Osteoarthritis: The degenerative joint disease

Osteoarthritis Degenerative disease

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Osteoarthritis is a chronic joint disease affecting about 25% of adults over 50 years of age. It is commonly known as degenerative joint disease as it leads to the gradual breakdown of the bones and cartilage within a joint. The degeneration of bones and cartilage leads to pain, stiffness, and reduced mobility in the affected joints, particularly the knees, hands, and spine. 

It occurs when the protective cartilage that cushions the joints starts to wear away leading to friction, inflammation, and eventually the formation of bone spurs. 

Causes and risk 

For understanding and managing osteoarthritis, it is necessary to know the underlying mechanism and risk factors associated with it. Anyone can develop osteoarthritis, but the likelihood of developing the condition increases with age and women are more susceptible to osteoarthritis as they grow older. It is estimated that the lifetime risk of osteoarthritis is approximately 40% in men and 47% in women. It is often referred to as wear and tear arthritis because it develops gradually over time as the cartilage in the joints deteriorates. Cartilage is a thin layer of tissues covering the end of the bones and provides a slippery cushion that absorbs shocks, helps to facilitate joint movement, and prevents friction of bones from rubbing against each other. 

Apart from age, overweight is also a factor that contributes to the risk and cause of this condition. Some of the factors, such as genetics, diet, estrogen use, bone density, joint injury or trauma, muscle weakness, obesity, and joint laxity also increase the risk. By recognizing these key factors, an individual can take proactive measures to prevent and manage the condition.


Signs and symptoms 

Osteoarthritis manifests differently in everyone, but common symptoms include joint pain, stiffness, swelling, a reduced range of motion, tenderness, and the formation of hard nodules around the joints. If neglected these symptoms worsen over time and can significantly impact the daily activities and overall quality of life. Recognizing the signs of osteoarthritis is vital for early intervention and effective management. 

The pathological changes seen in osteoarthritis joints include progressive loss and destruction of articular cartilage, thickening of the subchondral bone, formation of osteophytes, variable degrees of inflammation of the synovium, degeneration of knee ligaments, and hypertrophy of the joint capsule. 

Diagnosis and management 

Diagnosis typically involves a combination of patients history, physical examination, and imaging studies like X-rays and magnetic resonance imaging (MRI) scans. These tools help doctors assess joint structure, cartilage loss, and any bone spurs that may have formed.  

 Effective management of osteoarthritis focuses on relieving pain, improving joint function, and enhancing quality of life. It is usually well managed by a combination of pharmacologic treatments like NSAIDs, and non-pharmacologic like exercise, splints, braces, and physiotherapy.   

The management interventions for osteoarthritis are as follows: 

  • Lifestyle modifications and self-care

In addition to medical interventions, lifestyle modifications play a crucial role in managing osteoarthritis. Maintaining a healthy weight, engaging in regular exercise to strengthen muscles and improve joint flexibility, adopting joint-friendly activities, using assistive devices (e.g., canes or braces) for support, and applying heat or cold therapy contribute to reducing pain, inflammation and improving overall joint function. Additionally, self-care practices such as managing stress, getting adequate rest, and adopting a balanced diet can support overall well-being.

  • Physical therapy 

A trained therapist can design an exercise program tailored to an individuals needs, focusing on improving joint flexibility, strength, and range of motion. They may also incorporate other modalities like ultrasound or electrical stimulation to relieve pain and enhance mobility. 

  • Surgical options and advanced therapies 

In severe cases where conservative treatments are not sufficient, surgical interventions such as joint replacement surgeries or joint realignment procedures may be recommended. These procedures aim to alleviate pain and restore function. 

Osteoarthritis is a chronic and progressive joint disease that affects millions of individuals worldwide. While it cannot be cured, there are numerous treatment options available to manage the symptoms and improve the quality of life. By adopting a comprehensive approach that includes lifestyle modifications, physical therapy, medications, and in some cases surgical interventions, individuals with osteoarthritis can find relief and continue to live an active life.