Osteoarthritis: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prognosis

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1Overview

The musculoskeletal system is important because it aids in motion and gives shape to the body. With all its uses, when something goes wrong with any of the system’s part, it will take a toll on one’s ability to move around.

The joints, for instance, are the body’s hinges. They provide a broad range of motion throughout the body, allowing the person to bend, rotate, swing and much more. Each joint has many parts, too. It consists of the ligaments, cartilage and synovial fluid, a lubricating fluid, which all work together to provide a cushion between bones.

Since the joints like the hips, knees, and ankles carry most of the body’s weight.
As a result, these are ones usually affected by joint problems. One of the most common joint problems is arthritis.

Specifically, osteoarthritis (OA) is the most common type of arthritis. It leads to joint pain and stiffness. The condition usually develops slowly, over time. Osteoarthritis occurs when the protective cartilage on the ends of the bones wears down affecting many joints in the body, most commonly the knees, hands, spine, and hips.

Despite the fact that osteoarthritis or OA occurs in people of all ages, the condition is most common in older people, above 65 years old. The most common risk factors include obesity or being overweight, overuse of the joint, previous joint injury, genetics and weak thigh muscles.

Osteoarthritis is the most common joint problem in the United States. In fact, among adults who are 60 years old and above, the prevalence of OA is about 10 percent of men and 13 percent in women.

2Symptoms

The signs and symptoms of osteoarthritis happen or develops gradually and worsen over time. These symptoms may come and go in episodes, which is linked to the weather or even on activity levels. In severe cases, however, the pain may be continuous. The signs and symptoms of OA include:

  • Joint tenderness
  • Pain on the joint during or after movement
  • Worse pain and stiffness when you have not yet moved the joints for a while
  • Limited range of motion
  • Joint feels tender when there is light pressure applied to it
  • Weakness and muscle wasting
  • Grating or crackling sound in the joints
  • Formation of bone spurs or extra bits of bones forming on the affected joint.

3Causes

Osteoarthritis happens when the cartilage that provides a cushion to the bone ends in the joints slowly wears down and deteriorates. The cartilage is a firm and slippery tissue that allows about frictionless joint movement.

Normally, the joints are exposed to a continuous low level of damage, which is termed as “wear and tear”. In most cases, the body repairs the damage on its own and the person does not experience any symptom. However, in osteoarthritis, the protective cartilage on the bone ends breaks down, causing swelling, inflammation, pain, and mobility problems. In some cases, bony growths start to develop in the area, leading to inflammation.

4Risk Factors

Many factors may increase one’s risk of developing osteoarthritis, including:

Older Age – People who are older may have increased risk of developing osteoarthritis. This is due to the wear and tear of the cartilage and the risk increases with age.

Gender – Women are at a heightened risk of developing osteoarthritis, but the exact reason is still unclear.

Joint injuries – When someone had a joint injury in the past, he or she is at a higher risk of having osteoarthritis later on. Injuries, such as those incurred while playing contact sports or through an accident, may pose serious stress on the joints, leading to a higher risk of having osteoarthritis.

Family history – Osteoarthritis may run in families, but further research is still needed to confirm which gene is responsible for this.

Obesity – One of the most common risk factors for osteoarthritis is being overweight or obese. Carrying extra body weight may contribute to osteoarthritis in many ways. The heavier you are, the greater is the risk. This is because increased weight puts added stress on the weight-bearing joints. Moreover, fat tissue produces certain proteins that may cause harmful swelling and inflammation around the joint area.

Bone deformities – People with deformities in the bones or malformed joints may have a greater risk of developing osteoarthritis.

Certain occupations – Some jobs involve tasks that put repetitive stress on the joint and eventually, contribute to the development of osteoarthritis.

Other conditions – Some conditions of the bones such as rheumatoid arthritis and gout may increase the likelihood of a person to develop osteoarthritis.

5Complications

Osteoarthritis is a degenerative disease, which means it progresses slowly in time.
Joint pain and stiffness may also become severe that it may affect one’s daily activities. Some people may find it hard to work or go school, making them less able to move around.

The other possible complications of osteoarthritis include a rapid or complete breakdown of the cartilage, leading to loose tissue in the joint (chondrolysis), and bone death or osteonecrosis.

