Osteoarthritis (OA) is one of the oldest and most common diseases among humans. When a person has osteoarthritis, the cartilage of the joints wears, which can cause pain and stiffness in the joints. OA is also known by many other names, such as degenerative joint disease, osteoarthritis, or hypertrophic arthritis. (Warning: Osteoarthritis is not the same disease like osteoporosis, which weakens the bones due to a loss of bone mass, which can result in rounded shoulders, loss of height and even painful fractures). There are many conditions and ailments that can cause OA: excess weight, injury to a joint; muscular weakness; damage to the nerves that supply the area of the joints; synovial disease and even hereditary factors.
Osteoarthritis can affect any joint, but it occurs more often in the small joints of the hands and in the joint at the base of the big toe (the “bunion joint”). It also usually affects the hips, knees and spine. Rarely affects the wrists, elbows or ankles, except as a result of injury or overexertion.
What is the cause?
Researchers have shown that there are several factors that increase the risk of developing OA. These factors include heredity, obesity, joint injuries, repeated excessive use of certain joints, muscle weakness and nerve damage. These factors are analyzed below.
Inheritance
In some families, osteoarthritis can result from a hereditary defect in one of the genes responsible for collagen, one of the main protein components of cartilage. This results in defective cartilage that deteriorates faster. It is possible that during the youth such problems do not pose any difficulty, but with the passage of time, the joints may wear away. Women who are predisposed to this condition due to hereditary factors could develop bony nodules in the joints of the fingers.
People born with minor defects that prevent the joints from fitting and moving properly, such as bowed legs or a hip with congenital abnormalities, may be more likely to develop OA. Being born with too flexible joints also increases the tendency to develop osteoarthritis.
Obesity
Studies indicate that obesity increases the risk of OA in the knee. The researchers found that body weight during the middle and late years seems to be the most important factor in the risk of a person developing osteoarthritis of the knee, especially during the period of eight to 12 years before the symptoms appear. . Therefore, avoid excessive weight gain as the years go by or lose weight. It could help prevent osteoarthritis of the knee.
Muscle weakness
Studies have shown that individuals with weak quadriceps (upper thigh muscles) may be more likely to develop OA of the knee than those who do not suffer from muscle weakness. Also, OA of the knee is more likely to progress if the quadriceps are weak.
Injury or excessive use (occupational)
Some people develop osteoarthritis in certain joints due to injuries or excessive uses of specific type. A history of significant knee or hip injuries increases the risk of developing OA in those joints. For example, football or football players who injure their knee may have higher risks. Avoiding trauma or joint injuries can help prevent osteoarthritis.
Joints that are used repeatedly in certain tasks may develop osteoarthritis. The tasks that require bending the knees multiple times seem to increase the risk of OA of the knees. There are studies that indicate, for example, that miners or shipyard or port workers have higher OA rates of the knees. Fortunately, there are methods to modify these tasks in order to prevent damage to the joints due to excessive use.
Ageing
The frequency of OA increases with age, and is more common in people over 65. OA affects men and women. Up to 50 years old, OA is more common in men. After this age, it is more common in women.
CAN OSTEOARTHRITIS BE PREVENTED?
Rheumatologist in Delhi believes that some people can reduce their risk of developing OA or delay its onset. Some of the same techniques that are used to treat OA can also be used in their prevention. Controlling weight is very important in helping to prevent OA of the knee, staying physically active, taking care and avoiding certain occupational injuries and adapting the jobs that require loading and flexing the knees also helps prevent OA.
Although the incidence of OA reaches its peak around 45 years, more and more young people are developing the disease. In certain cases, OA results from childhood sports injuries that manifest approximately a decade later. Children with congenital disorders may also present OA prematurely. Research shows that young people who work in the military may also be more prone to the disease.
What are the symptoms?
In general, the affected joint or joints hurt more after using them in excess or after periods of inactivity. You may find it difficult to move the affected joint easily, but it should not become completely stiff.
If you do not move and exercise the affected joint, the surrounding muscles will weaken and sometimes even shrink. In turn, weak muscles may not be able to fully support the joint. This could cause more pain in the joint. You may also notice negative changes in both coordination and posture.
What happens when you have osteoarthritis?
In normal joints, a firm, elastic substance called cartilage covers the end of each bone. The cartilage provides a smooth and slippery surface that facilitates the movement of the joints and acts as a cushion between the bones. In osteoarthritis, the cartilage between the joints wears out and causes symptoms such as pain and swelling, as well as problems using the joint.
Cartilage wear in osteoarthritis occurs in several stages:
- The structure of the cartilage begins to change over the years. When this happens, the cartilage loses its elasticity and is more prone to damage due to injury or excessive use. The timing of these changes, as well as the extent of these changes, depends on factors such as inheritance, traumas suffered by the articulation and others.
- Over time, the synovium (the lining of the joints) becomes inflamed as a result of cartilage wear. The inflammation produces cytosine (inflammatory proteins) and enzymes that could cause greater damage to the cartilage.
- As the cartilage wears out, the underlying bone is exposed and the joint can lose its natural shape. The ends of the bones become denser, forming bony shoots, or spurs.
- Cysts filled with fluid can form in the bone next to the joint. Pieces of bone or cartilage may float loose in the space of the joint, causing further inflammation of the synovium.
