Osteoarthritis (OA) is the most common joint disorder, caused by ‘wear and tear’ on a joint. More than 26 million Americans have OA and over one-third are women. It can occur at any age but is more likely in those who are older than 45. Most people believe that OA is a natural consequence of aging, but heredity and mechanical injury are also strong risk factors.
Osteoarthritis occurs when the protective cartilage covering the bones of the joint wears away. This leads to joint space narrowing, which in turn causes bony spurs and inflammation of nerve endings ultimately leading to pain.
Patients with osteoarthritis usually complain of joint pain after exercise and when placing weight or pressure on the joint. Morning stiffness is common, but typically lasts under 30 minutes, and is improved by mild activity that “warms up” the joint. During the day, the pain may get worse with activity and feel better when you are resting. After a while, the pain may be present when you’re resting. It may even wake you up at night.
Other factors can also lead to OA. It tends to run in families. Obesity significantly increases the risk of OA of the hips, knees, ankles, and feet. Fractures and other joint injuries can lead to OA later in life. Long-term overuse at work or in sports can lead to OA. Medical conditions such as hemophilia, avascular necrosis, chronic gout and pseudogout can also lead to osteoarthritis.
Diagnosis of osteoarthritis based on patient history, a physical exam, and x-rays. Joint movement may cause a cracking (grating) sound, called crepitation. Joint swelling can occur, but is usually mild. Joints are often tender when pressed. An x-ray of affected joints will show a loss of the joint space, due to the loss of cartilage. There are no blood tests that are helpful in diagnosing osteoarthritis.
OA cannot be cured. Treatment focuses on relieving pain, reducing inflammation and improving joint motion. Non-steroidal antiinflammatory drugs (NSAIDS) such as Aleve® are often used to treat the pain of osteoarthritis. Acetaminophen can be used in patients intolerant to NSAID’s, or in those with impaired kidney function or cardiovascular disease. Many people find that glucosamine is beneficial in the treatment of osteoarthritis. Regular exercise and maintenance of ideal body weight is essential in the treatment of the disease. Complementary therapies such as acupuncture, aquatic therapy, and medical massage therapy have also shown to be beneficial. Surgical intervention is sometimes required to relieve pain in damaged joints, or to replace joints that are severely damaged.