Osteoarthritis is the most common type of arthritis in Anguilla. It affects individuals of all ages, but appears to be more common in females. The damage to affected joints cannot be reversed, but many of the symptoms can be successfully managed.
What is osteoarthritis?
Osteoarthritis, also known as degenerative joint disease (DJD), is more likely to develop as people age. The changes in osteoarthritis usually occur slowly over many years, though there are occasional exceptions. Inflammation and injury to the joint cause bony changes, deterioration of tendons and ligaments – and a breakdown of cartilage, resulting in pain, swelling, and deformity of the joint.
There are two main types of osteoarthritis:
• Primary: Most common, generalised, primarily affects the fingers, thumbs, spine, hips, knees, and the great (big) toes.
• Secondary: Occurs with a pre-existing joint abnormality, including injury or trauma such as repetitive or sports-related; inflammatory arthritis, such as rheumatoid, psoriatic, or gout; infectious arthritis; genetic joint disorders, congenital joint disorders and metabolic joint disorders.
What causes osteoarthritis?
Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates. Cartilage is a firm, slippery tissue that enables nearly frictionless joint motion. Eventually, if the cartilage wears down, completely, bone will rub on bone.
Osteoarthritis has often been referred to as a wear and tear disease. Besides the breakdown of cartilage, osteoarthritis affects the entire joint. It causes changes in the bone and deterioration of the connective tissues that hold the joint together and attach muscle to bone. It also causes inflammation of the joint lining.
Who is affected by osteoarthritis?
Approximately 80% of older adults, ages 55 years and older, have evidence of osteoarthritis on X-ray. Of these, an estimated 60% experience symptoms. It is estimated that 240 million adults worldwide have symptomatic osteoarthritis. Post-menopausal women have an increased incidence of knee osteoarthritis compared to men.
What are the risk factors for osteoarthritis?
In addition to age and secondary causes, such as inflammatory arthritis and prior injury/ trauma, several other risk factors increase the chance of developing osteoarthritis – including obesity, diabetes, elevated cholesterol, being female, and genetics.
What are some symptoms of osteoarthritis?
Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include the following:
• Pain. Affected joints might hurt during or after movement.
• Stiffness. Joint stiffness might be most noticeable upon awakening or after being inactive.
• Tenderness. Your joint might feel tender when you apply light pressure to or near it.
• Loss of flexibility. You might not be able to move your joint through its full range of motion.
• Grating sensation. You might feel a grating sensation when you use the joint, and you might hear popping or crackling.
• Bone spurs. These extra bits of bone, which feel like hard lumps, can form around the affected joint.
• Swelling. This might be caused by soft tissue inflammation around the joint.
Diagnosis
It you have symptoms suggestive of osteoarthritis you should see your doctor. Your healthcare provider can diagnose osteoarthritis by obtaining a complete history of your symptoms and examining your joints. X-rays may be helpful to make sure there is no other reason for the pain. Magnetic resonance imaging (MRI) is generally not needed except in unusual circumstances – or in cases when the cartilage or surrounding ligament tear is suspected. There are no blood tests that diagnose osteoarthritis. If a joint is particularly swollen, a doctor may need to drain fluid from that joint. Tests can be performed on the fluid to look for clues for other types of arthritis, such as gout.
Treatment
There is no cure for osteoarthritis. Mild to moderate symptoms are usually well managed by a combination of pharmacologic and non-pharmacologic treatments. Medical treatments and recommendations include:
• Medications (topical pain medicines – and oral analgesics including nonsteroidal anti-inflammatory medications, NSAIDs).
• Exercise
• Intermittent hot and cold packs.
• Physical, occupational, and exercise therapy.
• Weight loss (if overweight).
• Healthy eating – managing diabetes and cholesterol.
• Supportive devices such as braces, orthotics, shoe inserts, cane, or walker.
• Intra-articular injection therapies (steroid, hyaluronic acid “gel”).
• Complementary and alternative medicine strategies, including vitamins and supplements.
There is no medication yet available that has been shown to reverse osteoarthritis. Currently, medications are focused on decreasing symptoms of the disease. Although many of these medications are available in over-the-counter preparations, individuals with osteoarthritis should talk to a healthcare provider before taking the medications. Some medications may have dangerous or unwanted side effects – and/or may interfere with other medications that are being taken. Some over-the-counter medications still require routine laboratory testing.
Surgery may be helpful to relieve pain, and restore function, when other medical treatments are ineffective or have been exhausted, especially with advanced OA.
Conclusion
Osteoarthritis is the most common form of arthritis affecting many individuals, today. The main symptoms of osteoarthritis are joint pain and stiffness, and problems moving the joint. There is at present no medication to reverse the damage to the affected joint, but there are several treatment options available to manage the symptoms of osteoarthritis – and prevent progression of the disease and complications. Staying active, maintaining a healthy weight might also prove beneficial.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field is ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty eight years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
