Osteoarthritis in the Active Patient
Osteoarthritis is also called as degenerative joint disease; this is the most common type of arthritis, which occurs often in older people. This disease affects cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick out at the end of a joint, called a bone spur.
Osteoarthritis causes joint pain and can limit a person's normal range of motion (the ability to freely move and bend a joint). When severe, the joint may lose all movement, causing a person to become disabled. Disability most often happens when the disease affects the spine, knees, and hips.
Osteoarthritis is caused by the wearing out of the cartilage covering the bone ends in a joint. This may be due to excessive strain over prolonged periods of time, or due to other joint diseases, injury or deformity. Primary osteoarthritis is commonly associated with ageing and general degeneration of joints. Secondary osteoarthritis is generally the consequence of another disease or condition, such as repeated trauma or surgery to the affected joint, or abnormal joint structures from birth.
Doctors diagnose arthritis with a medical history, physical exam and x-rays of the affected part. Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans are also performed to diagnose arthritis.
Initial treatment for arthritis is conservative, consisting of rest, avoidance of vigorous weight bearing activities, and the use of non-narcotic analgesic and/or anti-inflammatory medications. With worsening symptoms a cane or a brace may be helpful. For more severe symptoms, an injection of cortisone into the joint is frequently advised and can be quite helpful. When conservative measures have been exhausted and are no longer helpful, and the arthritis has become disabling, surgery may be recommended.
Treatment of arthritis focuses on decreasing pain and improving joint movement, and may include:
- Exercises to keep joints flexible and improve muscle strength
- Many different medications are used to control pain, including corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs). Glucocorticoids injected into joints that are inflamed and not responsive to NSAIDS
- For mild pain without inflammation, acetaminophen may be used
- Heat/cold therapy for temporary pain relief
- Joint protection to prevent strain or stress on painful joints
- Surgery (sometimes) to relieve chronic pain in damaged joints
- Weight reduction to prevent extra stress on weight-bearing joints