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Osteoarthritis: Causes, Symptoms, Diagnosis and Prevention

Last Updated: Feb 21, 2023

What is Osteoarthritis

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The most frequent and common arthritis, osteoarthritis, attacks countless people globally. When the protective cartilage that covers the edges of the bones gradually deteriorates, it happens. Although osteoarthritis may cause adverse effects on any joint, it predominantly hampers mainly the hands, knee, spine and hip joints.

In terms of joint disease, osteoarthritis (OA) is the most prevalent type. The biochemical deterioration of cartilage in the synovial joints is the cause of this chronic, destructive illness. Joint pain, soreness, and inflammation in the joints are some of its symptoms, which usually appear slowly.

Certain joints, such as the ankles, may be protected because of the articular cartilage in those joints' special tolerance to loading force. Changing one's lifestyle (diet, exercise), receiving therapies, using medications, and having surgery are all possible treatments to lessen pain and incapacity.

Types of Osteoarthritis

Osteoarthritis is majorly of two types. It can be classified as primary or subsequent to a particular condition.

Primary osteoarthritis

This type of osteoarthritis is the most frequently diagnosed and is thought to develop primarily as a result of 'wear and tear' through time. As a result, it is linked to aging; in fact, the most significant risk factor for OA is aging, and the more a person utilizes their joints, the greater the likelihood that they will develop this type of OA. Theoretically, if we live to a sufficiently old age, primary OA is unavoidable.

Beginning about the age of 55 or 60, people typically start to experience this type of osteoarthritis. Primary OA is typically classified by the site of involvement (e.g., hands and feet, knee, hip), yet it may potentially affect many joints, as it may be localized to specific joints.

Secondary osteoarthritis

This type of osteoarthritis is brought on by circumstances that alter the surroundings of the cartilage. Severe trauma, genetic joint anomalies, metabolic problems (such as Wilson disease), allergies, diseases (such as neuropathy), and conditions that affect the natural function and structure of cartilage are some examples of these conditions (eg, Rheumatoid Arthritis, gout).

The onset of secondary osteoarthritis typically occurs in people between the ages of 45 and 50.

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Causes of Osteoarthritis

Osteoarthritis is a chronic illness which may aggravate with time. It may be caused due to many reasons. Some of the reasons are listed below:

Osteoarthritis increases with time when the cartilage which shields the edges of the bones in the joint gradually tears away. Joint action is almost smooth thanks to the cartilage. It should come as no surprise that osteoarthritis has numerous causes and risk factors given that it is the most prevalent chronic joint illness.

Age is among the main contributing factors to osteoarthritis since the joint harm it causes increases with time. Generally, an individual's joints have been under increased strain and use as they age. Osteoarthritis can result from this use.

If somehow the cartilage is totally worn away, bone will ultimately rub against bone.

Osteoarthritis is commonly considered to be a disease of injury. But osteoarthritis also damages the whole joint in addition to the cartilage. The connecting tissues which helps in keeping the joint intact and link muscles to bone wears away, and it alters the bone. In addition, it leads to joint lining irritation.

What are the symptoms of Osteoarthritis

Symptoms of osteoarthritis frequently tend to appear slowly and become worse with years. The symptoms of Osteoarthritis include:

  • Pain: Any slight movement could hurt the joint either during or after the activity.
  • Hardness: Joint hardness could be more prominent in the inactivity state or during morning.
  • Softness: While pressing on or near the joint, it could feel soft and delicate with a little soreness.
  • Decrease in agility and flexibility: Your joint might not be capable of moving through its entire motion range.
  • Unpleasant feeling: While you use the joints, you may notice a stinging sensation and hear crackling or popping.
  • Bone growths: Near the problematic joint, these extra parts of bone that appear as firm lumps, might develop.
  • Swelling- Soreness and swelling of the soft tissues around the affected joint could be the major reason for this.

