Osteoarthritis (osteoarthritis, deforming osteoarthritis, DOA) is a very common disease in which the destruction of articular cartilage, bones under them, as well as other elements of the joint occurs. At the same time, the recovery processes in the joints slow down.
Manifestations of osteoarthritis have individual characteristics in individual people, and also depend on the type of affected joint. Some people have significant joint damage without any external symptoms. In other cases, even in the presence of pronounced subjective sensations, the mobility of the joint is practically not limited.
The three main signs of osteoarthritis are:
All this can lead to soreness, stiffness and impaired joint function.
Most often, osteoarthritis affects the knees, spine, small joints of the hands, thumb joint and hip joints. However, the disease can affect any other joint in the body.
In Europe osteoarthritis affects from 10% to 12% of the entire population, which is more than 14,000,000 people. Osteoarthritis usually develops in people over the age of 50 and is more common in women than in men.
It is commonly believed that osteoarthritis is an inevitable part of aging, but this is not entirely true. In elderly people, during X-ray examination, tissue changes associated with the disease are visible, however, these disorders do not always cause painful sensations or problems with joint mobility. Young people can also suffer from osteoarthritis, often the reason for this is an injury or other joint disease.
It is impossible to completely recover from osteoarthritis, but the symptoms can be alleviated with the help of various medical procedures, as well as physical exercises or comfortable shoes. However, with more advanced cases of the disease, surgery may be required.
The main symptoms of osteoarthritis are painful sensations and joint stiffness. You may experience difficulties with the mobility of damaged joints or discomfort when performing certain actions. However, osteoarthritis may not cause any symptoms at all or the pain may be episodic. Most often, one or more joints are affected. The disease can progress slowly.
Other symptoms characteristic of osteoarthritis:
Osteoarthritis is most affected by the knee, hip joints, joints of the arms and spine.Knee with osteoarthritis copy.jpg
In osteoarthritis of the knee joints, the process is usually bilateral. At first, symptoms appear in one knee, and eventually in the other. The exception is post-traumatic osteoarthritis, when only the previously injured knee is exposed to the disease.
Pain in the knee joints can be most intense when walking, especially when climbing uphill or stairs. Sometimes the knee joint may "pop out" under the weight of the weight or there may be difficulties with fully straightening the leg. You may also hear slight clicks as the affected joint moves.
Osteoarthritis of the hip joint often causes difficulties in hip movement. There may be difficulties with putting on socks and shoes, boarding and disembarking from the car. With osteoarthritis of the hip joint, pain is felt in the groin area or on the outside of the thigh, which increases with movement.
Sometimes, due to the peculiarities of the nervous system, the pain may be felt not in the hip, but in the knee.
In most cases, pain will occur while walking, at the same time, pain at rest is not excluded. If you experience severe pain at night (during sleep), your doctor may refer you to an orthopedic surgeon to resolve the issue of joint replacement (endoprosthetics).
Osteoarthritis of the spine The most prone to osteoarthritis of the spine are the neck and lower back, since these are the most mobile parts of it.
If the cervical spine is affected, the mobility of the cervical joints may be reduced, which affects the ability to turn the head. Pain may occur if the neck and head are in the same position for a long time or in an uncomfortable position. Neck muscles may spasm, pain may be felt in the shoulders and forearms.
When the lumbar spine is affected, pain occurs when bending or lifting weights. During rest after performing physical exercises or bending the torso, stiffness is often observed. Pain in the lower back can sometimes move to the hips and legs.
Basically, osteoarthritis affects three areas of the hand: the base of the thumb, the middle joints and the joints closest to the fingertips.
Fingers can lose mobility, swell and cause you pain, and the formation of bumps on the joints of the fingers is also possible. However, over time, the pain in the fingers may decrease and eventually disappear altogether, although bumps and swelling may remain.
Your fingers may be slightly bent to the side in the area of the affected joints. It is possible to develop painful cysts (fluid-filled seals) on the back of the fingers.
In some cases, a lump may form at the base of the thumb. It can be painful and restrict the performance of certain actions— such as, for example, writing, opening a jar or turning a key in a keyhole.
Osteoarthritis occurs when there is damage inside or around the joint that the body cannot repair. The exact causes are not known, but there are several factors that increase the risk of developing the disease.
