Osteoarthritis is a non-inflammatory arthritis affecting synovial joints, mostly in elderly and is characterized by pain and disability. It is the commonest type of arthritis and is also known as a ‘degenerative disease’ because it is associated with marked wear and tear of the joint.

Osteoarthritis affects the synovial joint. Synovial joints are present in joints where a wide range of movement is possible. The synovial joint is where a portion of the bone is coated with articular cartilage and lubricated with synovial fluid. In osteoarthritis there is a focal loss of this articular cartilage with proliferation of new bone and remodeling of the joint contour. Synovial joints include wrists, knees, ankles, shoulders, and hips.

The prevalence of osteoarthritis increases with age. Similar prevalence is found in men and women aged between 45-55 years. After age 55, prevalence becomes greater in women.

There are several factors that play a role in the development of the osteoarthritis. These include:

• Genetic factors

• Gender and hormonal status

• Family history

• Being overweight

• Joint Injuries

• Work and leisure factors (repetitive occupational trauma)

• Frequent squatting or kneeling

• Jobs that involved heavy lifting

• Climbing stairs

• Strenuous exercise (Marathon runners, however, have a relatively low rate of osteoarthritis in general. Some scientists speculate that running enhances cartilages health)

• Bone infection

• Joint shape (such as mismatched surfaces on the joints, legs of unequal length or skewed feet)

This disease is characterized by classical clinical features among which the main symptoms that draw a patient’s attention are PAIN and FUNCTIONAL RESTRICTION.

If you have observed the following features about your pain then you should consult a doctor:

• Your pain is of insidious onset (over months or years).
• Your pain is variable or intermittent (not consistent) over time and you experience good days (without or with less pain) and bad days (with pain).
• Your pain is mainly related to movement and weight bearing.
• Your pain is relieved on taking rest.
• Your joint feels stiff on getting up in the morning but only for a brief period (<15min).
• Only few joints are painful (not multiple regional pains).
• Pain is accompanied by a grinding sensation (crepitus).

When osteoarthritis involves the spine, it can affect the bones of the neck and lower back, and may cause numbness, tingling, pain or weakness in the extremities.

Osteoarthritis is mainly a clinical diagnosis but you may be asked by your doctor to do some investigations, most commonly an X-ray of the affected joint, as supportive evidence and also to assess the degree of damage.

If osteoarthritis is not well treated, especially in the early stages, it may result in irreversible deformities. Initially there is a mild degree of swelling around the joint along with impaired activity of the joint. Gradually muscle wasting and bony deformities may develop.

Treatment options include:

o Lifestyle Modification:

• Avoid excess strain on joints.

• Maintain a healthy weight to avoid putting extra stress on your joints.

• Warm-up/cool-down before and after exercising.

• Wear proper shoes.

• · Using aids such as canes or walkers can also take off some of the strain

• Using elastic supports on affected or important joints.

• Exercise (range of motion, isometric, isotonic, isokinetic, postural, strengthening) maintains healthy cartilage and range of motion and develops stress-absorbing tendons and muscles.

• Pace yourself. An occupational therapist can help you modify your home or work environment.

• Rehabilitation techniques, which are focused on preventing dysfunction, attempting to begin management before disability develops, and decreasing the severity or duration of disability.

o Pharmacological Treatment:

Drug therapy should generally be a small aspect of optimum management. Pain alleviation and improvement of joint mobility are the two basic aims of drug therapy. The following drugs may be useful:

• Acetaminophen

• Non Steroidal Anti-Inflammatory Drugs (if clinical response to acetaminophen is not satisfactory)

• Muscle relaxants

• Opioids

• Chondrointin sulphate and Glucosamine

• Intra-articular injections

o Surgical Treatment:

If one of the joint becomes badly damaged, or if the pain is too severe, you may be recommended surgery.

There are different kinds of surgery for osteoarthritis. With some surgery, bits of cartilage are removed from the joint. Other kinds of surgery repair or rebuild parts of the bone, or replace a joint with an artificial or a man-made joint.

• A combination of glucosamine and chondroitin sulfate is used as a dietary supplement to relieve the symptoms of osteoarthritis.

• Vitamin D and calcium are recommended for bone strength.

• A diet to achieve some degree of weight loss may also be beneficial.

Find out how your Osteoarthritis can be more effectively treated.

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