In addition to cartilage wear, the fluid found in the joint may play a role in the disease process. Synovial fluid lubricates the joint and is necessary for it to function properly. Joint fluid is mainly made up of a substance called a hyaluronic acid substitute. In osteoarthritis, there may be more hyaluronan than normal, but it may be diluted. It is also possible that there is a change in the quality of the hyaluronan found in the joint fluid, which could diminish its protective function.
Affected joints
OA joints usually hurt more after using them in excess or after periods of inactivity. It is likely that it will be difficult for you to move the affected joint after getting up in the morning, or after using the joint more than usual.
If you do not move and exercise, the muscles around the affected joint will weaken and sometimes even shrink in size. Weak muscles may not be able to fully support the joint. This could cause more pain in the joint. It is also possible to observe negative changes, both in coordination, posture and walking.
Trochanteric bursitis is often confused with arthritis of the hip. The bursitis is inflammation or irritation of the bursa, small bag full of fluid that lies between the bone and muscle. The trochanteric bursa is on the promising bone on the side of the hip. Although you may have hip arthritis and trochanteric bursitis, bursitis is more common.
OA OF THE HIPS
If OA affects your hip, you may feel pain in your groin, inside your thigh, or on the outside of your hip. Some people feel pain reflected in the knee or on the sides of the thigh (that is, they feel pain in an area that has not really been affected). The pain may cause the hip to limp when walking.
OA OF THE KNEES
You may feel pain moving your knee. You may also feel a “rough” or “grab” feeling in the knee when you move it. Climbing or descending stairs or getting up from a chair can be painful. If pain prevents you from moving or exercising your leg, the large muscles that surround the area will weaken.
OA OF THE JOINT OF THE HAND
OA in the joints of the fingers can cause pain, swelling and, over time, the formation of bony shoots (spurs) in these joints. If the spurs are formed in the joints of the end of the fingers, they are called Heberden nodules. If they appear in the joints of the center of the fingers, they are called Bouchard’s nodules. You may notice redness, swelling, tenderness, and pain in the affected joint, especially during the initial stage of OA when these nodules are forming. These nodules can cause pain in the joints of the fingers and make them look thicker. Activities that require fine movements of your fingers, such as pinching, can be difficult.
OA OF THE FEET
If OA affects your feet, you may feel pain and tenderness in the large joint at the base of the big toe. Wearing tight shoes or high heels can make the pain worse.
OA OF THE SPINAL COLUMN
Chronic disc dislocation of the spine and the bony outbreak that this entails can cause stiffness and pain in the neck and lower back. In addition, it could exert additional pressure on the nerves of the spine. This is commonly known as contracture. You may feel pain in your neck, shoulder, arm, lower back, or even your legs. When OA affects the nerves of the spine, it may manifest as weakness or numbness in the arms or legs.
Differences between osteoarthritis and rheumatoid arthritis
Some confuse osteoarthritis with rheumatoid arthritis. As you will see below, these are very different diseases. Some people may have osteoarthritis and rheumatoid arthritis at the same time.
It is also possible that some confuse osteoarthritis with osteoporosis. Both diseases focus on problems with the bones (literally, osteo means bone), but they are not the same. Osteoporosis causes bones to lose mass and become brittle, which can lead to painful fractures.
Osteoarthritis
- Usually begins after 40 years.
- It affects approximately 27 million adults in this country.
- It usually develops slowly over many years.
- It affects some joints and can occur on both sides of the body.
- Redness, warmth and swelling are usually minimal. Morning stiffness is frequent and may be severe, but brief (less than 30 minutes).
- It usually affects only certain joints, such as those of the hands, hips, knees and spine. Rarely affects the wrists, elbows or ankles, except as a result of an injury.
- Does not cause a generalized feeling of illness.
Rheumatoid arthritis
- Usually begins between 30 and 60 years.
- It affects approximately 1.5 million adults in this country.
- It can develop suddenly, in weeks or months.
- It usually affects many joints, but it often starts in the small joints on both sides of the body.
- Causes redness, warmth, swelling and morning stiffness in the joints (which often lasts for hours).
- Affects many joints, such as wrists, elbows, shoulders, hips, knees and ankles.
- It usually causes a general feeling of illness and fatigue, as well as weight loss.
How is it diagnosed?
Your arthritis specialist in Delhi usually diagnoses osteoarthritis based on your medical history and a physical examination. However, your doctor may also recommend additional procedures, such as x-rays, that will help confirm the diagnosis, eliminate other causes of pain, and determine the extent of damage to the joints. Joint aspiration, a procedure through which the fluid is removed from the affected joints for examination, could also be used to rule out other diseases.
Treatment options
A good program for osteoarthritis treatment in Delhi can help reduce joint pain and stiffness, improve joint movement, and increase your ability to carry out daily activities. A plan will be designed exclusively for you, which should include a combination of physical and/or occupational therapy, gentle aerobic exercise, weight management, patient education and medication. If these measures do not produce results, consideration could be given to the surgical intervention.
Your treatment program will depend on the severity of your illness, the affected joints, the type of symptoms and other medical problems. Your age, occupation and daily activities will also be taken into account. You will work in collaboration with your rheumatologist in Delhi and other health professionals, such as physical and occupational therapists, in order to ensure that the program meets your needs.