Osteoarthritis (OA) is a joint disease that causes the cartilage to break down and bone to overgrow or form cysts. Cartilage is a smooth, shiny material that lines the joints - allowing them to glide easily as you move. It is a type of resilient connective tissue that covers and protects the ends of bones in joints. Although OA can affect any joint in the body, it most frequently affects the hips, knees, hands, feet, and spine.
Arthritis is among the leading causes of disability in Canada. OA is the most common form of arthritis. It affects 1 out of every 10 people in this country. Statistics show that men and women are affected in equal numbers. OA usually occurs after the age of 45, but it can occur earlier in life, and even be seen in the spines of teenagers. After menopause, women tend to get more severe and complicated problems.
Risk factors for developing OA include:
There's no cure for OA, although research is beginning to unravel the mechanisms of the disease, which should lead to new treatments. Treatments currently focus on managing pain, reducing the load on the joints, and improving the strength of the muscles supporting the joints. Experimental therapies try to slow the progression of the disease and increase the mobility and flexibility of the joints.
As you move or put pressure on a joint, cartilage allows bones to slide over one another and acts as a shock absorber. Cartilage itself does not have any nerve cells and therefore cannot sense pain. OA results when the cartilage becomes worn out, allowing the bones underneath to rub against each other and cause pain and swelling. It is not simple wear-and-tear but a process involving the cells and proteins of bone and cartilage.
As the condition progresses, the joint may become disfigured and small growths called osteophytes begin to grow inside the joints. Osteophytes are small, irregular, bony growths that are also called bone spurs. Bits of broken-off cartilage or bone are also found floating inside the joint. This causes even more pain, swelling, and immobility of the joint.
The exact cause of these changes is unknown. Scientists believe that the following factors play a role:
The following are symptoms of osteoarthritis (OA):
Weight-bearing joints such as hips, knees, and feet are more prone to OA. It is important to note that many people have OA but don't experience any symptoms. The symptoms of OA can be made worse by overusing the joints.
Most doctors use a number of methods to diagnose OA including:
Treatments include physical therapy to improve mobility and flexibility, medications to manage pain, and surgery.
Talk to your physiotherapist or occupational therapist about "aids of daily living" such as canes, walkers, and braces if you have OA.
Non-prescription medications may be sufficient to treat pain and swelling for milder symptoms, but prescription medications are needed for more severe symptoms. The following are commonly used medications to treat OA:
Surgery is an option if one joint is badly damaged or is causing severe symptoms. Different types of surgical options are available and include joint replacement, arthroscopy (a procedure where a small, flexible tube is inserted to do surgery), repair of bone deformity, rebuilding of the joint, or bone fusion. Joints that may benefit from surgery include knees, hips, shoulders, and certain joints in the hands and the feet.
For people with hip and knee OA that has progressed to the point of disability, joint replacement surgery is highly effective and a reasonably safe treatment option (essentially at any, even advanced, age). Many people are able to return to nearly completely normal activity after recovering from the surgery. When considering joint replacement surgery, talk to your doctor about the benefits and risks.
Many cases of OA can be prevented. To prevent the development of OA later on in life, maintain a healthy weight. Excess weight can put stress on weight bearing joints such as knees or hips and increase the wear and tear on the cartilage. Protect your joints from injury. Repeated minor injuries due to constant kneeling, squatting, or other postures that place stress on the knee joint can cause cartilage to breakdown. Exercise can help reduce joint pain and stiffness. Talk to your physiotherapist or occupational therapist about how low-impact exercise such as bicycling, swimming, or water exercise could be beneficial for you.
Athletes should understand that OA later in life is common for people who have lived a very active and rigorous lifestyle. For most, this risk is probably worth the value they receive from their athletic passion. They should be particularly careful to take immediate care of all injuries, even seemingly minor, and to carefully follow their doctor's advice.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
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