What are the Risk Factors of Osteoarthritis

There are quite a number of risks related to Osteoarthritis. Your risk of osteoarthritis may be affected by the following factors

  • Increasing age: Age raises the risk of osteoarthritis.
  • Gender: Though the reason may not be known, women are more prone to get osteoarthritis.
  • Weight gain: There are various ways that having more weight increases your chance of developing osteoarthritis. Weight gain puts additional strain on joints that support your body's weight, like your knees and hips. Additionally, proteins produced by adipose tissue have the potential to injure your bones by inflaming the area surrounding them.
  • Joint damage: Osteoarthritis risk can be boosted by injuries, such as those sustained in accidents or while participating in sports. The chances of osteoarthritis could be increased even by wounds that seemed to cure decades ago.
  • Continuous pressure on the joint: Osteoarthritis may start developing in a joint if continuous stress is applied to it owing to your occupation or your participation in such a sport.
  • Genetics- Some people inherit osteoarthritis as a result of genetics.
  • Bone anomalies: Some people are born with damaged cartilage or deteriorated joints.
  • Specific metabolic conditions: Specific conditions like diabetes and hemochromatosis.

How can you prevent Osteoarthritis

Although the impairment of joints cannot be repaired, osteoarthritis symptoms are typically manageable. Physical activeness, keeping a healthy weight, and obtaining specific therapies may limit the disease's course and assist to reduce discomfort and enhance joint mobility.

Dos

Weight Management
Keeping your weight under control may be the most crucial thing you can do to fend off osteoarthritis if you are obese. Losing weight could be your best protection against the illness. Becoming overweight puts tension on the joints, especially the ones that support the weight of the upper body, such the knees, hips, and foot joints, which results in cartilage erosion.

Working out
According to study, you have a higher chance of developing severe knee osteoarthritis if the muscles that go along the front of your leg are weak. Regular exercise can lower this risk.

Don’t

Don't get injuries: When you are younger and sustain a joint injury, you are more likely to develop osteoarthritis in that particular joint later in life. A joint may be much more at danger if it is injured as an adult. According to a study those who damaged a knee as adolescents or young adults had a threefold increased risk of developing osteoarthritis in that knee versus those who did not. Adult injuries to the knee increased the likelihood of osteoarthritis inside the joint by five times.

Osteoarthritis: Diagnosis and Tests

OA is a joint condition characterized by fibrosis, the growth of osteophytes, and destruction to the articular cartilage. There is no recognised cause for OA. However, a number of risk factors, such as age, fat, inflammation, trauma, heredity, and other variables, are frequently linked to the development of the condition. There are plenty of methods to diagnose this problem.

Diagnosis

The doctor will examine the affected joint during the checkup to look for signs of soreness, edema, redness, and stiffness.

Imaging exams

Your doctor could advise getting photos of the injured joint.

X-rays. Although cartilage cannot be seen on X-rays, cartilage loss can be detected by a shrinking of the joint's gap between both the bones. Bone spurs around a joint can also be seen on an X-ray.

Imaging with magnetic resonance (MRI). An MRI creates precise images of bone and other soft tissues, especially cartilage, using radio waves and an intense magnetic field. Osteoarthritis can be diagnosed without an MRI, although it might be useful in complex instances when more information is required.

Lab Tests

Confirming the diagnosis may involve assessing either blood or joint fluid.

  • Blood test- Even while there isn't a blood test to indicate osteoarthritis, certain procedures can assist in identifying other conditions that might cause joint pain, like rheumatoid arthritis.
  • Joint fluid analysis: To remove fluid from an injured joint, the doctor may use a syringe. The fluid is then examined for symptoms of inflammation and signs of infection or gout in order to rule out osteoarthritis as the cause of your pain.

What are possible complications of Osteoarthritis

Osteoarthritis might also pose certain risks and complications, A few of them are listed below:

  • Potential osteoarthritis side effects include: Complete and rapid cartilage degradation leading to weak tissue in the joint (chondrolysis).
  • Bone death (osteonecrosis).
  • tension fractures (hairline crack in the bone that develops gradually in response to repeated injury or stress).
  • internal joint bleeding

Home Remedies for Osteoarthritis

Osteoarthritis might be a severe ailment, but it can be prevented by following certain practices. A few home remedies can be applied to refrain from Osteoarthritis.

