Osteoarthritis or osteoarthrosis is a degenerative disease of the joints which involves the wearing of the cartilage between the joint which results in tension and friction of the two adjacent bones. The cartilage is responsible for joint motion and provides load-bearing surface of joints and low-friction movement. When the cartilage is damaged, the bone compensates by hardening and forming a cyst. Because of this, there is resulting pain and inflammation around the joint. Osteoarthritis also involves other tissues around the joint such as the muscles, ligaments, synovium and the joint capsule. It usually develops on the weight-bearing joints in the body such as the knees, hips and cervical vertebrae.
Osteoarthritis develops in stages which include:
Stationary Phase-This phase involves the formation of osteophytes on the damaged cartilage with resulting joint space narrowing.
Obliteration of joint space- The resulting growth of bone in the joint space leads to obliteration. Because of this, the bones come in contact with each other and produces friction that lead to inflammation and pain.
Erosive Phase- This phase involves the growth of subchondral cysts or cysts underneath a cartilage.
Bone repair and remodeling- The last phase of the disease progression involves remodeling of the bone in the joint in its attempt to repair itself.
There are many different possible causes of osteoarthritis and various contributing factors including diabetes, acromegaly and obesity which place undue tension on weight bearing joints such as the knees. Trauma and infection on the joint also causes the cartilage and surrounding tissues to be damaged. Other conditions that may lead to osteoarthritis include genetics, congenital malformations of the bones and metabolic diseases that damage the surface of the joints.
The symptoms of osteoarthritis involve pain, joint stiffness, inflammation and swelling in the area which limits the joint movement. Treatments for osteoarthritis focus on supportive managements to reduce symptoms and improve range of motion of the joint. These include:
Weight reduction significantly reduces the tension on weight bearing joints. Patients are instructed to reduce weight through exercise and proper diet.
Exercise is thought to improve muscle strength and stimulate cartilage joint formation. Exercises should be non-impact in the form of aerobics, range of motion exercises and stretches.
Use of Warm Packs
Warm packs may be placed over the affected joint to reduce pain and relax the muscles. Apply warm packs for 15 minutes two to three times a day.
Use of Anti-inflammatory medications
Over-the-counter NSAIDs as well as prescription anti-inflammatory drugs are given to reduce inflammation and pain. The most common anti-inflammatory drugs used are ibuprofen, aspirin and naproxen. Newer NSAIDs come in the form of COX-2 inhibitors, which have lesser gastrointestinal side-effects than the COX-1 preparation. The most popular COX-2 drug used for osteoarthritis is celecoxib.
Use of Chondroitin and Glucosamine
Chondroitin and Glucosamine are natural chemicals found in the synovial fluid. Administration of exogenous forms may help stimulate synthesis of collagen and proteoglycans, responsible for building cartilage. The use of Glucosamine should be monitored in diabetes because this drug may increase glucose levels in the blood.
Surgery may also be employed in severe cases of osteoarthritis. Surgery types include chondroplasty (repair of the cartilage), osteomy (removal of bone growths) and joint replacement (involves the replacement of damaged joints by artificial joints).
As always, surgery should only be considered as a last resort in the most severe cases, but seeking alternative and less invasive treatments like those offered by Dr. Mohr, your Tampa chiropractor, are always your best first line of defense.