Saturday, December 29, 2007

Osteoarthritis




What Is It?


Osteoarthritis literally means "degenerative joint disease." It affects more than 16 million Americans and is the most common form of arthritis. After the age of 45 it occurs ten times more commonly in women than men. Onset of this disease is increasingly common with age, and symptoms usually creep up on people slowly.





Causes


The most common causes of osteoarthritis are injuries, joint overuse and aging. Scientists also suspect that inherited gene defects may be another factor, and they are currently investigating this link. Studies point to the conclusion that this disease tends to run in families, possibly through a recessive gene.





Cartilage


Osteoarthritis affects the protective material around joints called cartilage, which covers and cushions the ends of the bones. In a healthy person, cartilage is flexible and hardwearing. However, eventually cartilage frays, wears down, and may even disappear completely, leaving behind a joint consisting of bone meeting bone with no padding. Consequently, the other sections of the joint such as the tendons, ligaments and muscles, become weaker until the joint itself becomes deformed.





Prevention


Currently, the only known methods of prevention are avoiding repetitive joint injury and weight control.





Symptoms


Pain, swelling and stiffness are the most common results of joint deterioration, and they often become worse with time. Morning stiffness and excessive pain in one joint are typical early warning signs. Symptoms may appear in the hands, knees, hips, back and neck. The affected joint's range of motion will also become increasingly limited.





Treatments:


Although Osteoarthritis is a chronic disease that may last a lifetime, several approaches to treatment are effective.





Exercise


It used to be thought that exercise causes 'wear and tear' on the body, especially in joints. Now, however, being inactive is considered detrimental to joint health. Experts now recognize the importance of exercise for strengthening joints, both before and after symptoms of arthritis appear. Swimming, walking, low-impact aerobics and range-of-motion exercises are beneficial to dealing with joint pain and stiffness.





Medications


Cortisone is used to reduce inflammation and improve joint mobility. The most commonly used corticosteroids are Prednisone, methylprednisone, Decadron and Aristocort. Occasionally, the hormone is injected into the joint to stop pain. However, the use of any corticosteriods should be discussed extensively with a doctor, as they do have side effects (depending on the dosage and length of time they are used.



Acetaminophen is commonly used for pain relief, although it is dangerous in doses higher than 4,000 mg daily and poses a risk for patients with liver disease.



Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be used, although inflammation is less of a problem in this kind of arthritis. A new kind of NSAID called COX-2 inhibitors recently came onto the market with the promise of fewer gastrointestinal side effects. Please read our in-depth articles in the library for more information.



Hyaluronan and Viscosupplementation. Hyaluronan, a naturally occurring substance in synovial fluid reduces joint pain by enriching the natural properties of synovial fluid. Vicosupplementation is the name of the therapy in which hyaluronan is injected into the knee. Synvisc and Hyalagan are two brand names to look for, and are recommended for the treatment of OA in the knee after traditional therapies are unsuccessful.





Weight reduction


Being overweight is a definite risk factor for developing osteoarthritis. The increased load on joints may accelerate the breakdown of cartilage; for example, it is estimated that people with the highest body weight in the population have up to ten times the risk of developing knee osteoarthritis than those with the lowest weight. Weight issues are an important part of arthritis management. Successful strategies include calorie reduction, increased physical activity, and general adjustments in eating and exercise habits.





Heat and Ice


Warm baths, heat lamps and warm compresses can relieve pain. Heat also reduces stiffness and increases movement. Other people find relief in cold packs, especially for inflammation. In either case, remove the compress or ice after 20 minutes.





Topical Products


Topical products are sometimes used to provide temporary relief from arthritis pain. Capsaicin, a compound found in hot peppers, reduces pain when applied to the affected area three or four times a day. Other products, called counterirritants, use camphor, menthol or turpentine oil to mask the pain. Skin irritation may develop, but otherwise there are few side effects.





Surgery


In severe cases, surgery can help to repair torn cartilage and remove loose bone fragments. There are several different types of procedures, from arthroplasty, where the entire damaged joint is replaced, to osteotomy, which removes damaged bone tissue.

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