The most prevalent form of arthritis is osteoarthritis, a condition that affects the joints. As people get older, osteoarthritis is more likely to occur. Though there are occasionally exceptions, osteoarthritis changes often take place gradually over a long period.
The smooth cartilage that protects the bone surfaces at the joints is damaged or deteriorates over time in osteoarthritis, a degenerative joint condition (4). Osteoarthritis with inflammation and joint damage results in bony alterations, and the degeneration of tendons, ligaments, and cartilage, which cause pain, swelling, and also several joint deformities (1).
Because osteoarthritis is a degenerative condition, symptoms progressively get worse over time. Although there is no cure, medication can keep a person active and mobile while managing pain and swelling (2).
Types Of Osteoarthritis
Osteoarthritis can come in two different forms:
- 1. Primary Osteoarthritis: The spine, hips, fingers, knees, thumbs, and great (large) toes are the most frequently occurring, generalized, and affected body parts.
- 2. Secondary Osteoarthritis: Occurs in conjunction with a pre-existing joint abnormality, such as a repetitive or sports-related injury or trauma, inflammatory arthritis like rheumatoid arthritis, psoriasis, or gouty arthritis), infectious arthritis, genetic joint disorders (such as Ehlers-Danlos, also known as hypermobility), congenital joint disorders, or metabolic joint disorders (1).
Joints Commonly Affected In Osteoarthritis
Although osteoarthritis can affect any joint, the spine, neck, knee, hips, and hands are the most frequently affected.
Unless it is brought on by an injury, ailment, or a pre-existing condition, osteoarthritis typically affects both knees. When walking, especially up the hills or upstairs, there may be a pain, according to the condition.
It becomes more difficult to stretch the leg because the knees freeze into place. When they flex or bend their knee, a faint, grating sound can be heard.
Any action of the hip joint, such as trying to stand up or sit down, may be difficult or uncomfortable for someone who has osteoarthritis in the hips.
Hip pain is a typical symptom of the illness. Pain in the knee, thighs, and buttocks can also result from Osteoarthritis in the hips. For instance, a person may feel this pain when walking or while resting.
OA can manifest in:
- – The hands at the thumb base.
- – At the upper joint of the finger.
- – The other fingers’ middle joint (2).
Swelling, discomfort, deformity, and stiffness are common symptoms of all types of hand arthritis. Osteoarthritis can occasionally form bony nodules known as osteoarthritis nodes in the middle or end joint of the finger (Bouchard’s nodes or Heberden’s nodes).
At the base of the thumb, osteoarthritis can result in swelling, a lump, and excruciating discomfort. Osteoarthritis patients may find it challenging to turn a key or open a jar due to their weak grasp and pinch due to the osteoarthritis nodes (4).
Osteoarthritis: What Age Group Is Commonly Affected?
On X-ray, osteoarthritis can be seen in about 80% of older persons who are 55 years of age and older. An estimated 60% of them have symptoms. Over 30 million persons in the United States are among the 240 million adults globally who are estimated to have symptoms of osteoarthritis. It is important to also state that osteomyelitis can occur at any age too (1).
Risk Factors Of Osteomyelitis
The likelihood of having osteoarthritis is increased by several risk factors.
Sex: Women are more likely than men to develop osteoarthritis, particularly after 50 years of age.
Age: Although osteoarthritis can occur in younger people after an injury, particularly to the knee, or as a result of another joint ailment, symptoms are more likely to start manifesting after 40 years of age.
Obesity: is a risk factor for osteoarthritis, especially knee osteoarthritis. Obesity has been linked to osteoarthritis through its metabolic and inflammatory effects in addition to taxing the body’s weight-bearing systems. For those who are at risk, maintaining a healthy weight or decreasing excess weight is crucial (1).
Metabolic Diseases: Diabetes and hyperlipidemia (high lipids/cholesterol) both increase the dangers of osteoarthritis by triggering the body’s inflammatory response. Similar to how atherosclerosis affects blood vessels, oxidation of lipids can also result in deposits in cartilage that disrupt the blood flow of subchondral bone.
Genetics: As those born with certain bone illnesses or genetic features may be more prone to developing osteoarthritis, heredity can play a part in the development of osteoarthritis.
Work: Jobs that require repeated motions in a specific joint enhance the risk (2).
Other medical conditions that can predispose to osteoarthritis are:
- – Osteoarthritis with inflammation, such as rheumatoid arthritis.
