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Osteoarthritis: Causes, Symptoms & Treatment
Osteoarthritis is a degenerative joint disease in which the protective cartilage gradually breaks down, causing pain, stiffness, and reduced mobility.
Add as Preferred SourceThings worth knowing about "Degenerative joint disease"
Osteoarthritis is a degenerative joint disease in which the protective cartilage gradually breaks down, causing pain, stiffness, and reduced mobility.
What is Osteoarthritis?
Osteoarthritis (also known as osteoarthrosis or degenerative joint disease) is the most common joint disorder worldwide. It is a progressive degenerative condition in which the protective cartilage covering the ends of bones gradually wears down. Over time, the underlying bone, joint capsule, and surrounding muscles can also become affected. While osteoarthritis can affect any joint, it most commonly involves the knees, hips, hands, and spine.
Causes and Risk Factors
Osteoarthritis develops when the balance between cartilage stress and the joint's ability to recover is disrupted. Key risk factors include:
- Age: The ability of cartilage to regenerate declines with age.
- Obesity: Excess body weight increases pressure on weight-bearing joints such as the knees and hips.
- Genetic predisposition: A family history of osteoarthritis increases individual risk.
- Previous joint injuries: Ligament tears, meniscus damage, or fractures can accelerate cartilage breakdown.
- Joint misalignment: Conditions such as knock knees or bowlegs place uneven stress on joint surfaces.
- Occupational strain: Physically demanding work or repetitive movements can overload joints over time.
- Physical inactivity: Weak muscles around the joint reduce its stability and resilience.
Symptoms
Symptoms of osteoarthritis typically develop gradually over months or years. Common signs include:
- Start-up pain: Pain at the beginning of movement that eases after a short time.
- Activity-related pain: Pain that worsens with prolonged physical activity or weight-bearing.
- Joint stiffness: Particularly noticeable in the morning or after periods of rest.
- Reduced range of motion: The affected joint cannot be moved through its full range.
- Joint sounds: Clicking, cracking, or grinding sensations (crepitus) during movement.
- Swelling and warmth: Especially during inflammatory flares (activated osteoarthritis).
Diagnosis
Osteoarthritis is diagnosed through a combination of clinical and imaging assessments:
- Medical history and physical examination: The physician assesses symptoms, their progression, and risk factors, and examines the joint for swelling, tenderness, and range of motion.
- X-ray imaging: Typical findings include joint space narrowing, osteophytes (bone spurs), and subchondral sclerosis.
- MRI (Magnetic Resonance Imaging): Provides detailed visualization of cartilage, ligaments, and soft tissues.
- Ultrasound: Useful for detecting joint effusions and soft tissue changes.
- Blood tests: Used to exclude inflammatory joint diseases such as rheumatoid arthritis.
Treatment
There is currently no cure for osteoarthritis. Treatment focuses on relieving pain, maintaining joint function, and slowing disease progression.
Non-pharmacological Treatment
- Physiotherapy and exercise: Targeted exercises to strengthen the muscles surrounding the joint and improve stability.
- Weight management: Reducing body weight significantly decreases stress on affected joints.
- Assistive devices: Orthotic insoles, braces, or walking aids to offload the joint.
- Heat and cold therapy: Can reduce pain and improve joint flexibility.
Pharmacological Treatment
- Pain relievers (analgesics): Paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
- Corticosteroid injections: Provide short-term relief during inflammatory flares.
- Hyaluronic acid injections: May improve joint lubrication and reduce pain in some patients.
Surgical Treatment
- Arthroscopy: A minimally invasive procedure to wash out the joint or remove loose cartilage fragments.
- Osteotomy: Surgical correction of joint misalignment to redistribute load across the joint.
- Joint replacement (arthroplasty): Total or partial replacement of the joint with a prosthesis, typically recommended for advanced osteoarthritis of the knee or hip.
References
- World Health Organization (WHO): Musculoskeletal conditions. Fact Sheet 2023. https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
- Kolasinski SL et al. - 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research, 2020;72(2):149-162.
- Hunter DJ, Bierma-Zeinstra S. - Osteoarthritis. The Lancet, 2019;393(10182):1745-1759.
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