Understanding Osteoarthritis: Causes, Symptoms, and Treatments

Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people worldwide. It's a degenerative joint disease that occurs when the protective cartilage that cushions the ends of your bones wears down over time. While osteoarthritis can damage any joint, it most commonly affects joints in your hands, knees, hips, and spine.

What Causes Osteoarthritis?

Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates. Cartilage is a firm, slippery tissue that enables nearly frictionless joint motion. In osteoarthritis, the slick surface of the cartilage becomes rough. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone, causing pain, stiffness, and reduced mobility.

Several factors can contribute to the development of osteoarthritis:

• Age: The risk of osteoarthritis increases with age, with most people showing some signs of wear and tear in their joints by middle age.
• Gender: Women are more likely to develop osteoarthritis than men, especially after age 50.
• Obesity: Excess weight puts additional stress on weight-bearing joints, such as your knees and hips, accelerating the breakdown of cartilage.
• Joint injuries: Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis in the affected joint.
• Repetitive stress: Jobs or activities that place repetitive stress on a particular joint can lead to osteoarthritis in that joint.
• Genetics: Some people inherit a tendency to develop osteoarthritis.
• Bone deformities: Some people are born with malformed joints or defective cartilage, which increases their risk.
• Certain metabolic diseases: Diabetes and other metabolic disorders can accelerate the breakdown of cartilage.

Recognizing the Symptoms of Osteoarthritis

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

• Pain: Affected joints may hurt during or after movement.
• Stiffness: Joint stiffness is most noticeable upon awakening or after a period of inactivity.
• Tenderness: Your joint may feel tender when you apply light pressure to or near it.
• Loss of flexibility: You may not be able to move your joint through its full range of motion.
• Grating sensation: You might hear or feel a grating sensation when you use the joint.
• Bone spurs: These extra bits of bone can form around the affected joint, feeling like hard lumps.
• Swelling: Inflammation of the soft tissues around the joint may cause swelling.

Diagnosis of Osteoarthritis

During physical examination, your doctor will check the affected joint for:

• Tenderness
• Swelling
• Redness
• Flexibility
• Range of motion

Diagnostic tests that help confirm osteoarthritis include:

• X-rays: Cartilage doesn't show up on X-ray images, but cartilage loss is revealed by a narrowing of the space between the bones in your joint. X-rays may also show bone spurs around a joint.
• MRI: This imaging test uses radio waves and a strong magnetic field to produce detailed images of bone and soft tissues, including cartilage. An MRI isn't commonly needed to diagnose osteoarthritis but may help provide more information in complex cases.
• Blood tests: While there's no blood test for osteoarthritis, certain tests can help rule out other causes of joint pain, such as rheumatoid arthritis.
• Joint fluid analysis: Your doctor might use a needle to draw fluid from an affected joint, which is then examined for inflammation and to determine whether your pain is caused by gout or an infection rather than osteoarthritis.

Treatment Options for Osteoarthritis

While there's no cure for osteoarthritis, treatments can help reduce pain and maintain joint movement. Treatment options include:

Non-Surgical Treatments

1. Medications:
   • Pain relievers such as acetaminophen (Tylenol) can help alleviate pain.
   • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) can reduce both pain and inflammation.
   • Duloxetine (Cymbalta), a medication for depression, is also approved to treat chronic musculoskeletal pain, including osteoarthritis pain.
2. Physical therapy: A physical therapist can help you develop an exercise program that strengthens the muscles around your joint, increasing flexibility and reducing pain.
3. Occupational therapy: An occupational therapist can help you discover ways to do everyday tasks without putting extra stress on your already painful joint.
4. Supportive devices: Canes, walkers, braces, shoe inserts, and other devices can help reduce stress on your joints.
5. Injections:
   • Corticosteroid injections can reduce inflammation and provide short-term pain relief.
   • Hyaluronic acid injections may offer pain relief by providing some cushioning in your knee.
   • Platelet-rich plasma (PRP) involves injecting portions of your own blood into the affected joint, which may reduce pain and improve function.

Surgical Treatments

If conservative treatments don't provide sufficient relief, your doctor may suggest surgery:

1. Arthroscopy: For minor arthroscopic procedures, your surgeon inserts a small, flexible tube through a small incision near your joint to repair tears or remove loose cartilage.
2. Osteotomy: This procedure involves cutting and reshaping bones to reduce pressure on the joint.
3. Joint replacement (arthroplasty): In joint replacement surgery, your surgeon removes the damaged joint surfaces and replaces them with plastic and metal parts. Surgical risks include infections and blood clots, and artificial joints can wear out or become loose and may need to be replaced.

Lifestyle Modifications and Home Remedies

Lifestyle changes that can help manage osteoarthritis include:

• Exercise: Low-impact activities like swimming, walking, and cycling can strengthen the muscles around your joints, increase flexibility, and reduce pain.
• Weight management: Losing excess weight reduces stress on weight-bearing joints, such as your knees and hips.
• Heat and cold therapy: Applying heat or cold to painful joints can provide temporary relief.
• Acupuncture: Some people find that acupuncture helps relieve osteoarthritis pain.
• Dietary supplements: Glucosamine and chondroitin supplements have mixed results in research, but some people report they help relieve pain.
• Yoga and tai chi: These movement therapies involve gentle exercises and stretches combined with deep breathing that may help reduce osteoarthritis pain and improve movement.

Advanced Treatment Options at Ayushman Hospital, Nagpur

Dr. Murali B.K. at Ayushman Hospital in Nagpur offers cutting-edge treatments for osteoarthritis, including:

• Advanced minimally invasive arthroscopic procedures
• Regenerative medicine therapies including PRP and stem cell treatments
• Computer-assisted joint replacement surgery for precise implant positioning
• Multi-disciplinary approach with pain management specialists and physical therapists
• Customized rehabilitation programs for optimal recovery

Prevention Strategies

While you may not be able to prevent osteoarthritis, you can reduce your risk and slow its progression:

• Stay active but don't overdo it: Regular exercise strengthens the muscles around your joints, which can help prevent wear and tear on cartilage.
• Control your weight: Excess weight puts additional stress on weight-bearing joints.
• Avoid injury: Major joint injuries can cause cartilage damage, leading to arthritis.
• Use proper posture: Good posture can prevent uneven wear and tear on your joints.
• Rest when needed: Give your joints time to recover after intense activity.

When to See a Doctor

If you have joint pain or stiffness that doesn't go away, make an appointment with your doctor. Early diagnosis and treatment can help manage osteoarthritis symptoms and prevent the condition from worsening.