- – Paget’s bone disease
- – Bacterial arthritis clinically called septic arthritis
- – Inadequate hip, ankle, and knee alignment.
- – Having varying lengths for the legs.
- – A few cartilages and joint problems exist from birth (2).
Causes Of Osteoarthritis
Since primary osteoarthritis has many distinct causes and is not only “wear and tear” arthritis, it is a heterogeneous illness. Some risk factors for osteoarthritis are changeable (may be adjusted), whereas others cannot be changed. They are permanent.
Although not all older persons will acquire osteoarthritis, and even among those who do, not everyone will have pain, age is a contributing factor. In addition to the inflammatory and metabolic risks mentioned above, osteoarthritis can also be more common, especially when there is diabetes and/or high cholesterol.
Both primary cases of osteoarthritis, like nodular OA of the hands, and secondary cases linked to other hereditary illnesses, like hypermobility of joints, can be inherited.
Due to persistent inflammation and joint damage, inflammatory and infectious arthritis can accelerate the onset of secondary osteoarthritis. Osteoarthritis can also be caused by prior trauma or injuries, particularly sports-related and repetitive actions.
Although the precise causes of bone deterioration and cartilage loss are still understood, progress has been made recently. The slow deterioration of cartilage within joints is thought to be caused by complicated signaling systems, joint inflammation, and inadequate repair mechanisms in response to damage. Joint pain is brought on by exercise as a result of other changes that make the joint less mobile and functional (1).
Symptoms of Osteoarthritis
The most prevalent symptoms of osteoarthritis include
- – Joint discomfort.
- – The joint is stiff.
- – Restricted range of motion and a lack of flexibility
- – Pushing the affected areas causes sensitivity or discomfort.
- – Osteoarthritis with inflammation.
- – Popping noises are known as crepitus.
- – Bone spurs, often known as additional lumps of bone, are usually painless.
- – Loss of muscle bulk
- – Difficulty moving the affected areas (6).
When osteoarthritis progresses, it involves the following:
- – Synovitis is tissue inflammation around the joints and cartilages
- – Degradation and cartilage loss are all signs of advanced OA.
- – Bony growths also develop along the borders of joints (2).
Diagnosis Of Osteoarthritis
There are osteoarthritis tests that need to be done before making a diagnosis of osteoarthritis. The doctor will inquire about your symptoms and do a physical checkup.
osteoarthritis tests can demonstrate whether there has been damage and help rule out alternative causes, but there is no definitive test to diagnose OA.
The tests include:
- 1. Blood Test: This is not exactly an osteoarthritis test but it can help rule out other related disorders like rheumatoid arthritis
- 2. Joint X-Rays And Mri: These may show bone spurs around a joint or a constriction within a joint, both of which indicate deteriorating cartilage. Unless there are uncommon conditions or there is a suspicion of a cartilage tear or injury to the ligament, an MRI is typically not necessary.
- 3. Analysis Of Joint Fluid: A doctor will take fluid for testing from an inflammatory joint using a sterile needle. This osteoarthritis test can rule out an infection or gout (2).
Treatment Of Osteoarthritis
Osteoarthritis treatment aims to reduce pain and improve function (4). It is impossible to cure osteoarthritis. A mix of pharmaceutical and non-pharmacological therapies typically works well to control mild to severe symptoms (1).
The interventions include:
- 1. Medication
- 2. Lifestyle modification
- 3. Physical therapy
- 4. Surgery
- 5. Assisted devices
The following medications are used in the management of osteoarthritis
- – Acetaminophen (Tylenol):
People who experience mild to severe discomfort can benefit from this. Pay attention to your doctor’s instructions because disobeying them can result in negative side effects and drug interactions.
- – Medications That Are Non-Steroidal And Anti-Inflammatory:
The doctor can advise a stronger painkiller, such as ibuprofen, aspirin, or diclofenac if acetaminophen is ineffective.
These can be consumed orally or topically, which involves administering the drug right to the skin.
- – Capsaicin Lotion:
The active ingredient in chilies is included in this topical medicine. The burning sensation it produces can lower levels of substance P, a molecule that serves as a pain transmitter.
It may take two weeks to a month for pain relief to become fully effective.
Avoid touching your eyes, face, or genitalia after applying the lotion to skin that is damaged or inflamed (1).
