Osteoarthritis – Causes & Management

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Pliro
Written by Pliro
Apr 6, 2018 Last updated: Apr 6, 2018
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Osteoarthritis (OA) is the most common type of arthritis and is a chronic disorder of bone cartilage and surrounding tissues. It is caused by the degeneration of the protective cartilage between the joints over time. Osteoarthritis can affect any joint in the body but most of the time affects the weight bearing joints like knee joint, hip joint, spine etc. Mostly common in people after 70 years yet before the age of 40 years it is more common in males. While between the ages 40 to 70, women develop osteoarthritis more often than the men do.

According to a study by World Health Organization, “The prevalence of OA is increasing due to population ageing and an increase in related factors such as obesity”.

According to the United Nations, “by 2050 people aged over 60 will account for more than 20% of the world’s population. Of that 20%, a conservative estimate of 15% will have symptomatic OA, and one third of these people will be severely disabled. This means that by 2050, 130 million people will suffer from OA worldwide, of whom 40 million will be severely disabled by the disease”.

Causes

Osteoarthritis occurs as a result of abnormality of the cells in the joint cartilage that synthesize the components of cartilage leading to partial or complete degeneration of the cartilage responsible for the reduction in friction between the two ends of the joints.
Causes of osteoarthritis can be divided as:

  • Primary or Idiopathic: When the cause is not known.
  • Secondary: When there are other factors leading to this condition. Common secondary causes include:
    • Trauma
    • Obesity
    • Steroids
    • Family history
    • Other diseases like Paget’s disease, infections.
    • Over use of the Joint.

Signs and Symptoms

Symptoms of OA develop gradually and initially affects unilateral weigh bearing joints like hip or knee joint.

Some common signs and symptoms include:

  1. Pain- Pain in OA mostly increased by activity.
  2. Joint stiffness – It is more common after long hours of inactivity like early in the morning but mostly subsides within 30 minutes.
  3. Reduced range of movement of the joint.
  4. Grating sensation- the irregular joint surface causes grinding, grating or crackle when moved.
  5. Bony growth at the end or middle of the fingers- known as Bouchard’s and Harbenden’s nodes.
  6. Abnormal walk or gait.

Management

Osteoarthritis is diagnosed through imaging studies e.g. X-ray or MRI. Once diagnosed, long term life modification is advised that makes up most of the conservative management.

Conservative Management

It includes pain management through analgesics and anti-inflammatory drugs like Nsaids, steroids, Opioids and an atypical Opioid known as Tramadol. Moreover Glycosaminoglycan (GAGs), Calcium and vitamin D supplementation is also helpful in reducing the symptoms.

Physiotherapy and occupational therapy also help to manage OA conservatively. Water therapy like waterborne exercises or swimming has also shown great results. Physical activity like regular exercises and aerobics  helps people with OA to a great extent.

The U.S. Department of Health and Human Services recommends that everyone, including those with arthritis, get 150 minutes of moderate exercise per week“. Weight reduction and good posture is advised while managing OA.
Definitive treatment is done through the replacement of the affected joint. It may include Knee Replacement Surgery or Hip Replacement Surgery.

Both pharmaceutical companies and Physicians are actively searching for therapies to treat OA and its associated symptoms. There has been some progress in the appropriate management of OA, yet lack of awareness leads to aggravated symptoms and thus poor outcomes of pain management and surgeries.

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