Osteoarthritis

What is Osteoarthritis?

Osteoarthritis, the most common type of arthritis, impacts millions of people worldwide. It occurs when the cartilage that cushions the ends of your bones gradually wears down and no longer protects your bones from rubbing together at your joints. This leads to pain and discomfort. Osteoarthritis usually affects the joints in the hands, knees, hips, spine, and other joints. 

Joint damage caused by osteoarthritis cannot be reversed. However, it is possible to slow the progression of this disease and treat joint pain and discomfort.

A symptom flare-up may occur at any time or due to aggravating factors like changes in weather or exercise. These periods typically involve swelling, more severe pain, and stiffness, or decreased range of motion. Because of this, osteoarthritis can make it challenging to use the affected joints and even carry out daily activities. 

An important distinction is the difference between osteoarthritis and rheumatoid arthritis, even though they share similar symptoms. Osteoarthritis is due to damage from the “wear and tear” of your joints. In contrast, rheumatoid arthritis is an autoimmune condition where your immune system attacks and damages your joints.

Pathophysiology and Risk Factors

Osteoarthritis occurs due to the degradation of the cartilage that pads the ends of your bones in your joints. Your body naturally breaks down and regenerates tissues, including bone and cartilage, to maintain them. However, with use over time and aging changes, cartilage and bone are sometimes broken down faster than your body can rebuild them. This leads to a net loss of cartilage in the joints causing the symptoms of osteoarthritis.

As a disease that affects a large number of people, osteoarthritis can result from any number of combinations of risk factors: 

  • Age - Bones and joints become weaker and more vulnerable to wear and tear as you age.
  • Gender - Women may be more likely to develop this condition due to hormonal differences affecting bone density.
  • Weight - Extra weight puts greater pressure on your joints, increasing wear.
  • Joint injuries - Physical damage to a joint can permanently alter the bones and cartilage in negative ways.
  • Genetics - If osteoarthritis affects other members of your family, you may be at an increased risk.
  • Bone deformities - A small number of people are born with cartilage and bone deformities that may predispose their joints to faster degradation.

Signs and Symptoms

Osteoarthritis symptoms are usually most evident in the affected joints. You may first notice pain, stiffness, swelling, or decreased range of motion, or some combination of several of these. 

Discomfort is usually worse in the morning or after long periods of rest. Although pain is typically limited to the affected joint, it can also radiate to other areas. Stiffness in the morning is also very common. It usually subsides within 30 minutes of waking up but may return during the day after periods of rest. 

Some patients with osteoarthritis also notice changes in their symptoms depending on the weather. Moisture and cold are common triggers that can worsen stiffness. 

If you have noticed any of these symptoms or think you may be suffering from osteoarthritis, speak with one of our online physicians now.

Diagnosis

Diagnosing osteoarthritis can take some time. Your healthcare provider will check your medical history and family history. They will also perform a physical exam and focus specifically on your joints and any other areas you have noticed symptoms. 

Sharing your symptoms and how they affect your daily life is essential to help your doctor assess your condition. This information can also help guide the creation of an effective treatment plan that addresses any known triggers of your osteoarthritis. 

Depending on your physical exam findings, your physician may need additional tests to reach a diagnosis. These can include laboratory tests, joint aspiration, or imaging such as x-rays or magnetic resonance (MRI).  

Lab tests can help assess whether any underlying conditions such as chronic inflammation contribute to your symptoms. In a joint aspiration, a small amount of fluid is withdrawn from your numbed joint using a needle. The fluid is then analyzed to assess joint health and the presence of any unexpected contaminants like bacteria.

X-rays help visualize the bones in your joints and any damage to them. An MRI shows soft tissue such as cartilage in addition to bone.

Based on exam findings, your discussion, and the results of any additional tests ordered, your healthcare provider will be able to determine whether you have osteoarthritis. Depending on the severity of your joint damage, your diagnosis will fit into one of the following four stages of this condition: 

Stage 1 - The mildest of the stages, the affected joint(s) has only minor wear and tear. Some discomfort may be present, but there is usually little to no pain at this point. 

Stage 2 - The affected joint(s) feel stiff and/or painful after periods of rest. In this stage, a brace may be necessary to support and aid the affected joint(s)

Stage 3 - The cartilage in the affected areas begins to erode. In addition to pain and stiffness after rest, discomfort is common during daily tasks.

Stage 4 - This is the final stage of osteoarthritis. There is a lot of pain, and the cartilage is either almost or entirely gone. As a result, bone damage leads to joint inflammation. Pain and limitations in range of motion can be debilitating, and daily tasks are challenging to complete.

Treatment

Unfortunately, there is no way to reverse the joint damage that has occurred due to osteoarthritis. Therefore, treatment focuses on preventing further damage and controlling symptoms. 

Maintaining a healthy weight and active lifestyle is an excellent way to keep your joints healthy. An additional natural option to relieve pain and stiffness and increase range of motion is physical therapy. In addition to improving flexibility, it can also help you learn how to carry out daily activities safely to prevent additional joint damage. 

The first line of treatment for symptoms is usually oral non-steroidal anti-inflammatory drugs (NSAIDs) to help reduce pain. Many types of these, such as ibuprofen and naproxen, are available over the counter. 

However, taking these long-term can pose health risks. For this reason, you should discuss your use of these medications with your doctor. Prescription NSAIDs designed for chronic use are also available for osteoarthritis. 

In more severe cases, non-narcotic or narcotic pain medications can be used to control pain. Steroid injections into the joint are another option for symptom control. Joint surgery or replacement can also help restore the health and function of eroded joints.

Prognosis

Your prognosis with osteoarthritis depends on the number of joints affected and the severity of the damage each has sustained. This condition can cause pain and stiffness that lead to physical limitations. Lifestyle changes like weight loss, medications to control symptoms, and physical therapy can improve your quality of life.

While osteoarthritis complications are not common, they can occur. These include joint infection and bleeding, bone death, and stress fractures. Working with your care team can help you avoid developing these conditions.

If you are experiencing joint pain, stiffness, or decreased range of motion, speak with one of our online physicians now. We can help determine the cause of your symptoms and provide relief with appropriate treatment.

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Meredith Hays
Meredith Hays
of experience
since July, 2021 with SkyMD

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