Osteoarthritis

Osteoarthritis (OA), sometimes called degenerative joint disease, is the most common form of arthritis. It affects nearly 1 out of every 10 Canadians, occurs equally in women and men, and usually develops after age 45. It is a painful and sometimes debilitating condition that can affect several joints including the hips, knees, neck, shoulders, back, fingers and big toes. Osteoarthritis is defined as the breakdown and eventual loss of cartilage in one or more joints. Cartilage is a cushioning substance that covers the ends of the bones and serves as a shock absorber, preventing the bones from rubbing against each another. When cartilage begins to degenerate, it thins and the cushioning between the joints is lost, resulting in joint pain.

Causes

Several factors increase the risk of osteoarthritis:

  • Family history
  • Wear and tear (job or sport with repetitive movement)
  • Lack of physical activity
  • Obesity
  • High heel shoes (knees OA)

Symptoms

Osteoarthritis limits joint mobility and hinders overall movement. Over time, the cartilage deteriorates and small but painful outgrowths called bone spurs or osteophytes can form in the joint. This causes the joints to become deformed, swollen and stiff. In addition to causing pain, this joint disease causes sensitivity to pressure and stiffness after a prolonged period of inactivity. When a joint reaches an advanced stage of OA, the cartilage wears away completely and bone-on-bone contact occurs.

Diagnosis

Osteoarthritis is a disease that requires a medical diagnosis. During the consultation, the doctor will ask for a detailed description of the pain, its exact location, and what elicits the most pain (sitting in a car for extended periods, exercising, etc.). The doctor will then want to rule out other possible causes. Blood tests, x-rays and even a synovial fluid (lubricant around the joints) analysis may be ordered.

Treatment

Treatment focusses mainly on symptom relief, including pain. Acetaminophen (Tylenol®) is usually the treatment of choice. Anti-inflammatories may also be used to reduce inflammation. Ointments and lotions can be applied on the sore joint for more localized pain relief. Compresses may also help alleviate pain. Use cold compresses to reduce inflammation and warm compresses to reduce stiffness.

In more severe cases, codeine may be prescribed to help relieve pain. Codeine however, can cause drowsiness, stomach upset and constipation. Older patients tend to be more sensitive to its effects. Cortisone injections, which involve administering injections directly into the joint, are another option worth considering when movement is seriously impeded. While the full effect of an injection can take a few days, it lasts several weeks and even several months. Individuals can receive between 2 and 4 cortisone injections yearly.

As a last recourse, when the joint becomes unusable or when the pain is intolerable, replacing the damaged joint with an artificial joint by way of a surgical procedure is possible. This type of surgery is known as arthroplasty.

For more information or for support :

The Arthritis Society

www.arthritis.ca

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