In everyday life, the joints of your body are regularly subjected to stress and receive microtrauma. In most cases, the body is able to cope with the damage on its own. As a rule, the recovery process goes unnoticed, and you do not experience any symptoms. Types of injuries that can lead to the development of osteoarthritis:
On your joints, lump-like nodes may occur in places where marginal bone growths, called osteophytes, form on the bones. Due to the thickening and enlargement of bones, your joints will become worse to move and hurt. Due to inflammation, fluid may accumulate in the joints, which leads to the formation of edema.
It is not known why osteoarthritis worsens the restoration of damaged joint tissues. However, a number of factors presumably contribute to the development of the disease. They are presented below:
Consult a doctor if you suspect that you have osteoarthritis. There is no special test to detect this disease, so the doctor will ask you about the symptoms and examine your joints and muscles. The probability of developing osteoarthritis increases in people:
If your symptoms are slightly different from those listed above, your doctor may assume that you have a different form of arthritis. For example, if you have a feeling of stiffness in the joints in the morning that lasts more than an hour, this may be a sign of an inflammatory form of arthritis.
Additional tests, such as an X-ray examination or a blood test, can be used to rule out other causes of symptoms, such as rheumatoid arthritis or a fracture. However, they are not always required for the diagnosis of osteoarthritis.
Treatment of osteoarthritis is aimed at relieving pain, reducing disability and supporting an active lifestyle in patients with osteoarthritis for as long as possible. Osteoarthritis cannot be cured completely, but treatment can alleviate the symptoms and prevent their impact on daily life. First of all, it is recommended to try to cope with the disease without medication, for what:
If you have mild or moderate osteoarthritis, you may not need additional treatment. Your doctor can give you advice on how to manage your symptoms with lifestyle adjustments. This may be enough to control the disease.
Osteoarthritis can be controlled by improving overall health. Your doctor can give you advice on how you are able to help yourself: for example, how to lose weight and lead an active lifestyle.
Physical exercises are the dominant way of treating osteoarthritis, regardless of the age and level of physical fitness of the patient. Your physical activity should include a set of exercises to strengthen muscles and improve overall physical fitness.
If osteoarthritis causes you pain and stiffness, it may seem to you that exercise will worsen the course of the disease, but this is not the case. As a rule, regular physical exercises improve mobility in the joints, lead to strengthening of the muscular corset of the body and weakening of the symptoms of the disease. Exercises are also good for relieving stress, weight loss and improving posture, which in combination will greatly facilitate the course of osteoarthritis.
Your attending physician or physiotherapist can make an individual lesson plan, including exercises that you can do yourself at home. It is important to follow this plan, as in some cases excessive load or improper exercise can lead to joint damage.
Overweight or obesity worsens the course of osteoarthritis. Excess weight increases the load on damaged joints, the ability to restore which is reduced. The joints of the lower extremities, on which the main weight falls, experience a special load.
The best way to lose weight is a proper exercise regime and a healthy diet. Before starting classes, the training plan should be discussed with your doctor. It will help you create an optimal exercise program for you. Your doctor will also advise you how to lose weight slowly and without harming your health.
Your doctor will discuss with you a list of medications that will help control the symptoms of osteoarthritis, including painkillers. You may need a combination of several treatment methods: physiotherapy, medications, as well as surgical correction methods.
The type of painkiller (analgesic) the doctor may recommend to the patient, depending on how severe the pain is, as well as on whether the patient has other diseases or health problems.If you experience pain caused by osteoarthritis, your doctor may first suggest taking paracetamol. It can be bought in pharmacies without a prescription. It is best to take it regularly, rather than waiting until your pain becomes unbearable.
If paracetamol is ineffective, the doctor may prescribe stronger painkillers. These may be nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are painkillers that reduce inflammation. There are two types of NSAIDs, and they work differently. The first type is traditional NSAIDs (for example, ibuprofen, naproxen or diclofenac), the second type is COX-2 inhibitors (cyclooxygenase 2), which belong to the coxib group (for example, celecoxib and etoricoxib).
