Osteoarthritis | اوسٹیو ارتھرائٹس

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Osteoarthritis is a very common condition, affecting millions of people worldwide.
It is the most common type of arthritis in which the cartilage that protects the joints of the bones is damaged.

Back pain-1015574_640

Healthy cartilage are hard slippery tissues present between the joints. The main function of cartilage is to provide padding to the joints enabling their smooth movement.

Normally, our joints experience minor level of constant wear and tear as part of daily activities.  In most cases, it is repaired itself and thus our joints function properly.

In osteoarthritis, the cartilage surface becomes rough restricting the free friction-less movement. Overtime the patient may have complete damage of the cartilage exposing the joints rubbing each other, causing constant pain and stiffness.

Any joint can be affected, but this condition is most often seen in the hands, neck, knees, lower back and hips.  The condition gradually worsens, especially when it is left untreated.  There is no complete cure, but there are many life-style changes and treatment options to help in controlling discomfort and symptoms and to slow down disease advancement.

The symptoms vary in severity from person to person.  Some joints cause more pain than the other joints. Also, pain is more severe in colder weather.  Some people with mild symptoms experience pain for few days after every few weeks, whereas others feel discomfort and pain continuously.

Knee joints

Usually, signs and symptoms appear gradually and get worse over time. They may include

  • Pain in joints, especially with movement
  • Stiffness in joints that is usually worse in the morning or with inactivity
  • Grating (feeling rough)or crackling sound sensation due to friction in joints
  • Tenderness with light pressure on joints such as in severe case standing up
  • Reduced flexibility in the joints
  • Bone spurs (small deposits of bones) that can develop around the affected joint

Arthritis Xray

This condition occurs when the cartilage responsible for cushioning the joints is damaged.  The main function of the cartilage is to allow smooth motion in joints that is nearly friction less. In Elderly - grandparents-1800224_640this condition, the slippery surface of the cartilage gets rough and over time damages completely.  This can result in bone rubbing on bone causing pain.

Many risk factors are associated with this condition and these include

  • Being older - because a large percentage of people over age 60 have this 
    condition due to normal wear and tear from living life
  • Being female - however, it is not known why females are more affected to this condition
  • Previous injuries to the joints - because this can make joints or cartilage more easy to be damaged
  • Weighing machineWorking a job - that puts regular pressure on joints e.g. bending or lifting weight
  • Genetic defect - resulting in not proper development of bones and cartilage
  • Being overweight - because extra weight puts more stress on the joints
  • Certain other diseases - such as gout, diabetes, Paget's disease or under active thyroid

Physical examination and patient history

Diagnosis starts with a thorough physical examination where the doctor will pay close attention to the joints, measuring overall range of movement and looking for physical symptoms, such as swelling, redness or tenderness. In addition, doctor will ask questions to understand the type of the pain, its frequency or any associated injury. If there is some evidence of joint problems, testing is done to definitively diagnose osteoarthritis.

Osteoarthritis - knee-1406964_640

Doctors usually begin by X-raying the joints that are causing pain and discomfort to rule out other possible issues, such as fractures, and to get a better look at the joint. Common imaging tests include:

  • X-rays:  Basic X-rays will not show the cartilage, but if the joint space looks reduced between two bones, this can indicate cartilage loss. This type of imaging can also reveal any bones spurs (small bone deposits) that may be present. In many cases, the symptoms of this condition present on an X-ray before someone even starts to have symptoms.
  • Magnetic resonance imaging (MRI):  This test uses a strong magnetic field and radio waves to create pictures of the soft tissues and bones. This type of imaging is able to give doctors a detailed look at the cartilage. This is a good test to get a good idea of what is causing pain to the patient.

Other tests

Doctor may also request for joint fluid testing and blood testing to diagnose the condition, as well as rule out other possibilities. Blood testing can be done to test for other possible conditions, such as rheumatoid arthritis. Joint fluid testing involves getting a sample of the patient's joint fluid through inserting a needle into the affected joint. . The fluid is then tested for signs of inflammation. This can also rule out other possible conditions, such as infection or gout.

Mainly, treatment includes combination of exercise and medication.  For overweight patients, losing weight greatly helps in reducing pain and inflammation.

Life-style modification carrying out regular physical exercise and maintaining healthy weight is essential.

Based on the available medical methods, osteoarthritis cannot be cured, but there are many different treatments that are proven to be helpful in slowing down disease progression and reducing severity of symptoms.  There is no magic treatment and each patient usually goes through a trial and error process before finding the best treatment regimen for them.

Medications that are commonly used to reduce symptoms associated with this disease, include:

  • Paracetamol or Acetaminophen:  This is a basic pain relieving medicine that can reduce mild to moderate pain.  However, this medication does not reduce inflammation.
  • Non-steroidal anti-inflammatory drugs (NSAIDS):  Medicines in this group are referred as pain-killers.  These drugs assist in reducing pain and inflammation, but long-term use can cause serious side effects.  Always consult the doctor before taking these medications.
  • Narcotic medication:  These are not commonly used due to the risk of addiction and physical dependence, but can help to manage severe pain for short term.

There are different therapy options that help many patients to live more comfortable and productive lives, including:

Physical therapy:  This can help to increase range of motion, strengthen the muscles surrounding joints and reduce pain.

Shoe insets and braces:  This can help to reduce pain by relieving pressure on a joint.
Occupational therapy: This can help patients to alter how they do everyday tasks to allow for greater productivity.

Other treatment options that may be considered when the above methods fail include:

  • Cortisone injections to reduce inflammation and pain in a specific joint
  • Osteotomy to surgically realign the bones
  • Lubrication injections to cushion the joint and diminish pain
  • Surgery is rarely recommended. Joint replacement surgery to replace a completely destroyed joint

This is a degenerative disease that almost always gets worse as the years pass.

The stiffness and joint pain associated with osteoarthritis can become quite severe for some people, lowering quality of life and making completing daily tasks quite difficult. Some people have to give up favorite hobbies or their jobs. In severe cases with significant joint damage, patients may require joint replacement surgery.

Osteoarthritis is very common so millions of people throughout the world live with this condition. There are many things that can be done to help to manage symptoms and prevent worsening of the condition, including:

  • Rest during times of inflammation and pain
  • Lose weight if the patient is overweight
  • Use over-the-counter pain creams with permission from your doctor
  • Exercise regularly to strengthen the muscles around affected joints
  • Use ice and heat around the affected joint to manage pain
  • Use assistive devices when necessary
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