OSTEOARTHRITIS (अस्थिसंधिशोथ in Hindi) is a very pervasive form of arthritis that affects the lives of millions of people across the world. Osteoarthritis (O.A.) is also known as the joint degeneration disease.
WHAT IS OSTEOARTHRITIS?
The word ‘Osteo’ in Greek language means Bone, ‘Arthr’ means joint and ‘itis’ means inflammation.
Therefore, osteoarthritis is the wear and tear of protective cartilage between the joints. This protective cartilage acts as cushions at the end of our bones and protects our bones from rubbing over each other.
It generally affects the weight bearing joints of the body- like neck, hand, lower back, hips, and knees.
WHAT ARE THE MAIN CAUSES OF O.A.?
The causes of OA can be of two types:
- Primary Causes- Aging is the most common cause of OA
As a person ages, the body looses its ability to repair the joint cartilage cells. Repetitive use of the joints cause micro fractures and tears in the cartilage. Partial or total loss of cartilage causes friction between the bones that leads to joint stiffness, pain and swelling.
- Secondary Causes-
- Other disease or condition (comorbidity) increase the risk for OA. These conditions include obesity, trauma, congenital disabilities, diabetes, or any surgery or any other state.
- Previous injuries in the load bearing joints increase the risk of OA.
- Poor nutrition and diet
WHO ARE AT RISK?
The common risk factors for Osteoarthritis are:
- Age – Osteoarthritis is more common among the elderly, but even young adults can develop Osteoarthritis.
- Obesity – Excessive weight can put stress on joints and promote cartilage damage.
- Injury – Significant injury, like ligament damage, can eventually cause Osteoarthritis.
- Gender – Women are more likely to develop Osteoarthritis.
- Heredity – Slight joint defects or increased joint mobility (“double-jointed”) may contribute to the event of Osteoarthritis.
- Muscle weakness due to injuries, diseases or inactive lifestyle.
- Scoliosis or other curvatures of the spine.
- Congenital disabilities that affect the hip, like congenital hip dysplasia or congenital dislocation.
- According to NCBI, OA occurs in 10% men and 13% in women aged 60 years or older, and the number of affected people likely to increase with the aging and obesity epidemic.
The most common symptoms are:
- Pain in joints of neck, hand, lower back, hips, or knee
- Stiffness, especially in the morning/ after being ideal for a very long time/ during cold and rainy days
- Swelling and redness in the joints
- Tenderness to light pressure and touch
- Grating sensation or crackling/ crisping sensation in the joints when moving
- Bone spurs or hard and small bony structures that can be felt around the joints
WHAT ARE THE STAGES OF O.A.?
There are mainly four stages of O.A:
- Grade 1 (Minor):
- Very little wear and tear in the cartilage
- Usually, no pain is felt at this stage.
- Cannot be detected on XRay
- Grade 2 (Mild):
- Joints start becoming stiff, especially after extended periods of inactivity.
- Intense and recurrent pain
- X-rays show definitive bone spurs and possible joint space narrowing.
- Grade 3 (Moderate):
- Severe pain in joints
- Inflammation after rigorous daily activities (like fast walking, running, climbing up and down the stairs, standing in one place for a long period of time)
- Increased joint stiffness due to overactivity or inactivity.
- Crackling or crisping sensation while moving around.
- X-rays show narrowing in the joint space, beginning of bone deformity and increased bone spurs, sclerosis (stiffness of the surrounding soft tissues and hardening of bones)
- Grade 4:
- The cartilage is completely damaged
- Physical immobility due to joint stiffness
- Excruciating pain and inability to perform daily chores
- Chronic inflammatory response
- Decreased joint fluid causes more friction, therefore greater pain and discomfort when walking or moving the joint
- Xrays show clear narrowing of joint space and severe deformity of the bones
HOW IS OSTEOARTHRITIS CLINICALLY DIAGNOSED?
O.A. can be detected using an X-ray, where the loss of cartilage, narrowing of space between the joints, and bone spur formation can be observed.
WHAT CAN BE DONE?
There is no permanent cure for O.A., but certain treatments may prevent it the symptoms from getting worse.
Treatments such as:
- Lifestyle Measures: Regular exercising and a healthy diet helps to strengthen your muscles and joints. It also acts as a natural stress reliever and helps to maintain a healthy weight.
Timely physiotherapy intervention can greatly help maintain the joints for a longer period of time.
- Medication: Mainly used to give you relief from pain. It can be used in combination with other therapies for better results. Some medicine includes- paracetamol, NSAIDs, Opioids, Capsaicin Cream, Steroid Injection, etc.
Alternative medications such as homeopathy and Ayurveda may also provide benefits to improve joint flexibility and muscle strength, along with natural remedies like herbs, certain nuts and seeds.
- Supportive Therapies:
- Transcutaneous electrical nerve stimulation (TENS)
- Applying Hot and cold Pads on joints
- Assistive Device
- Manual Therapy
- Surgery (in certain conditions)
- Joint Replacement
- Joint Fusing
- Cortisone Injection
- Lubrication injection
- Realigning bones
- Complementary and Alternative Therapies:
- Acupuncture and Acupressure
- Rubefacients (These are gels and creams which produce war, reddening effect on skin that helps in Pain management)
- Nutritional Supplement (Should be taken after taking advice from your doctor)
Note: Any therapy or procedure should be done after taking proper consultation from your physician. Even it is recommended that you before doing any exercise, you should ask your physiotherapist about it.