Some NSAIDs are available in the form of creams that are applied directly to the area of the affected joints. Most NSAIDs are available in pharmacies without a prescription. They can be especially effective if you have osteoarthritis of the knee joints or hands. The drugs relieve pain and at the same time reduce swelling in the joints.
NSAIDs may be contraindicated in people with certain diseases, such as asthma, stomach ulcers or angina pectoris. It is also not recommended to take NSAIDs shortly after a heart attack or stroke. Do not take ibuprofen or diclofenac without a doctor's prescription if you have at least one of the above contraindications. If you are taking aspirin in small doses, consult your doctor whether you should use NSAIDs.
If a doctor prescribes NSAIDs, he usually also prescribes simultaneous administration of so-called proton pump inhibitors (PPIs). The fact is that NSAIDs can damage the gastric mucosa, which protects it from the destructive effects of hydrochloric acid. PPIs reduce the amount of hydrochloric acid produced by the stomach, reducing the risk of mucosal damage. When taking COX-2 inhibitors, the risk of stomach problems is low, but, nevertheless, you need to take PPIs if you use COX-2 on a regular basis.
Opioid analgesics, such as codeine— are another type of painkillers that can relieve pain if paracetamol does not have the desired effect. Opioid analgesics can relieve severe pain, but at the same time they can cause side effects such as drowsiness, nausea and constipation.
Codeine is found in the composition of common drugs in combination with paracetamol — for example, in such as "Codelmixt". Other opioid analgesics that can be prescribed for osteoarthritis include tramadol and dihydrocodeine ("DHA Continuus"). Both drugs are available in the form of tablets and solutions for injection. Tramadol is contraindicated if the patient has epilepsy. Dihydrocodeine is not recommended for patients with chronic obstructive pulmonary disease (COPD). Opioid analgesics are contraindicated for pregnant women. Opioid analgesics are dispensed at the pharmacy strictly according to a doctor's prescription.
When prescribing opioid analgesics, the doctor may prescribe a laxative to avoid constipation.
If you have osteoarthritis of the joints of the hands or knees, and NSAIDs do not relieve the pain, the doctor may prescribe an ointment with capsaicin. Ointments with capsaicin block the transmission of nerve impulses that cause pain. The effect of the drug develops after some time from the start of use. The pain should subside a little during the first two weeks of applying the ointment, but it may take up to a month before the treatment becomes fully effective.
To achieve the effect, apply a small amount of ointment (the size of a pea) to the skin in the area of the affected joints no more than four times a day. Do not apply capsaicin cream to damaged or inflamed skin and always wash your hands after the procedure.
Do not allow the capsaicin cream to get on sensitive skin areas, such as eyes, mouth, nose and genitals. Capsaicin is obtained from chili peppers, so if it gets on sensitive areas of the body, it can cause very painful sensations for several hours. However, this will not cause serious harm to health.
You may notice a burning sensation on the skin after applying capsaicin ointment. There is nothing to worry about, and the longer you use it, the less such feelings will appear. However, try not to use too much ointment and do not take a hot bath or shower before and after applying it, as this can increase the burning sensation.
In severe forms of osteoarthritis, treatment with painkillers may not be sufficient to control the symptoms of the disease. In this case, it is possible that the drug is injected directly into the joint affected by osteoarthritis. This procedure is known as intra-articular injection.
Most often, intra-articular injections of corticosteroids are used to treat osteoarthritis, reducing swelling and pain. Also in our country, hyaluronic acid is used for injections, which is a natural component of intra-articular fluid and reduces joint pain for a period of 2 to 12 months after the procedure. While the National Institute of Health and Clinical Practice of the UK does not recommend intra-articular injections of hyaluronic acid.
When performing percutaneous electroneurostimulation (CHANCE), an apparatus is used that helps to ease the pain caused by osteoarthritis. The procedure causes numbness of the nerve endings in the spinal cord that control the perception of pain, and you stop feeling pain.
The application of hot or cold compresses (the procedure is sometimes called thermotherapy or cryotherapy) to the joint area can relieve pain and symptoms of osteoarthritis in some people. A hot water bottle filled with hot or cold water and applied to the affected area of osteoarthritis can effectively relieve pain. You can also purchase special hot and cold compresses that can be cooled in the freezer or heated in a microwave oven — they work in a similar way.
