelling, limited range of motion, tenderness when joint is pressed on. Blood tests are not helpful when diagnosing OA but x-rays can show a loss in joint space in effected joints.

Treatment

Unfortunately osteoarthritis cannot be cured and will most likely get worse over time, but there are some lifestyle changes that can control the symptoms. Staying active can help maintain joint movement, water exercises such as swimming are especially helpful. Other lifestyle changes can include, applying hot and cold, eating a balanced diet, getting rest, and maintaining a healthy weight. Physical therapy may also have benefits by strengthening muscles and the motion of stiff joints. Physical Therapists have many techniques for treating OA. Braces may also be used to help protect weakened joints but should not be used unless recommended by a doctor.  As far as medications go, Tylenol is recommended to relieve pain. Other medications may included a corticosteroid injected into the joint to reduce swelling  and  Zosterix, a skin cream that can relieve pain. Surgery may also be an option if other treatments have not worked. Arthroscopic surgery can be preformed to trim torn and damaged cartilage. Changing the alignment of bones may also relieve some of the pain. Or totally joint replacement can be an option.

Incidence and Mortality

Osteoarthritis is the most prevalent from of arthritis in the United States, effecting more than 70% of people between the ages of 55 and 78. So, about 20 million people in the US currently are suffering from OA which is the leading cause of disability in the over 65 years of age population. People with osteoarthritis do not die from it, but many times it is accompanied by high blood pressure, diabetes, and obesity.

Research, Charities, and Support Groups

OARSI is the premier international organization for scientists and health care professionals focused on the prevention and treatment of osteoarthritis through the promotion and presentation of research, education and the worldwide dissemination of new knowledge. And they are the only organization whose sole concern is OA.

You can donate to the Arthritis Foundation, who not only help fund research but also help families suffering for OA and the doctors who help them.

http://www.arthritis.org/

You can also join a support group at everydayhealth.com which can help you to deal with your symptoms by reading others comments and ideas.

http://www.everydayhealth.com/osteoarthritis/support-for-osteoarthritis.aspx

http://www.nlm.nih.gov/medlineplus/osteoarthritis.html

http://osteoarthritis.about.com/

http://emedicine.medscape.com/article/330487-overview

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