What are Osteoarthritis

Osteoarthritis is also known as degenerative joint disease. It is the most common form of arthritis.In normal joints cartilage covers the end of each bone. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As OA worsens over time, the cartilage wears away and bone rubs against bone leading to joint damage and more pain.OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toeOsteoarthritis is common, affecting 25% of adults.In the age group below 50 years, men are more often affected, while in the older population the disease is more common in women.

Types/Causes

It can be classified into two categories:

Primary Osteoarthritis:

Absence of an antecedent insult. A strong genetic component with the disease primarily affecting middle-aged women

Secondary Osteoarthritis:

Involves a specific trigger that exacerbates cartilage breakdown. Common triggers for secondary OA include:

    1. Injury: Bone fractures increase a person’s chance of developing OA and can bring about the disease earlier.
    2. Abnormal mechanical forces (e.g. occupational stress, obesity)
    3. Inactivity
    4. Inflammatory Diseases: Perthes’ disease,Lyme disease and all chronic forms of arthritis (e.g., costochondritis, gout, and rheumatoid arthritis)
    5. History of certain conditionsg. Diabetes, Marfan Syndrome, Wilson’s Disease, Joint infection, Congenital disorders of joints, Ehlers-Danlos Syndrome, Hemochromatosis.

Risk Factors

Age, female gender, obesity, anatomical factors, muscle weakness, and joint injury.

Signs and Symptoms

  1. Pain: This is a mechanical type of pain which is generated by mobilization, increases with fatigue and decreases with rest.
  2. Pain occurs in the morning or after a period of inactivity. Mostly, there’s no overnight pain.
  3. The intensity of pain is variable. Sometimes it’s dull and tolerable, other times it’s very heavy with short peaks. It can be stimulated by cold, trauma and fatigue.
  4. Limitation in movement: it is insidious, progressive and will be noticed after several years. The severity increases with time and is accompanied with the joint deformities and wear of the cartilage.
  5. Sounds: The sounds you can hear are cracking, scraping and sounds from crepitation.

Treatment

  1. Treatment goals for OA are to minimize pain and functional loss.
  2. Exercise programs that include aerobic and resistance training, to enhance muscle strength and flexibility, increase joint motion, increased aerobic capacity and optimal body weight.
  3. Manual Therapy
  4. Falls prevention strategies for older patients.
  5. Modalities: like ultrasound, TENS, heat or cold therapy.
  6. Balance training
  7. Assistive devices can help with function and mobility. These include items like scooters, canes, walkers, splints, shoe orthotics or helpful tools, such as jar openers, long-handled shoe horns or steering wheel grips.