In some cases, people with untreated and severe osteoarthritis may develop stress fractures or hairline cracks in the bone, bleeding inside the joint, pinched nerve usually in the spine, deterioration of the ligaments and tendons around the joint and infection in the joint.

6Diagnosis

The doctor will conduct a complete physical assessment to confirm the diagnosis of osteoarthritis. The doctor will examine the joints and ask about the symptoms experienced. The doctor may suspect osteoarthritis if the patient is more than 50 years old, has stiffness in the joints and has joint pain that gets worse when the joint is used or moved.

Further diagnostic tests will be requested, including:

Imaging tests – Imaging tests are important to visualize the joint area. These will provide photos of the affected joint. These include:

Magnetic resonance imaging (MRI)This imaging test utilizes radio waves and a strong magnetic field to create detailed photos or images of the bone and surrounding soft tissues. This is not recommended all the time but it can be used to diagnose complicated cases or severe cases.

X-raysX-rays can show cartilage loss shown as a narrowing of the space between bones in the joints. An X-ray may also show some complications of osteoarthritis such as the formation of bone spurs around a joint.

Blood Test – There is no blood test to diagnose osteoarthritis, but it can help in ruling out other causes of joint swelling and pain such as gout or rheumatoid arthritis.

Joint fluid analysis – The doctor will conduct this test by drawing fluid out of the affected joint. The specimen is then sent to the laboratory for testing, particularly looking for signs of inflammation or infection.

7Treatment

Osteoarthritis is a long-term condition and sadly, there is no cure for it. However, it does not mean that you can’t prevent its progression. Some treatments are available to reduce the symptoms. The mild symptoms of osteoarthritis can be managed through simple measures, such as:

  • Losing weight if obese, and maintaining a healthy weight
  • Wearing proper footwear
  • Engaging in regular exercise
  • Practicing proper mechanics
  • Using proper and special devices when moving to reduce strain in the joints.

Medicines

The most common medicines used are those to relieve the pain and swelling in the joints. Osteoarthritis has no cure but the medicines used are to relieve the symptoms.

Pain relievers – Analgesics or painkillers are recommended, depending on the severity of the pain. A licensed doctor should only prescribe the drugs. Despite the fact that some of these can be bought over-the-counter, a doctor’s advice is still needed and important before taking the medicines.

  • Paracetamol – For joint pain, paracetamol is usually recommended, to begin with. It is best to take it regularly rather than waiting for the pain to emerge before taking it.
  • Acetaminophen – Acetaminophen or Tylenol has been used for many years in the treatment of osteoarthritis. However, do not take acetaminophen more than the recommended dosage to prevent liver damage.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) – NSAIDs including ibuprofen and naproxen sodium are recommended for people with osteoarthritis. However, these should be taken after meals and at the recommended doses only.
  • Duloxetine (Cymbalta) – This is usually used as an antidepressant but has been used to treat chronic pain, including that caused by osteoarthritis.
  • Opioids – Opioids can help relieve severe pain. However, there are adverse effects such as nausea, drowsiness, and constipation. These drugs should only be prescribed by a licensed doctor because they may lead to addiction and dependence.
  • Capsaicin cream –The doctor may also prescribe capsaicin cream, which works by blocking the nerves that are responsible for sending pain messages to the brain. You may apply it on the joints or other affected areas. Do not use the cream on sensitive skin, broken skin or in delicate areas such as the eyes

Surgical and other procedures – Many procedures are done to relieve the pain and swelling in your joints, including:

  • Corticosteroid injections – If the osteoarthritis is severe and the inflammation has caused severe pain, corticosteroids may help reduce the pain and swelling. This is usually recommended of the pain relievers can’t reduce the pain the patient is experiencing.
  • Bone realignment – If the osteoarthritis has caused damage to one side of the knee, a surgical realignment of the bone is needed. In an osteotomy, the doctor will cut through the bone to remove the protruding part of the bone. This will prevent further damage and friction that can lead to severe pain and swelling.

Natural remedies to help prevent and manage osteoarthritis:

  • Do regular exercise
  • Lose weight
  • Use heat and cooling pads to relieve pain
  • Use protective and assistive devices
  • Observe proper body mechanics

8Prognosis

If the condition is treated and managed properly, the degeneration of the cartilage is slowed down. This will prevent further damage to the bone ends. However, untreated osteoarthritis may lead to joint pain and other complications.