  • Learn everything you possibly can about your illness and ways to control it, particularly how symptomatic changes in lifestyle can be managed. Exercise and weight loss, if you're obese, are vital steps you can take to minimize osteoarthritis-related stiffness and joint pain.
  • Exercise- Moderate exercise can improve your stamina and enhance the muscles surrounding your joint, resulting in improved stability at your joint. Try water aerobics, cycling, or walking. Avoid it if you experience acute joint pain.
  • If you experience new discomfort that persists for long after working out, it's likely a sign that you overdid it rather than injury or a sign that you need to quit. Try once more a day or two later, but this time, reduce the intensity.
  • Movement therapies- Tai chi and yoga involve gentle exercises and stretches combined with deep breathing. Many people use these therapies to reduce stress in their lives, and research suggests that tai chi and yoga might reduce osteoarthritis pain and improve movement.
  • Make sure the yoga you choose is a gentle form and that your instructor knows which of your joints are affected. Avoid moves that cause pain in your joints.
  • Heat and cold- Both heat and cold can relieve pain and swelling in your joints. Heat, especially moist heat, can help muscles relax and ease pain. Cold can relieve muscle aches after exercise and decrease muscle spasms.
  • Assistive devices: The joints can experience less strain thanks to assistive technology. When using a walking stick or walker, your hip or knee is relieved of weight.

If you suffer from finger osteoarthritis, using grabbing and clutching tools in the kitchen may be more convenient. Search out catalogs or medical supply shops, or inquire regarding assistive gadgets with the physician or exercise physiologist.

What to eat in Osteoarthritis

None of the meals will completely get rid of osteoarthritis symptoms. However, a healthy diet has a positive effect on osteoarthritis and could even stop the disease's continued growth. Concentrate on eating things like

  • Brown rice
  • Green Vegetables and fruits
  • Potatoes
  • Stream fish, skim milk, etc.
  • Wholesome foods for osteoarthritis sufferers
  • The bulk of cartilage is believed to regenerate with the aid of millet. Additionally, one must use only cold-pressed oils like walnut, sesame, safflower, rapeseed, and olive oil.

Free radicals might help reduce the inflammation associated with osteoarthritis, therefore consuming foods high in vitamins A, E, and C as well as minerals like selenium and copper is encouraged.

For this, you might take into consideration ingredients like anise, cumin, coriander, cinnamon, ginger, thyme cinnamon, fennel , etc. Certain of these herbs can be combined with cocoa and honey to make yogurt, a healthy food to consume if you have osteoarthritis. It is not recommended to take these herbs every day; instead, take them once or twice a week.

What not to eat in Osteoarthritis

These foods should be avoided if you have osteoarthritis:

  • Anything made with animal protein
  • Meat/sausage fish
  • Dairy goods and cheese
  • Eggs
  • Sugar/sweets
  • Cereals
  • Asparagus
  • Black tea and coffee
  • Alcohol/nicotine
  • foods containing tofu
  • Say yes to a vegetarian or vegan diet, at least while you're receiving therapy for osteoarthritis. It is advised to eat only natural, primarily unprocessed foods.

Osteoarthritis Treatments

Although osteoarthritis cannot be cured, there are therapies that can lessen discomfort and improve your mobility. There are a number of methods to treat Osteoarthritis. Some of them are listed below:

  • Physical therapy: a physiotherapist can demonstrate exercises for you to improve your agility, relieve pain, and develop muscle strength surrounding your joint. Regular, mild activity through your own, such as walking or swimming, can be similarly beneficial.
  • Occupational therapy: You can learn how to carry out routine duties without adding more strain to a painful joint with the aid of an occupational therapist. For example, if you suffer from osteoarthritis in both hands, a toothbrush with a strong grip may help you brush your teeth more easily. If you suffer from knee osteoarthritis, a chair in your bathroom could help with the discomfort of standing.
  • Transcutaneous electrical nerve stimulation (TENS) -This reduces pain by applying a low-voltage current. For some persons suffering from knee and hip osteoarthritis, it offers momentary alleviation.

