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Osteoarthritis

What is Osteoarthritis?

The term "arthritis" refers to over 100 diseases affecting the joints and the areas surrounding them. Osteoarthritis, rheumatoid arthritis, gout, lupus, fibromyalgia, ankylosing spondylitis and scleroderma are all forms of arthritis.

osteoarthritis-cartilage

Arthritis By the Numbers

 Osteoarthrtitis is the most prevalent joint disease worldwide. The burden for the patient and for the economic system is enormous. Worldwide estimates are, so a WHO report from the year 2003, that 9.6 % of men and 18.0 % of women aged ? 60 years have symptomatic osteoarthritis. Radiographic studies of US and European populations aged ?45 years show higher rates for

Arthritis is the leading cause of disability. among those over the age of 15, particularly among women. osteoarthritis of the knee: 14.1% for men and 22.8% for women. Hip osteoarthritis is less common, with a radiographic prevalence of 1.9% among men and 2.3% among women aged >45 years as described in one Swedish survey. In general, osteoarthritis is more prevalent in Europe and the USA than in other parts of the world.

Symptoms of Osteoarthritis 

Osteoarthritis causes the cartilage that caps the ends of the bones to dry out and break down, triggering pain, stiffness, crackling and popping sounds on movement, and difficulty in moving the afflicted joint. As the cartilage wears away, the bone ends may begin to grind against each other, and bony overgrowth may develop. Little bits of bone or cartilage can break off and float around in the joint space, causing pain, and the joint lining (synovium) can become inflamed. In severe cases, the entire joint may become deformed. Physicians can rate the severity of osteoarthritis on a scale of 1 to 4, depending on "radiology space" This system of radiographic grading of osteoarthritis was developed by Kellgren and Lawrence and is the key in current radiological assessment of osteoarthritis. Another grading system uses the amount of space between the bones in a joint as seen on X-ray. However, this grade does not necessarily correspond with the amount of pain one experiences. 

Which Joints Are Most Likely to be Affected by Osteoarthritis? 

Osteoarthritis typically strikes in weight-bearing joints such as those found in the knees, hips, fingers, hands, ankles and spine. 

What Triggers Osteoarthritis? 

There is no "osteoarthritis germ" or other single cause of the disease. Instead, a number of factors may be to blame, including biochemical changes in the cartilage tissue, a family history of the disease, injury to the joint, weakness of the muscles supporting the joint, certain sports that cause joint overuse, Paget?s disease or other bone ailments, obesity, and repetitive motion injuries (as might occur in a data processor?s wrist, for example). 

Who Is Likely to Develop Osteoarthritis? 

The chances of developing osteoarthritis increase if you?re past age 45, you?ve had a joint injury, your joints have been repeatedly stressed, your parents had it or you?re overweight. The disease affects women a little more than it does men. Osteoarthritis can be detected in the x-rays of some 70% of those over the age of 70, although only half will actually develop symptoms. 

Does Everyone Have the Same Symptoms?

 People respond differently to the disease, with some shrugging off the symptoms and others struggling with on-going pain and disability. A patient?s age, degree of cartilage loss and joint damage, general health, attitudes toward pain and other factors all play a role in determining how much he or she will suffer from pain and other symptoms. People with different "patient profiles" may require different types of levels of treatment. 

What Do Doctors Do for Osteoarthritis? 

Standard Osteoarthritis treatment includes: 

  1. Physical therapy - Exercises are prescribed to strengthen the muscles supporting afflicted joints and increase range of movement. Heat therapy, water therapy, massage and other "hands-on" therapies are used primarily to relieve pain.
  2. Medicinal treatments:

Acetaminophen and nonsteroidal anti-inflammatory drugs such as ibuprofen are routinely prescribed for standard pain relief. 

Corticosteroids may be injected into an afflicted joint to handle more severe pain. These are fast acting drugs.

Slow acting symptomatic treatments for osteoarthritis (SYSADOA) have a slow onset of action, but their clinical efficacy gradually increases over time until it reaches an overall efficacy level comparable to that of nonsteroidal anti-inflammatory drugs. 

The reduction of symptoms lasts longer and may even persist some months after treatment has stopped. SYSADOAs are for example hyaluronic acid, chondroitin sulfate and glucosamine.

Treatments that can modify the course of osteoarthritis, are also known as (S/DMOADs) or simply structure-modifying drugs – an example is chondroitin sulfate.

3. Surgery - In the case of serious pain or where joint has been severely damaged, arthroscopy or joint replacement may be recommended.

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