What is Osteoarthritis?
Osteoarthritis is the most common type of arthritis affecting to millions of people in over the world, especially in middle-age and elderly people. It occurs when the cartilage covers the ends of bones worn down over the time. Osteoarthritis may affect to any joint in the body, but mostly affect to the knees, hips, back, neck, small joints in fingers and toes. This disease is usually developed after many years of osteoarticular operation. The other risk factors of Osteoarthritis may include obesity, joint injuries and family history of OA.
Osteoarthritis and Rheumatoid Arthritis are two different types of arthritis and they have different treatment therapies. Rheumatoid Arthritis is an autoimmune disease that causes joint inflammation due to the healthy tissues being attacked, leading to joint pain, swelling and stiffness, while Osteoarthritis is the degeneration condition of joint cartilage and spinal disc causing joint pain and swelling. However Rheumatoid Arthritis and Osteoarthritis have some similarities – both can occur in the hands, feet and wrists. At the moment, there is no cure for RA or OA but there are several treatment therapies that can help to significantly reduce the symptoms of both diseases.
What are the symptoms of Osteoarthritis?
There are variety of symptoms of Osteoarthritis depending on the affected joints and its severity. However the most common symptoms are joint pain and joint stiffness, especially in the morning or after resting. The affected joints may be swelling up, particularly after having prolonged activities.
Some common symptoms may include:
- Joint pain or stiffness, especially in the hips, the knees, the lower back after a time having no activities or strenuous activities
- Stiff joints, restrict movements.
- The crunched sounds in the joints when moving
- Mild swelling around the areas of joint inflammation
- The pains become worse after having physical activities or at the end of the day.
Osteoarthritis also has several symptoms that affect to different parts of the body including:
- Hips: people with OA will feel pain in the inguinal region or gluteal region, and sometimes inside the knees or thighs.
- Knees: People with OA feel jarring, or hear the crunched sounds when moving the knees.
- Fingers: bones grow on the edge of joints causing swelling, redness and pain in the fingers, maybe pain in the base of the thumb.
- Feet: pain and swelling appear at the ankles or toes
If these symptoms are not being prevented in time, they may interfere in your job, daily life and social activities. You will feel difficult when doing daily activities such as walking, climbing upstairs, holding daily supplies.
How to diagnose
Doctors may diagnose OA partially basing on the signs and symptoms appearing on the patient. In order to diagnose correctly, the osteoarticular experts will ask some questions relating to personal and family history as well as process clinical examinations and require diagnosed tests.
Images of affected joints may be obtained during the process of imaging tests.
X-ray: the X-ray images may show the lost cartilage, injured bones and bone spurs. In some people, Osteoarthritis may be diagnosed through X-ray images before they experience any symptom.
Magnetic resonance imaging (MRI): MRI technique uses radio frequency waves and a strong magnetic field to creating detailed images of bones and soft tissues, including cartilage. Commonly MRI is not necessary to diagnose Osteoarthritis but it can help to provide more information in some complex cases.
Blood tests or joint fluid analysis may help to diagnose Osteoarthritis.
Blood test: Doctors may require a blood test to rule out the other reasons that have the same symptoms as Rheumatoid Arthritis.
Joint fluid analysis: Doctors may use a needle to prick a little bit joint fluid from affected joints, then do checking and testing the fluid from the joints, from that can define the inflammatory condition and the origin of this inflammation is due to gout or due to infection.
How to treat Osteoarthritis?
Currently, the process of Osteoarthritis basically can not be cure completely. But the symptoms can be controlled effectively if patients maintain a healthy lifestyle, moderate physical activities combining with other treatment therapies such as using medicines or surgery, doing regular exercise and keeping a reasonable body weight are generally the best ways to treat Osteoarthritis.
Use drugs to treat OA
Acetaminophen is a pain relief ingredient found in some drugs such as Tylenol and generics. Tylenol is the first choice of doctors in Osteoarthritis treatment. Most of people can use Tylenol without having any problem as long as not exceed the recommend dosage. Tylenol is proven to be effective for people with Osteoarthritis having mild pains to medium pains. Using overdosage of acetaminophen may lead to severe hepatotoxicity, so people should avoid. The total dosage of acetaminophen is not allowed to exceed 3-4gram per day.
Non-steroidal anti-inflammatory drugs
NSAIDs help to relieve pain and joint stiffness. These drugs have rapid efficiency, often within few hours. You may see the positive signs after using NSAID in one to three weeks, sometimes longer. You may need to use from two to three different NSAIDs to find out the most suitable one for you. But you should be careful, just use one type of NSAID each time.
Cyclo-oxygenase 2 Inhibitors (COX-2 inhibitors)
COX-2 works as traditional NSAIDs but have less side effects to the stomach. COX-2 inhibitors prevent an enzyme that promotes inflammation named COX-2 including: Rofecoxib, valdecoxib and Celebrex, however Rofecoxib and valdecoxib have been removed from US market because of leading to heart attacks and strokes. Celebrex is still being used to treat Osteoarthritis but the doctors will provide low dose and for a short time. In order to reduce the signs and symptoms of Osteoarthritis, the recommended dose of Celebrex is 200mg per day using just one dose per day or 100mg devided twice per day.