Surgical Methods

If preventative measures are unsuccessful, you might wish to think about having surgeries like:

  • Shots of cortisone: A few weeks of pain relief may be possible after receiving corticosteroid injections into the joint. The doctor desensitizes the region around your joint before inserting a needle and medicine within your joint. You are typically only permitted to have three or four cortisone injections per year due to the medication's potential to exacerbate joint deterioration with time.
  • Lubrication injections: Injections of lubricant. Hyaluronic acid injections may help you feel better by padding your knee, but some evidence indicates that they are no more effective than a placebo. Hyaluronic acid resembles a substance that is often present in the fluid around your joints.
  • Bone realignment: An osteotomy may be beneficial if osteoarthritis has worsened the condition of half of your knee compared to the other. A surgeon performs a knee osteotomy by making an incision across the bone beneath or above the knee, and then he or she separates or inserts a chunk of bone. As a result, the worn-out portion of your knee is no longer bearing your weight.
  • Joint replacement: During a joint replacement procedure, the surgeon will remove the worn-out surfaces of your joints and substitute them with metal and plastic components. Blood clots and infections are two surgical hazards. Artificial joints are prone to deterioration and eventual replacement.

Which doctor to consult for Osteoarthritis

Rheumatologists are medical professionals that specialize in identifying and treating conditions that affect the bones, muscles, and joints, including arthritis. Additionally, you might need to see orthopedic doctors and other medical professionals like physiotherapists or occupational therapists. These might include nonsteroidal anti-inflammatory medications that ease pain and swelling in the joints, like meloxicam. naproxen or aspirin.

Which are the best medicines for Osteoarthritis

The following medicines can help with osteoarthritis symptoms, particularly pain:

  • Acetaminophen: Some osteoarthritis sufferers with moderate to minor pain have been shown to benefit from taking acetaminophen (Tylenol, among other brands). Acetaminophen overdose can harm the liver if used in excess of the advised dosage.
  • Non-steroidal anti-inflammatory (NSAIDs): Osteoarthritis pain is commonly treated with over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin IB, and other brands) and naproxen sodium (Aleve), when used in the dosage levels. By prescription, stronger NSAIDs are obtainable.
  • NSAIDs can harm the liver, kidneys, heart and lungs in addition to causing stomach distress and bleeding issues. NSAIDs may be just as effective in relieving pain when used on the skin over the injured joint as gels because they have less side effects.
  • Duloxetine (Cymbalta): This drug, which is typically taken as an antidepressant, is also permitted to treat long-term pain, specifically osteoarthritis pain.

How long does it take to recover from Osteoarthritis?

The muscles normally need approximately six weeks to heal sufficiently to stabilize the joint. It is typically possible to resume employment and begin engaging in approved sports after around three months.

Are the results of the treatment permanent?

Osteoarthritis symptoms can usually be managed, although the damage to joints can't be reversed. Staying active, maintaining a healthy weight and receiving certain treatments might slow progression of the disease and help improve pain and joint function. Treatment for osteoarthritis could significantly enhance your life quality, agility, and symptoms. You may continue to experience stiffness and aches from your condition after surgery, however there is no certainty that it will completely eliminate your symptoms.

Who is eligible for the treatment

Anyone can get osteoarthritis, but it is more common as people age. Women are more likely than men to have osteoarthritis, especially after age 50. Other factors that may make it more likely to develop osteoarthritis include: Overweight or obesity. Therefore people above the age of 50 usually are eligible for the treatment of osteoarthritis. Also people who need knee joint pain or hip joint pain, usually need surgery as well.

Who is not eligible for the treatment

Among the grounds for ineligibility are:

Infection
Patients who are susceptible to infection or who currently have an infection are absolutely contraindicated from having this operation. Severe post-surgical infections may necessitate a patient's readmission to a hospital, extensive intravenous antibiotic treatments, and in some instances, the replacement of the artificial hip or knee.

Nicotine
People who smoke and certain tobacco users are more likely to experience medical issues and require additional surgery. The likelihood of having a second (revision) joint replacement procedure was nearly ten times higher in smokers than it was in non-smokers. Candidates for total joint replacement are urged to give up or cut back on tobacco use to reduce post-surgical hazards.

What are the post-treatment guidelines?