Joint immobility can lead to muscle atrophy and to an increase in the symptom of stiffness caused by osteoarthritis. Manual therapy sessions are conducted by a physiotherapist or a chiropractor. Stretching techniques are used in therapy to maintain the elasticity and flexibility of your joints.
If the patient's mobility is reduced due to osteoarthritis or there are difficulties with performing everyday tasks, there are various auxiliary devices. The attending physician may refer the patient to an orthopedic doctor for advice or assistance.
If the patient has osteoarthritis of the joints of the lower extremities, such as hip, knee or foot joints, the orthopedic doctor may offer special shoes or insoles for shoes. Shoes with shock-absorbing soles are designed to reduce pressure on the joints of the legs while walking. Special insoles help to distribute the weight more evenly. Orthoses and fixators work in the same way.
If a patient has osteoarthritis of the hip or knee joint, which negatively affects mobility, he may need an auxiliary support when walking — for example, a cane or wand. Use a walking stick on the side of the affected leg to partially reduce the pressure on the affected joint.
A splint (a piece of solid material used to support a joint or bone) can also be useful if you need to take the load off a sore joint. The doctor should tell you and show you how to use it correctly.
If the joints of the hands are affected, you may need help in performing everyday tasks in which the hands are involved, for example, when unscrewing a water tap. Devices such as specialized nozzles on the mixer handle can greatly facilitate the performance of such actions. The attending physician can advise and give advice on the use of special devices in your home or workplace.
Osteoarthritis requires surgery in very rare cases. Sometimes the operation is effective for osteoarthritis of the hip, knee joints or the joint of the base of the thumb. The doctor may suggest surgery if other treatments have proved ineffective, or if one of your joints is severely damaged.
If the patient needs surgery, the doctor directs him to the surgeon. Performing a surgical operation can significantly reduce the symptoms of osteoarthritis, improve mobility and quality of life. However, the operation does not guarantee simultaneous and complete relief from all symptoms, pain and stiffness of the joints may manifest depending on your condition.
There are several different types of surgical treatment of osteoarthritis. During the operation, it is possible to restore the surface of the articular cartilage, replace the joint entirely or return it to the correct position.
Arthroplasty is a joint replacement operation, most often performed with hip and knee joints affected.
During this operation, the surgeon removes the affected joint and replaces it with an artificial prosthesis made of special plastic and metal. An artificial joint can serve up to 20 years, but after some time it will need to be replaced.
There is also a new type of joint surgery called grinding. During this operation, the damaged part of the articular surfaces is removed through a small incision in the joint area and replaced with implants. When performing such operations, only metal components are used. The operation is well suited for young patients.
Arthrodesis of the joint is performed if prosthetics of the joint is not possible. This is a procedure for fixing the joint in a permanent position. The joint will become stronger and will hurt much less, but mobility in the joint is completely lost.
Osteotomy is considered in cases where the patient has osteoarthritis of the knee joints, but he is too young for surgical prosthetics (arthoplasty). The surgeon adds or removes a small part of the bone either below or above the knee joint. This helps to redistribute the load on the knee joint and reduce the pressure on the damaged part of it. Osteotomy alleviates the symptoms of osteoarthritis, although knee replacement may still be required in the future.
Many people suffering from osteoarthritis practice alternative methods of treatment. There is evidence that some of the treatments can alleviate symptoms, but experts do not agree that alternative methods can actually help slow down the development of the disease.
Acupuncture, aromatherapy and massage are the most commonly used options for additional treatment of osteoarthritis. Some people believe that such treatments help, although they can be expensive and a lot of time is spent on them.
There are several dietary supplements for the treatment of osteoarthritis, among which the two most common are chondroitin and glucosamine. Glucosamine hydrochloride has not shown a positive effect, but there is evidence that glucosamine sulfate and chondroitin sulfate can alleviate symptoms with virtually no side effects.
The cost of these supplements can be high. The National Institute of Health and Clinical Practice in the UK does not recommend the medical appointment of chondroitin or glucosamine, but recognizes that patients often take them on their own.
There are also medications containing chondroitin and glucosamine sulfates. In our country, they are used by official medicine for the treatment of osteoarthritis.