Cymbalta (duloxetine) is an antidepressant approved by FDA and is also accepted to use for Osteoarthritis treatment and chronic pain such as fibromyalgia.
Steroid includes methylprednisolone acetate and betamethasone being directly injected to the joints. They help to relieve pain and inflammation and the efficiencies have been proven in the knees and hip joints.
Nutritious food supplements
The nutritious food supplements contain glucosamine and chondroitine sulfate not only helping to reduce the symptoms of Osteoarthritis but also offering benefits in pain control while having less risks as well as no side effects. However you should stop using glucosamine and chondrointine sulfate if there are no effects after 6 months using. Patients are allergic to shellfish such as shrimp, crab,..should not use glucosamine.
Bioflavonoids is also introduced that it has anti-inflammatory characteristic and help to prevent Osteoarthritis. It can be found in pericarp of citrus fruits, persimmon and black grapes. This substance helps to relieve inflammation by inhibiting cyclooxygease (COX) and lipoxygenase (5-LOX), relieves common pains and has antioxidative characteristic.
Artificial joint fluid
Hyaluronic acid is an ingredient found in the joint fluid working as a lubricant that allows the joints to move easily. In Osteoarthritis, HA may be lost or does not work well. Artificial hyaluaronic acid may be directly injected to the knee joints to relieve pain. Artificial hyaluronic acid is usually used for patients who are unresponsive to normal treatment, can not tolerate drugs, especially Non-steroidal anti-inflammatory drugs (NSAIDs) and people are waiting for arthroplasty.
In addition, a group of researchers headed by a biomedical engineer of Boston University have developed a type of joint fluid named Synthetic Polymer – it has brought the hope for millions of people who suffer from Osteoarthritis. This synthetic polymer is directly injected to the pained joints to supplement natural synovial fluid. This method currently works better than previous treatments.
Non-drugs Osteoarthritis treatment
The researchers indicated that do exercise is one of the best ways to treat Osteoarthritis. Doing exercise helps to improve the mood, relieve pain, and increase the flexibility, enhance your heart, improve the flow of blood and maintain stable body weight. Doing exercise does not take lot of money, if you do moderate exercise, it helps you a lot to gain a good health. Exercise forms and frequency will depend on the specific disease condition of each patient. Walking, swimming and aerobic are some common types of exercise beneficial for patients with Osteoarthritis. Note that, you should stop and rest when you feel tired or feel joint pain, this is to avoid causing pressure to your joints.
Heat and cold therapies
Heat or cold therapy helps to control the pains, joint stiffness and muscle pain. Heat therapy helps to relieve joint pain and stiffness. You can use hot towels, heat packs, hot bottles water or heat pads. Cold therapy helps to relieve pain and acute spasm. You can use ice packs or sprays to keep cool continuously in a short time.
Transcutaneous electrical nerve stimulation (TENS)
TENS is a technique using a small electrical device to create mild electrical pulses to the nerves under the skin of pain areas. TENS may relieve pains caused by Osteoarthritis.
Gentel massage or massage the muscles may help to increase the blood flow and bring the warmness for the massaged areas, the painful feelings or discomforts at the joints will be disappeared.
Some people have found out a solution to relieve pain, it is acupuncture. The scientists said that acupuncture needles stimulate the release of natural painkillers produced by the nervous system.
For many people, surgery helps to relieve pain and avoid being disability caused by severe Osteoarthritis. Surgery is necessary to replace or repair damaged joints in severe cases.
There are some types of surgery including:
- Arthroscopic: to remove bone debris and cartilage shards from the joints
- Osteotomy: to adjust or alter the position of associated bones
- Arthroplasty: to replace total or a part of degenerative joint by an artificial joint.
Deciding to use surgery depends on several factors including the patients’ age, the job, level of disability, the pain intensity and the extent of arthritis interfering in their lifestyle. After the surgery and rehabilitation, patients usually feel less pain and swelling, and they can move easily.
Complications may occur due to Osteoarthritis
The joint diseases in general and Osteoarthritis in particular often develop silently. When the signs and symptoms manifest outwardly, the disease condition has been severe and may cause injuries and complications to other organs such as the stomach, kidney, cardiovascular or more severe is complete disability.
The preventive measures
It is not very difficult to prevent Osteoarthritis. When you are young, let do exercise regularly, avoid being obesity, so strong movement, especially the sudden movements that may deflect joint axes and spinal column. You also need to adjust your eating habits, reduce salt and sugar and fat while increase the levels of calcium, vitamin C and vitamin D.
Some advices for patients with Osteoarthritis
Patients should have regular physical activities that help blood and oxygen circulating easily and firm muscles as well as help bones to avoid being under pressure. To protect osteoarticular, you need to have moderate activities, do not stand or sit too long. Should keep straight in shape, do not hunch or incurve when sitting or standing.
During the cold weather, patients need to keep the body warm, especially fingers and feet, limit going out when it is too cold.
In some severe cases, the physical therapists recommend that patients should have supportive devices at home such as raised toilet seats, power-lift chairs, canes, walkers, and bathroom shower/tub bars to make their daily life activities become easier.
The patients’ mentality directly affects to their physical condition, so it is esstial to have positive attitudes, keep comfortable mentalilty and stay away from stress.