Osteoarthritis
Osteoarthritis is a painful condition affecting the joints. It is the most common form of arthritis seen and is the most widely known condition which is described generally as arthritis. It is a degenerative arthritis, previously known as Wear and tear arthritis as the cartilage lining the joint is worn down. This condition not only affects the joint membrane and cartilage but also the surrounding bone causing weakness and joint instability. This degradation of bone and cartilage causes the pain with stiffness.
Osteoarthritis usually occurs at a later age, after 50 years. In case there is a history of injury to a joint, earlier onset is possible. This condition is also seen earlier in obese patients as there is more weight burden on the joints leading to more damage. Overuse of joints and occupations requiring overuse of the joints like sports or jobs requiring physical work also contribute to early disease. Though this condition occurs in men and women, women have greater damage as the associated muscle weakness is higher.
Though the symptoms start at a later age, the disease onset can be earlier in the body. Once the symptoms start, there is a rapid worsening of symptoms with a decrease in quality of life. The commonly affected joints are hands, hips and knees. Though every joint can be affected, pain in the above-mentioned joints cause difficulties. As the hand joints are responsible for the finer movements in daily activities like writing or holding objects and using a spoon or a knife, pain can reduce the functional capacity. When the pain occurs in the weight bearing joints namely hips and knees even walking is difficult.
There is joint pain which can be mild to severe with joint stiffness. The joint stiffness can be severe and can be present the whole day with it being described as Gel like. There is inability to move the joint completely due to this pain and the joint assumes a deformed posture. Due to the bone and surrounding ligaments also being affected, weakness and instability occurs leading to difficulty in doing daily work like climbing the stairs or holding bags. There is a constant feeling of the joint giving away especially in the knees leading to falls.
In a few patients there can be painful bony growths over the joints of the fingers. If these occur in the tips of the fingers it is called Heberden’s nodes and if they occur across the middle of the finger its known as Bouchard’s nodes. These nodes are painful and will restrict the joint movement. They also cause the gnarly appearance of the fingers. Similar bony growths can occur at other joints and they are termed Osteophytes. Diagnosis is through x-rays and clinical examination. Routine blood tests are to rule out other possible conditions.
The treatment for Osteoarthritis requires multiple approaches. Weight reduction is essential. This would reduce the strain over the joints. Weight bearing exercises and muscle strengthening exercises are a must to strengthen the muscles in order to support the joint. In flare ups with severe pain, Non-Steroidal Anti Inflammatories (NSAIDs) are given. Pain management is essential. In advanced cases, surgical treatment might be considered.
Though Osteoarthritis does not cause direct systemic complications, the pain and stiffness cause limited mobility which long term can cause issues. In obese patients, weight along with Osteoarthritis restricts mobility. Patients will not be able to do exercises to loose weight or to strengthen the muscles and this will aggravate both the weight gain and pain. Due to joint instability frequent falls occur and there is a possibility of fractures. There is drop in the quality of life and functional ability which can cause low mood.
Osteoarthritis needs a comprehensive management with good physiotherapy, pain management with weight reduction. Though it is not possible to prevent this condition, changes can be made to ones lifestyle to maintain the functional ability and quality of life.