Irritant drugs exist in the form of gels and ointments, when rubbed into the skin, such drugs cause a warming effect. Some of them can be used to treat joint pain caused by osteoarthritis. Studies have shown that irritating agents have little or no effect in the treatment of osteoarthritis. For this reason, their use is not recommended.
Guaranteed to protect yourself from the development of osteoarthritis is impossible. However, it is possible to minimize the risk of developing the disease by avoiding injury and following a healthy lifestyle.
Do regular physical exercises, but try not to put too much strain on the joints, especially the hip, knee and arm joints. Avoid exercises that put your joints under excessive strain, such as running or strength training. Instead, practice swimming and cycling, in which the joints are in a more stable position and their movements are easier to control.
Try to keep a good posture at all times and avoid being in the same position for a long time. If you have a sedentary job, make sure your chair is the right height, and take regular breaks to stretch.
Your muscles help support your joints, so having strong muscles will help your joints stay healthy. Try to devote at least 150 minutes (2 hours 30 minutes) to moderate-intensity aerobic exercise (cycling or brisk walking) every week to increase muscle strength. Training should bring joy, so do what you like, but try not to overload the joints.
Lose weight if you are overweight or obese. Being overweight or obese can worsen the course of osteoarthritis.
By taking certain measures, you can lead a healthy, active lifestyle with a diagnosis of osteoarthritis. Osteoarthritis does not always progress and leads to disability.
Self-care is an integral part of everyday life. This means that you take responsibility for your own health and well-being with the support of those who also take care of you.Self-care is everything you do every day to stay in shape, maintain a good physical and mental condition. This is the prevention of diseases, accidents, timely treatment of prescriptive ailments and chronic diseases.
The lives of people suffering from chronic diseases can be significantly improved if they are properly supported. They can live longer, experience less pain and anxiety, not get depressed, get tired less often, live qualitatively at a higher level, be more active and independent.
Following a diet and regular exercise will help keep your muscles in good shape and control your weight — this will help in the treatment of osteoarthritis and improve overall health.
It is important to continue taking medications if they are prescribed, even if you have started to feel better. Continuous medication can help prevent pain, but if the medications were prescribed with a note "as needed", then there is no reason to take medications during remission.
If you have any questions or are concerned about the medications you are taking or side effects, talk to your doctor about it.
Instructions for the use of the drug may also be useful, it is written about the interaction with other drugs and supplements. Consult your doctor if you are going to purchase painkillers or dietary supplements, as they may not be combined with the medications prescribed for your treatment.
Osteoarthritis is a chronic disease, and you will be in constant contact with your doctor. A good relationship with your doctor guarantees you the opportunity to easily discuss with him any of your concerns or symptoms. The more the doctor knows, the better he will be able to help you.
Anyone suffering from osteoarthritis is recommended to undergo an annual flu vaccination. It is also recommended to be vaccinated against pneumococcal infection. It will protect against the possibility of infection with pneumococcal pneumonia.
If you have osteoarthritis, you may have difficulty moving, and the risk of injury and accidents, such as bruises or falls, increases.
Osteoarthritis of the feet most often affects the joint of the base of the big toe. This can lead to pain during walking and the appearance of bursitis of the big toe, which is accompanied by the formation of a bone outgrowth in the area of the affected joint. The reason for this may be the wrong shoes, so you should avoid shoes with high heels. A foot retainer can relieve symptoms.
If you have had joint replacement surgery (arthroplasty), the new joint may become inflamed. Septic arthritis (infectious arthritis) is a serious complication that requires urgent treatment in a hospital.
Many people find it useful to communicate with people suffering from the same disease. You can chat with a group or individually with someone who suffers from osteoarthritis. And there are groups in your city where you can chat with other people with osteoarthritis.
The diagnosis of "osteoarthritis" can be dumbfounded and confusing. Like many people with chronic diseases, osteoarthritis patients may experience anxiety or depression. There are people with whom communication can be useful. Talk to your doctor if you feel that you need support to cope with the disease.
A severe form of osteoarthritis can affect your performance. In some cases, difficulties in performing work duties can be overcome with the help of some changes in the workplace. However, if you are unable to work due to an illness or work only during periods of remission, you are entitled to sick leave payments, as well as disability registration.