The treatment of osteoarthritis is an intricate process and thus requires follow-up care. One needs to be extra cautious and take great care of themselves post the treatment. Here are some post-treatment guidelines that you can follow to reduce the inconvenience:

  • Refrain from heavy exercise- Minimal exercise can improve your stamina and build up the muscles surrounding your joint, resulting in improved stability at your joint. But heavy exercises or lifting weights is a big no no.
  • Employ heat or cold packs: Hot compresses help to increase blood flow, which reduces stiffness and discomfort. Cold compresses lessen edema. If you want to determine which method works better for you, try using heat instead of cold packs.
  • Seek assistance- Recovery might be a bit difficult. It can be beneficial to find somebody with whom you can converse and exchange views.
  • Rest well- A restful sleep will make it easier for you to deal with the anxiety and uneasiness of post osteoarthritis. Remove any distractions from your bedroom, including computers and televisions. If you have arthritis and find it difficult to sleep, try using pillows to relieve pressure on your sore joints. Consult your doctor if you frequently experience sleep issues.
  • Stay optimistic: Your state of mind can significantly affect how you feel and how well you perform. Try to accomplish something you like each day. Spend some time with your pals. Create pastimes that you can engage in. Your positive outlook will help you heal faster.

What is the price of Osteoarthritis treatments in India?

Osteoarthritis cannot be prevented because of the core reason or the mechanism that led to its development. However, by maintaining a healthy diet, and lifestyle the symptoms can be easily treated. If the situation worsens, you need to consult the doctor for medication or opt for a surgery. Osteoarthritis treatment is quite frequent and common in India. Its operational cost is also quite generic and can be afforded by the commoners. Look down to know the cost of lab tests and surgeries for osteoarthritis.

In India, prescription drugs typically cost between 923 and 1075 INR. Typically, lab tests cost between 1500 and 5000 INR. The cost of surgery might vary from 50,000 to 4.5 lakh INR. For 14 days, post-surgery physical treatment will cost between 20,000 and 25,000 Indian rupees.

What are side-effects of Osteoarthritis treatments?

  • Though Osteoarthritis treatment is known to reduce inflammation and pain, it also has potential side effects. There are also some setbacks to the treatment and medication.
  • NSAIDs can harm the liver, kidneys, and cardiovascular system in addition to causing stomach distress and bleeding issues. NSAIDs as gels, put on the skin over the afflicted joint, may lessen discomfort just as effectively and have less side effects.
  • During a joint replacement procedure, your surgeon will remove the worn-out surfaces of the joints and substitute them with metal and plastic components. Thrombosis and infections are two surgical hazards. Artificial joints are prone to deterioration and eventual replacement.

Osteoarthritis: Outlook / Prognosis

  • The severity of symptomatology, impaired functioning, and damaged joints all affect an osteoarthritis patient's prognosis. While some patients with osteoarthritis experience minimal symptoms, others may be severely disabled.
  • Most people think of osteoarthritis as a slow-moving condition that steadily wears down the joints. However, according to the most recent study, not all people with osteoarthritis get worse; some actually stable. In osteoarthritis, rapid joint degeneration progression is uncommon. Less than 5% of older adults receive reconstructive surgery, despite the fact that X-rays of their hips and knees show substantial osteoarthritis in roughly 40% of cases. This fact alone indicates that osteoarthritis does not progress for the majority of individuals.
  • Although osteoarthritis cannot be cured, it can be managed. It's also feasible that even minor lifestyle adjustments could reduce the disease's growth and enhance your own prognosis.
  • The American College of Rheumatology claims that losing merely 10 pounds across a ten-year span can cut the risk of contracting OA by up to 50%. Additionally, they advise regular strength training as well as other weight-loss methods to assist relieve joint pressure if you have OA and are overweight. Many people consider taking dietary supplements in addition to pharmacological therapy for OA-related pain management and edoema reduction. The National Center for Complementary and Integrative Health points out that there isn't any concrete proof that the supplements are effective. Although some early findings do appear promising, additional studies are still required to determine the effectiveness and safety of the majority of these natural remedies.

References

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Written ByDr. Kailash Kothari MD - Anaesthesiology,MBBSOrthopaedics
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