Degenerative Joint Disease: Treatment, Cost and Side Effects

The bones in the joints are covered with cartilage layer to provide cushion to the bones. Usually, with growing age the cartilage suffers wear and tear and breaks down, thereby causing the bones to rub directly against each other causing stiffness, pain and swelling of the joints. The joints that are mostly affected by degenerative joint disease are knee, hips, lower back, joint of the fingers, base of thumb and neck. It takes several years for the disease to develop to a severe level. Degenerative joint disease gradually affects daily activities. Severe symptoms of degenerative joint disease include increased swelling and inflammation of joints because when the cartilage breaks down, there is a build-up of synovial fluid level in the joint which also actually provides cushion to the bones in the joints. But excess synovial fluid causes inflammation of the joints and the floating bits of broken cartilage causes pain in the joints. Pain in the joints aggravates not only upon doing activities but also increases as the day grows. Not only inflammation and swelling but stiffness in the joints also increases affecting normal movements. This eventually causes joint disability and unstable joints. This is the reason why the knee joints become very unstable in several people and cause them to stumble down and injure themselves. Muscle weakness, joint deformity and bone spurs are the other symptoms that occur in degenerative joint disease. There is no treatment to cure the disease completely but only treatment options to manage and control the symptoms. The disease is initially treated using simple home remedies and lifestyle changes that include exercise, losing weight, adequate rest and sleep, heat and cold therapy and a few medications to treat it like oral analgesics, topical analgesics, NSAIDs, corticosteroids and Cymbalta. Surgical procedures may also be used if conservative treatment methods do not prove useful.

The causes of degenerative joint disease are mainly increasing age, obesity; also women are more prone to get the disease than men, joint injuries, and certain jobs that exert pressure on the joints, genetics and bone deformities right from birth like defective cartilage and malformed joints. Treatment options for degenerative joint disease are mainly ways to manage and control the symptoms. There are a few medications and therapies that your general physician can suggest to ease the pain, swelling and stiffness. In case, these methods fail to provide any help, surgical methods are applied. Diagnosis is done by imaging tests like X-rays and MRI, laboratory tests that include blood tests that mainly rules out other forms of arthritis and joint fluid analysis. Treatment options available for the disease cannot aim to cure it. They can only be aimed at managing and controlling the symptoms with changes in lifestyle, therapies and medication. Surgery is the last option that is undertaken to help cope with the disease. Medications that are prescribed or taken over-the-counter are acetaminophen like Tylenol that relieves pain, over-the-counter nonsteroidal anti-inflammatory drugs like ibuprofen, naproxen sodium to reduce inflammation and ease pain and Cymbalta is an antidepressant that is used in treating chronic pain. Physical therapy helps in strengthening the muscles, especially around the joints. Regular exercise helps in reducing pain and enables free movement. Along with regular light exercises, walking, jogging and swimming are also quite helpful. Yoga, Tai chi and occupational therapy are other methods to relieve pain and help in free movements. Surgical procedures like cortisone injection in the joints relieve pain, lubrication injection, realignment of bones with osteotomy that involves shifting the body weight from the knee by placing or removing a piece of bone somewhere above or below the knee bone. Joint replacement or arthroplasty is done when a complete joint surface demands replacement with a plastic or metal surface.

Any person suffering from joint pain, inflammation of joint and stiffness in the joints are eligible for the treatment.

If the inflammation, stiffness and pain are not intolerable and can be managed with simple home remedies, then the person will not require medication or injection and surgery.

Too much dependence on acetaminophen or relieving joint pain can lead to liver damage, NSAIDs can have some side effects like heart problems, diarrhoea, bleeding problems, kidney and liver damage, cortisone injection taken over a long time can in fact degrade the condition of the joints, lubrication injections are not very effective and are similar to a placebo and joint replacement has its own side effect of wear and tear over time requiring to undergo another replacement.

Post treatment guidelines for joint replacement or injections can be adequate amount of rest and sleep, eating healthy foods and doing light exercises.

Treatments like surgery can take 4 to 6 weeks to resume daily activities. Medications for relieving pain and swelling may take a few hours to days to show results.

The cost of treatment of degenerative joint disease can range from Rs. 500 to Rs. 1.50 lakh.

No, the results are not permanent. Treating the disease would require lifelong management with the help of medication, therapies and surgery.

Alternative treatment for degenerative joint disease mainly includes exercise like walking, swimming and biking to make the muscles stronger, exercise also helps lose weight that in turn help relieving the weight on the joints, using hot and cold compress on joints to reduce pain and inflammation, applying over-the-counter creams or gels to relieve pain, knee tapping and using assistive devices to relieve pain. Acupuncture, avocado-soybean nutritional supplements and glucosamine and chondroitin supplements have shown to slow down damage.