- – Injections Of Cortisone Intra-Articular:
Injections of corticosteroids into the joint can assist treat really bad pain, edema, and inflammation. Although they work well, frequent use can have negative consequences, including joint injury and a higher risk of osteoporosis.
An oral medication called duloxetine (Cymbalta) is used to treat chronic musculoskeletal discomfort (2).
It is also important to mention the use of supplements, especially containing glucosamine and chondroitin
- Lifestyle modification
The following lifestyle changes are necessary for the management of osteoarthritis:
- – Exercise:
Exercise is crucial to enhancing muscle strength, joint stability, and flexibility. It is advised to practice low-impact strength exercises, water aerobics, and swimming. These have been demonstrated to lessen the discomfort and functional limitations experienced by osteoarthritis patients.
- – Weight Loss
Working to better control weight will help prevent and treat osteoarthritis because obesity is one of the major risk factors for the condition. It has been demonstrated that weight loss in overweight people with osteoarthritis lowers stress and pain levels in weight-bearing joints and moderates the proinflammatory processes that cause OA (1).
Different kinds of physical therapies will help with osteoarthritis
- – Transcutaneous Electrical Nerve Stimulation (Tens): An electrode-equipped TENS unit is affixed to the skin. The neurological system is then overloaded by electrical currents from the device through the skin, which impairs its ability to convey pain signals.
- – Manual Therapy: Physical therapists use manual therapy to help maintain the suppleness and flexibility of the joints.
- – Thermotherapy: Using heat and cold to relieve joint pain and stiffness. A hot water bottle wrapped in a towel and applied to the injured joint might help (2).
When none of the aforementioned non-surgical approaches have worked, surgery is a possibility. Typically, you will inform your surgeon when you are prepared for surgery. As much function as possible will be restored, and your pain will be reduced.
Joint fusion surgery is a sort of procedure.
The bones on either side of the affected joints are fused after the damaged cartilage is removed, so the joint will still not move but won’t pain.
Joint reconstruction is a different option, involving the removal of the uneven joint surface and replacement with either the patient’s soft tissue or an implant (4).
The following device will help to improve movements in patients with osteoarthritis:
- 1. Osteoarthritis Unloader Knee Brace
An osteoarthritis unloader Knee Brace is a type of knee brace used to lessen knee osteoarthritis discomfort. It could be applied to put off or avoid a full or partial knee replacement.
Although meniscal injuries or other conditions that benefit from the lowering of stress may also benefit from its use, single compartmental knee osteoarthritis is the condition for which it is most commonly prescribed (5).
- 2. A Customized Footwear
If the osteoarthritis affects the feet, hips, or knee, this may aid by more evenly distributing body weight. Some insoles that absorb shock might help ease joint stress (2).
- 3. Crutches
This will help in body weight distribution to avoid excessing body weight falling on the affected joint especially when it is affecting the lower limbs (2).
Foods To Avoid During Osteoarthritis
Inflammation has been linked to diets heavy in fat, sugar, refined carbohydrates, and salt. This might make osteoarthritis symptoms worse.
The following are the osteoarthritis foods to avoid when a patient has osteoarthritis:
- 1. Red Meat: Red meat is an osteoarthritis food to avoid because it contains more fat and increases the process of inflammation which can further worsen the swelling in the affected joints.
- 2. High-Fat Diet: When you have arthritis, you should generally stay away from full-fat dairy and goods with added sugar because studies have linked a high-fat diet to inflammatory reactions.
- 3. Fries: Fried foods are frequently prepared in oils rich in omega-6 fatty acids and saturated fat. Both have been linked to a rise in inflammation and symptoms of arthritis.
- 4. Refined Sugar: This is an important osteoarthritis food to avoid because the majority of the nutrients and associated fibers are removed from grains during processing so that they can be made into white rice or white flour. As a result, the grain becomes a simple carbohydrate, which has a higher propensity to raise blood sugar levels and cause inflammation (3).
- 1. https://my.clevelandclinic.org/health/diseases/5599-osteoarthritis
- 2. https://www.medicalnewstoday.com/articles/27871#treatment
- 3. https://www.verywellhealth.com/foods-to-avoid-with-arthritis-5090739
- 4. https://www.assh.org/handcare/condition/osteoarthritis
- 5. https://orthoticsplus.com.au/orthotics/knee/unloader-brace/#:~:text=An%20Unloader%20Knee%20Brace%20is,total%20or%20partial%20knee%20replacement.
- 6. https://www.healthline.com/health/osteoarthritis#symptoms