Submitted by McLean County Orthopedics
Osteoarthritis, sometimes called degenerative joint disease, is the most common type of arthritis, especially among older people. However, younger people can develop it too, usually as the result of a joint injury, a joint malformation, or a genetic defect in joint cartilage. The disease affects both men and women, but after age 45, it is more common in women.
Osteoarthritis mostly affects cartilage, the hard but slippery tissue that covers the ends of bones where they meet to form a joint. Healthy cartilage allows bones to glide over one another and absorb energy from the shock of physical movement. In osteoarthritis, the surface layer of cartilage breaks and wears away. This allows bones under the cartilage to rub together, causing pain, swelling, and loss of motion of the joint. Over time, the joint may lose its normal shape. Also, small deposits of bone may grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space. This causes even more pain and damage.
People with osteoarthritis usually have joint pain, stiffness, and reduced motion. The most commonly affected joints are the hands, neck, lower back, knees, and hips. Osteoarthritis usually happens gradually over time. Early in the disease, joints may ache after physical work or exercise. Later on, joint pain may become more persistent. Joint stiffness is common, particularly when first waking up in the morning or after being in one position for a long time. In some people, osteoarthritis is relatively mild and interferes little with day-to-day life; in others, it causes significant pain and disability. Unlike some other forms of arthritis, such as rheumatoid arthritis, osteoarthritis affects only joint function. It does not affect skin tissue, the lungs, the eyes, or the blood vessels.
The knees and hips are the joints most commonly affected by osteoarthritis. Symptoms of knee osteoarthritis include stiffness, swelling, and pain, which make it hard to walk, climb, and get in and out of chairs and bathtubs. Symptoms of hip osteoarthritis include pain and stiffness of the joint itself, but sometimes pain is also felt in the groin, inner thigh, buttocks, or even the knees. Osteoarthritis of the hip may limit moving and bending, making daily activities such as dressing and putting on shoes a challenge. Osteoarthritis of the spine may show up as stiffness and pain in the neck or lower back. In some cases, arthritis-related changes in the spine can cause pressure on the nerves where they exit the spinal column, resulting in weakness, tingling, or numbness of the arms and legs.
Osteoarthritis doesn’t have one specific cause, but some risk factors that might lead to it include the following:
- Being overweight
- Getting older
- Joint injury
- Joints that are not properly formed
- A genetic defect in joint cartilage
- Excessive stress on the joints from certain jobs and playing sports
No single test can diagnose osteoarthritis, however, doctors may use tests to help confirm a diagnosis or rule out other conditions that could be causing symptoms. Most doctors use a combination of medical history, physical examination, X-Rays, MRI imaging, and possibly other tests, such as blood tests or exams of the fluid in the joints, to diagnose the disease and rule out other problems.
The goal of osteoarthritis treatment is to improve joint function and control pain. Most successful treatment programs involve a combination of approaches tailored to the patient’s needs, lifestyle, and health. Osteoarthritis treatment plans may include the following:
- Exercise is one of the best treatments for osteoarthritis. It is also inexpensive and, if done correctly, has few negative side effects.
- Weight loss can reduce stress on weight-bearing joints, limit further injury, increase mobility, and reduce the risk of associated health problems.
- Non-drug pain relief techniques such as heat and cold or a combination of the two.
- Over-the-counter medications to control pain may include acetaminophen, aspirin, ibuprofen, or topical pain-relieving creams, rubs, and sprays.
- Prescription medication is sometimes used when over-the-counter medications don’t provide sufficient relief. It’s extremely important to follow your doctor’s recommendation regarding any type of medication.
- Steroid injections are a temporary measure for pain relief, generally not recommended for more than two to four treatments per year.
- Viscosupplementation (Gel Injections) is a medical procedure in which lubricating fluid is injected into a joint to facilitate better joint movement, reduce pain, and perhaps even slow the progression of osteoarthritis.
- Complementary and alternative therapies such as acupuncture, massage, and nutritional supplements are sometimes helpful.
- Surgery is often the only treatment that will resolve the pain and disability for the long-term, especially if lifestyle changes, such as weight loss and exercise, have not provided adequate pain relief.
It is up to you and your physician to determine when or if surgery is the best solution. The decision to have surgery depends on many factors, including your age, occupation, level of disability, and pain intensity. Although surgery and subsequent rehabilitation is certainly a major process that must be carefully considered, surgical techniques have been greatly improved over the years leading to quicker recovery and excellent outcomes. After surgery, most people are pain-free and are able to move much more easily. In fact, the most common thing that people say after surgery is, “Why didn’t I do this sooner?”
For more information on any orthopedic problem, call 309-663-6461 to schedule an appointment with the board-certified physicians at McLean County Orthopedics or visit their website at www.mcleancountyorthopedics.com. Their new office is at 1111 Trinity Lane in Bloomington.