Osteoarthritis

Introduction Osteoarthritis is one of the commonest joint problems. Millions of people, particularly those above 40 years of age, have this degenerative disease. Osteoarthritis (OA) develops when the protective cartilage that cushions the ends of your bones of the joint wears down over time. This leads to reduced mobility, joint pain, and stiffness. Osteoarthritis can develop in any joints but is more common in the knees, hips, neck, and lower spine. Along with wear-down of the articular cartilage, it can also be characterized as subchondral bone sclerosis, osteophyte formation, and biochemical changes in the synovial membrane and joint capsule.

What are the Different Types of Osteoarthritis? Osteoarthritis can be of two types: Primary Osteoarthritis: Most common form

• Caused by normal age-related degeneration, with no specific identifiable cause
• Develops gradually over time
• Can be localised, generalised, or erosive

Secondary Osteoarthritis:

• It develops due to specific causes like joint injury or trauma, infection, inflammatory diseases, or previous joint surgery.

What are the Symptoms of Osteoarthritis? OA is a gradually developing condition of the joint that can cause subtle to troubling symptoms. These include:

• Joint pain that increases with activity and improves with rest
• Morning stiffness that improves less than 30 minutes after waking up
• Joint swelling, especially after prolonged activity
• Reduced range of movements
• Crackling noise or grating sensation when you move the joint (Crepitus)
• Crooked limbs or deformity (especially in knee OA)
• Daily activities like climbing stairs, squatting, or walking long distances become difficult
• You might feel some hard lumps around the affected joint (bone spur)

What are the causes of osteoarthritis? Primary osteoarthritis develops due to the wear and tear of the joint caused by aging. Several factors increase your risk of developing osteoarthritis, including:

• Age: Risk increases significantly after 45 years
• Gender: Women are more affected, especially after menopause
• Genetics: A family history of OA increases the risk
• Congenital joint abnormalities like Joint hypermobility syndrome
• Joint injuries: Previous trauma or overuse
• Other forms of arthritis: Gout or rheumatic arthritis increases the risk of OA
• Occupational factors: Jobs requiring repetitive joint stress
• Obesity: A major risk factor as extra weight puts undue pressure on the joint, increasing the risk
• Metabolic diseases: Diabetes and hemochromatosis increase the risk
• Lifestyle factors: Sedentary behaviour and limited movement of the joint increase the risk

How to Diagnose Osteoarthritis? Diagnosis typically involves: Clinical history review: Doctors ask you about your symptoms and what is the trigger activity that worsens the symptoms Physical assessment: Doctors examines the affected joints to know the extent of damage Blood tests: To eliminate doubt about other forms of arthritis X-rays: Show joint space narrowing, osteophytes, subchondral sclerosis and deformity MRI: For detailed evaluation of cartilage, ligaments, and other soft tissues (in early stages) Ultrasonography: To assess inflammation and joint effusion

What is the treatment for osteoarthritis? Treatment of OA includes: Non-pharmacological Interventions:

• Weight management to reduce pressure on the joint
• Physical therapy & exercise programs to strengthen the muscles around your joint and decrease pain
• Assistive devices (walking sticks, braces) support joints and reduce pain during movement
• Activity modification to reduce joint strain
• Hot and cold therapy to ease stiffness and reduce swelling

Pharmacological Management:

• Analgesics for pain relief
• Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain
• Intra-articular injections (corticosteroids, hyaluronic acid) to better mobility
• Topical agents—topical creams or gels—give temporary relief

Surgical Interventions

• Arthroscopic procedures - Minimally invasive surgery to repair the damaged joint
• Osteotomy—Cutting and realigning the joint bones to relieve pressure on the joint.
• Total or partial joint replacement with artificial ones
• Joint fusion—advised in severe cases to stabilise the joint