Osteoarthritis

Introduction

Osteoarthritis is a very common type of arthritis that affects millions of people around the world, particularly adults above 50 years of age and is one of the most common cause of disability. According to a WHO report, it is estimated that 10-12% of the people across the globe, above the age of 60-65 years, suffer from osteoarthritis. Among them, 80% of the people with OA have impaired mobility, and 25% of them cannot perform daily activities.

Osteoarthritis, also known as the arthritis of bone, is a chronic and degenerative condition which causes cartilage loss in the joints. It is often referred to as wear-and-tear arthritis. Typically, osteoarthritis may get triggered when the protective layer of the cartilage of the joint wears down due to factors such as aging or injury. Osteoarthritis can damage any joint in your body. The most common sites are hands, neck, lower back, knees, and hips. It is more common in women than men.

The exact etiology of the condition is not discovered, but it is said that osteoarthritis is a multifactorial disorder. It is seen correlated to risk factors like female sex, age, obesity, occupational knee bending, hereditary factors, Vitamin D deficiency and joint trauma.

Degenerative arthritis worsens gradually. While the diseases itself is incurable, a timely treatment is must to slow down the damage caused by osteoarthritis. If not managed well, Osteoarthritis leads to many other health issues that are caused due to lower mobility such as obesity, diabetes, increased cancer risk and high cholesterol.

How will you know if you have osteoarthritis?

The most common symptoms of knee arthritis are joint pain and stiffness in the knee or hip area. However, depending on the type of arthritis (e.g., rheumatoid arthritis or osteoarthritis) you may also experience a number of other symptoms.

Be careful if you notice the following symptoms:

• Pain, that often aggravates with activities.
• Limited range of motion.
• Stiffness of the knee.
• Swelling in the knee joint.
• Tenderness in the knee joint.
• Warm to touch, around the knee joint.
• Grinding feeling when you move the joint.

How to treat Osteoarthritis?

Life with Osteoarthritis is quite miserable due to the presence of pain as well as limited mobility, both of which cause lowering the quality of life one can live. Early diagnosis of Osteoarthritis can be helpful in its successful management and maintaining a high quality of life by slowing down the disease.

Conservative treament options:

Weight loss:

Shedding just 15 pounds can reduce the pain sensation by half! According to a study presented at a recent meeting of the American College of Rheumatology, reduction of weight can help delay the need for surgery by reducing the strain on the joints. Lower weight can also help in reducing post-surgery complications and helps in a smoother and quicker rehabilitation.

Physical activity:

Strong muscles surrounding the knee support the joint and relieve pressure. The strength of these muscles can help in both avoiding a surgery for as long as possible, but also, help in a quicker recovery in case one does get a joint replacement surgery done. That is why, muscles strengthening exercises should start even before having surgery.

Exercise and strengthen your thigh muscles (quadriceps):

An Australian study showed that the patients, who had thicker quadriceps muscles, developed less pain and cartilage damage with less risk of joint replacement surgery, as compared to those, who had smaller quadriceps muscles. Swimming, cycling, and pilates are the best non-traumatic knee-strengthening exercises to improve blood flow and buildup of these muscles.

Physiotherapy:

The physiotherapy treatment focuses on improving the symptoms of the disease (i.e. knee pain, swelling, stiffness). Following physiotherapy, a patient may start to notice a positive difference within one or few physiotherapy sessions.

The main goals of physiotherapy for your knee arthritis are:

1. Reduce the knee pain and inflammation.
2. Normalize the range of motion.
3. Strengthen the knee: esp. quadriceps (esp. VMO) and hamstrings.
4. Strengthen your lower limb: calves, hip and pelvis muscles.
5. Improve the patella-femoral (knee cap) alignment and function.
6. Normalize your muscle lengths.
7. Improve your proprioception, agility and balance.
8. Improve your technique and function, like walking, squatting.

Braces

The braces should be used as per the doctor’s prescription, and fitted by a physiotherapist. Braces can improve the alignment of the knee and help in relieving pain.

Electrical stimulation

This may reduce pain by strengthening the quadriceps, the large muscles on the front of the thigh that helps to stabilize the knee joint. It can stimulate the regeneration of the cartilage cells.

Corticosteroid injections

Corticosteroid injection is administered into the knee joint to reduce the pain and inflammation. It does not cause any side effects like oral corticosteroids.

Hyaluronic injections

Hyaluronic Acid may be injected directly into the knee joint to improve the lubrication of the affected joint to reduce inflammation and improve the motion.

Over the counter medications

Drugs such as the analgesic acetaminophen (Tylenol) and the non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve), can ease the pain.