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Osteoarthritis: Current concepts

K.M. Marya, MS (Orth)

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What Is Osteoarthritis? Also known as degenerative joint disease or osteoarthrosis, osteoarthritis is a joint disease that affects cartilage, the tissue that covers the ends of bones in a joint. Healthy cartilage allows bones to glide over one another, absorbing the shock of sudden physical movements. When a person has osteoarthritis, cartilage breaks down and wears away, and the bones eventually rub against each other. The resulting damage to the bones and underlying tissue can lead to tenderness, swelling, loss of joint motion, and chronic pain. As the stress on the joint continues, it may lose its normal shape. Bone spurs (tiny growths called osteophytes) also may develop. Small pieces of bone and cartilage can break off and float into the joint space, and fluid may accumulate within the joint if the tissue lining the joint becomes inflamed. Osteoarthritis commonly occurs in such weight-bearing joints as the knees and hips. It can also affect joints in the hands, fingers, lower back, and neck.

What Causes Osteoarthritis?

The cause of osteoarthritis is still unknown, but many factors can increase a person’s risk for developing the disease. These risk factors include: A family history of the disease. Genetics accounts for more than 50 percent of all cases of osteoarthritis. Inactivity. If joints aren’t used in a long time, the cartilage protecting the joints becomes weak and may eventually lose its function. Age. As the body ages, cartilage becomes less flexible and loses its ability to regenerate. Also, the repeated wear and tear on these joints over the years can lead to osteoarthritis. Traumatic injury to the joint. Former athletes and ballet dancers in particular are susceptible to developing the disease from repeated injuries to various joints. Obesity. Extra weight puts more strain on the joints. Lack of vitamin D. Low levels of vitamin D make bones more susceptible to osteoarthritis. What Are Symptoms of Osteoarthritis? Osteoarthritis usually develops very slowly. Initially the symptoms are mild, but they may eventually get worse. Symptoms include:

  • Steady or intermittent pain in a joint
  • Stiffness after getting out of bed
  • Joint swelling or tenderness
  • Crunching feeling or sound in the joint (called crepitus)
  • Enlarged, gnarled finger joints, which can be a sign of osteoarthritis in the hands
  • Limited joint movement.

People with osteoarthritis may experience referred pain, or pain in areas of the body on the same nerve pathway as the affected joint. For example, an arthritic hip may cause pain in the groin, buttock, or knee.

Diagnosing Osteoarthritis

If you think you have osteoarthritis, see your doctor. After a physical examination and a discussion of your symptoms, your physician might assess your reflexes, muscle strength, and your ability to walk, bend, and perform regular day-to-day activities. Depending on the assessment, your physician might order other tests, including: Blood test. A blood test can rule out other causes of pain in your joints. Joint aspiration. Your physician might need to test a sample of fluid from your joint. During a joint aspiration, a needle is inserted into the joint to collect fluid. X-rays. X-rays can help detect cartilage loss, bone damage, and bone spurs. Current Treatments The goals of osteoarthritis treatment are to improve your joint function and quality of life. Treatments for osteoarthritis include preventive measures to stop or slow disease progression, self-management, medication, and surgery. Some complementary therapies are available, as well.

Prevention

If you have a mild case of osteoarthritis, you and your doctor can develop a preventive plan to keep the disease from progressing. The following preventive interventions can help:

  • Exercising on a regular basis to keep the joints moving
  • Managing your weight to reduce the stress on the joints
  • Increasing your vitamin D intake
  • Limiting your participation in high-risk sports such as football, tennis, rugby, and basketball.


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