What is Osteoarthritis?
Osteoarthritis is a chronic degenerative disease characterized by joint pain, stiffness, swelling, and restricted movement. It is caused by the breakdown of joint cartilage, the strong and flexible tissue that protects the ends of bones. As the cartilage thins or wears away completely, the bones rub together. Osteoarthritis predominantly affects the hips, knees, spine, hands, neck, and feet.
Osteoarthritis is caused due to multiple factors including old age, female gender, joint injury, repetitive use of joints, muscle weakness, joint laxity, past surgeries, genetics and obesity.
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How to Manage Osteoarthritis?
Unfortunately, there is no cure for osteoarthritis. But there are several treatment options available to reduce joint pain, limit the progression of joint damage and improve joint function and mobility.
Osteoarthritis management options include
1. Non-drug treatments such as weight loss and exercise
2. Pain-relieving medicines
3. Surgery to repair or replace damaged joints
People who are overweight or obese have a high risk of osteoarthritis. Moreover, obesity makes osteoarthritis worse by putting extra strain on the joints. It also triggers the production of inflammatory proteins that may speed up cartilage degradation. Weight loss through a healthy diet and exercise can help people with osteoarthritis reduce cartilage damage and symptoms.
According to a 2018 study, obese or overweight people who lost 10% of their weight reported a 50% reduction in pain leading to significant improvements in mobility and daily function.
People with osteoarthritis think that exercise can make their symptoms worse. But lack of physical activity actually makes their joints even more painful and stiff. Experts suggest that regular light to moderate exercise is one of the best treatment options for osteoarthritis as it helps to build up muscle, strengthen the joints, reduce weight and relieve stress. It is highly advised to consult a GP, or a physiotherapist for a personalized exercise program because doing too much or the wrong exercise can damage your joints.
An exercise program to manage osteoarthritis may include
1. Aerobic exercise such as cycling, walking, or stair-climbing without stressing the joints.
2. Water exercise or pool therapy such as swimming, water aerobics, and walking laps are good options for those with functional limitations.
3. Stretching and flexibility exercises help reduce muscle stiffness.
4. Strengthening exercises such as quadriceps setting, straight leg raise, hamstring stretch, calf Stretch, and wall sit are useful for people with hip and knee osteoarthritis.
5. Tai Chi and yoga helps improve physical function.
Medications help reduce osteoarthritis pain and swelling, making it possible for patients to exercise and perform the daily activity. Painkillers are prescribed based on the severity of the disease.
1. Paracetamol is commonly used to treat mild to moderate pain in osteoarthritis.
2. Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs are prescribed if paracetamol is not easing the pain. NSAIDs come in topical and oral forms which help to reduce pain, inflammation, and stiffness.
Topical NSAIDs are available in the form of gels, creams, sprays, and patches that can be applied directly to the affected joints. For example- topical ketoprofen and diclofenac sodium.
Oral NSAIDs such as aspirin, ibuprofen, and naproxen are used to treat OA pain and inflammation. However, long-term use of these drugs can cause side effects such as stomach ulcers, stomach bleeding, and kidney problems.
3. Analgesics, another type of pain medication, works by blocking the nerves that send pain messages to the brain. Examples of analgesics include Tylenol and Capsaicin.
4. Opioids, such as codeine, are used to treat severe pain, and if paracetamol and NSAIDs treatments are no longer helpful. But opioids can also cause side effects such as drowsiness, nausea, physical dependence and constipation, and the risk of addiction.
5. Steroid or Corticosteroid injections are used to treat severe pain and inflammation if a patient cannot tolerate oral medicines. A single Steroid shot can reduce pain quickly for several weeks or months.
Surgery should be considered as a last resort for osteoarthritis. It is suggested only when other treatments are not effective and where the joints are severely damaged. A surgeon recommends different types of surgery based on the patient’s condition.
1. Joint replacement surgery, also known as Arthroplasty, is done to replace damaged knee and hip joints with an artificial joint of plastics or metal.
2. Bone or joint fusion surgery, also known as Arthrodesis, is done to treat pain in the spine, ankle, finger, and thumb. In arthrodesis, a surgeon fuses the bones of the affected joint in a permanent position. This reduces the movement in that joint and makes it less painful.