Osteoarthritis

General

Osteoarthritis, also called Degenerative Joint Disease, is the most common form of arthritis, affecting millions of people around the world. 14% of those over 25 years of age are afflicted, and 33.6% of those over 65. Often called wear-and-tear arthritis, osteoarthritis affects all aspects of a joint, including the protective hyaline cartilage on the ends of your bones, joint ligaments, and the bones themselves. When these structures wear down over time, pain is often the end result.

While osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, neck, lower back, knees and hips. OA does not have the systemic symptoms that usually accompany Rheumatoid Arthritis, such as fatigue and a sudden onset of bilateral joint pain.

Osteoarthritis gradually worsens with time, and no cure exists. But osteoarthritis treatments can slow the progression of the disease, relieve pain, improve joint function and most importantly improve quality of life. Pain from OA is one of the most common causes that prompt patients seek care at a Novocur facility.

Symptoms

The pain from OA generally begins slowly and worsens over time.

  • Pain. Your joint may hurt during or after movement. Sometimes the pain is delayed hours or even a day after activity as the inflammation process is ramping up.
  • Tenderness. Your joint may feel tender when you apply light pressure to it.
  • Stiffness. Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity and usually improves as one gets moving. Morning stiffness should resolve within an hour of waking.
  • Loss of flexibility. You may not be able to move your joint through its full range of motion.
  • Grating sensation. You may hear or feel a grating sensation when you use the joint.
  • Bone spurs. These extra bits of bone, which can feel like hard lumps, may form around the affected joint.
Treatment

  • Pharmacological Intervention.
    • Tylenol can help reduce pain, but does not reduce inflammation. Tylenol may be effective for mild to moderate arthritic changes, but is not usually effective for severe changes. Liver damage may occur with over use or dosing.
    • NSAID’s. Ibuprofen and naproxen can help reduce inflammation and pain. Stronger NSAID’s are available by prescription. Gastrointestinal bleeding is a serious complication of NSAID use for chronic pain. Kidney and liver damage can also occur.
    • These prescription drugs contain powerful analgesic properties to help relieve the pain of more severe arthritis. There is a risk of dependence, but severe pain can outweigh that risks for some.
  • Physical Therapy/Chiropractic Care. Stabilizing joints through aligning, strengthening and increasing flexibility can slow the progress of arthritis and help reduce pain. Often, occupational therapy is needed to show how to accomplish everyday activities in a less painful manner, such as brushing teeth or hair, rising from a chair, or twisting a top. Bracing, orthotics and other aids can help reduce pain, increase balance and take pressure off painful joints.
  • Intra-articular or Peri-articular Cortisone Injections.An injection of a corticosteroid either inside the joint space or into the surrounding joint tissue can rapidly reduce inflammation and pain. Sometimes nerve tissue that innervates the arthritic joint is targeted to reduce the firing of pain signals from the joint. There is a limit to the number of these injections you can receive within a year to reduce chances of further joint damage or systemic effects.
  • Epidural Injection.An injection of a corticosteroid into the epidural space overlying the spine can rapidly reduce inflammation and back or neck pain as a result of degenerative changes in the spine at the level of the disc or nerve roots.
  • Facet Injection.An injection of a corticosteroid medication around the nerves that supply pain signals from the facet joints can rapidly reduce inflammation and pain in the back or neck area.
  • Trigger Point Injection.Injections of an anesthetic mixed with a corticosteroid into the soft tissue surrounding a painful and swollen arthritic joint often helps reduce the pain associated with that joint. Often, the pain associated with a degenerated joint comes from the irritation of surrounding soft tissue. This irritation occurs from altered joint movement, compensation movement, altered gait, weakness, or instability that arises from OA.

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