What is Osteoarthritis?

Osteoarthritis is the most common form of arthritis and affects an estimated 26 million people in the United States. It occurs when the cartilage that cushions the ends of bones wears down over time, making it difficult for your joints to move freely.

Osteoarthritis most commonly affects weight-bearing joints such as hips, knees, ankles and shoulders. It can also affect the fingers, particularly at their base near the knuckle.

Osteoarthritis often develops as a result of aging or genetics, but certain lifestyle and environmental factors can increase your risk for developing osteoarthritis. These include:

Overweight or obesity. Being overweight makes you more susceptible to developing osteoarthritis because extra weight puts pressure on your joints, causing them to wear down faster than they normally would. A healthy diet and regular physical activity can help keep your weight under control as you get older and reduce your risk of developing osteoarthritis later in life.

Why Osteoarthritis is degenerative disease?

Osteoarthritis is a degenerative disease occurring when the cartilage between bones wears down. Cartilage acts as a cushion between bones, providing the joints with movement and stability. As you age, cartilage can become damaged or worn down, which may result in osteoarthritis.

The risk of developing osteoarthritis increases with age, starting around age 30 and increasing to 50 percent by age 70. While anyone can develop osteoarthritis, it does tend to affect older people more often than younger ones.

Osteoarthritis is degenerative disease. The cartilage in the joints breaks down over time. This is because of wear and tear on the joints.

It can be caused by any injury or trauma to the knee joint, causing damage to the articular cartilage.

Over time, the articular cartilage becomes damaged and inflamed due to wear and tear on the joints and it causes stiffness in the joints.

Osteoarthritis usually occurs in people aged 40 years or above but it can also happen at any age. It is more common in women than men.

Diagnosis

To diagnose osteoarthritis (OA), your doctor will perform a physical exam and ask about your medical history and symptoms. He or she may also order blood tests or imaging tests to rule out other causes for your symptoms. The following tests may be used:

X-rays : X-rays are often used to check for bone damage caused by OA. Abnormalities may include bone spurs or narrowing of the joint space.

Magnetic resonance imaging (MRI) : An MRI produces images of soft tissues like cartilage and ligaments as well as hard tissues like bone. An MRI is often used to help rule out other conditions that cause similar symptoms as OA such as rheumatoid arthritis, ankylosing spondylitis, gout, bursitis and tendonitis.

Treatment

Osteoarthritis treatment is aimed at relieving symptoms and slowing progression of the disease. Non-surgical treatments include:

Pain relievers, such as acetaminophen (Tylenol), ibuprofen (Advil) or naproxen sodium (Aleve). These drugs can help reduce pain and swelling. But don’t use them for more than 10 days without checking with your doctor because they can cause serious side effects if taken at high doses over a long period of time.

Over-the-counter topical creams or gels that contain capsaicin, a substance found in hot peppers, may help relieve pain. Capsaicin works by depleting substance P, a chemical that sends pain signals to the brain. Your doctor may suggest using it before exercise to improve flexibility and reduce stiffness.

Exercise programs that build strength and improve flexibility can help slow osteoarthritis progression by keeping joints strong and flexible. Activities such as swimming, walking, bicycling or low-impact aerobics are good choices because they’re low impact on your joints but still provide cardiovascular fitness benefits.

Weight loss can improve joint function by reducing stress on weight-bearing joints such as knees and hips. A healthy diet that includes plenty of fruits and of course exercise.

Non-Pharmacologic

When osteoarthritis is severe or progressive, non-pharmacologic approaches may be useful. These include physical therapy and exercise programs that improve balance and reduce joint stress.

Physical therapy is recommended for patients with osteoarthritis who have joint pain and minimal deformity, as well as those who have had an acute injury or surgery on their joints. The goal of physical therapy is to increase mobility and decrease pain. Physical therapists use a variety of treatment techniques, including joint mobilization (massaging the joint to improve mobility), heat and cold treatments, ultrasound, electrical stimulation, and massage therapy.

Joint injections with corticosteroids (steroid medications) may be used to relieve pain in some patients with osteoarthritis of the knee or hip. Injections are usually given just under the skin around the affected joint. They may help reduce swelling and allow movement at the affected joint for several months after injection but do not improve long-term outcomes for most people with osteoarthritis.

Pharmacologic

The most common treatment for osteoarthritis is non-steroidal anti-inflammatory drugs (NSAIDs). These include aspirin, ibuprofen and naproxen. NSAIDs work by reducing inflammation and pain. They also have effects on cartilage synthesis, which may slow disease progression.

If the pain is severe or does not respond to NSAIDs, corticosteroids may be used. They are usually injected into the joint space and may relieve symptoms for several weeks. Cortisone injections are not recommended for long-term use because of side effects such as weight gain and high blood pressure.

Surgical options include knee replacement surgery, hip replacement surgery and partial knee replacement surgery (patellofemoral arthroplasty). In these procedures, damaged cartilage is removed from the joint surface and replaced with metal or plastic implants designed to restore function and improve quality of life.

Alternative Medicine to Osteoarthritis?

Alternative medicine is a broad term that describes the use of non-traditional, holistic and unconventional practices. The term is often used interchangeably with complementary medicine, which may or may not be considered alternative. Alternative medicine is generally used outside of conventional medicine to treat chronic conditions and diseases such as osteoarthritis.

Types of Alternative Medicine

Alternative medicine therapies include natural products and dietary supplements, mind-body interventions, biofeedback techniques, energy healing methods and mind-body movement therapies. Some of these therapies are supported by scientific research while others are not well documented in the medical literature.

Natural Products and Dietary Supplements

Some natural products that have been shown to have benefit for osteoarthritis include fish oil supplements (omega-3 fatty acids), glucosamine sulfate supplements, chondroitin sulfate supplements and green tea extracts (catechins). These supplements are thought to work by reducing inflammation in joints, slowing cartilage breakdown or possibly helping repair damaged cartilage.

Clinical Trials for Osteoarthritis

There are many different types of clinical trials for different kinds of diseases and conditions, including osteoarthritis trials:

– Efficacy trials (or phase III trials) are used to determine whether a treatment is effective or safe. These studies involve large numbers of participants at multiple sites around the world. Phase III trials can include double-blind randomized controlled trials (DBRCTs), which compare an experimental drug with a placebo or an existing standard treatment; open label randomized controlled trials (OLRCTs), which compare new drugs with existing ones; and single-arm phase II/III trials, which provide data on safety and efficacy but do not compare equal treatments with each other.

– Safety/toxicity studies evaluate how safe a drug is when taken by people at different doses over different periods of time to determine what side effects might happen if apply it to patients.