Osteoarthritis

Osteoarthritis is a degenerative joint disease, classified under mechanical degradation of joints and joints tissue. Symptoms of a person with osteoarthritis will include pain within the affected joint, stiffness, 'locking' of the knee and tenderness to the touch. When cartilage wears off due to wear and tear, the bone surfaces becomes more vulnerable to physical trauma (as the cartilages serve as 'shock absorbers'). This in turn

causes pain, and the patient will limit the movement of the joint, which causes muscle atrophy and ligamental laxity.

Treatments involves a mix of exercise therapy, lifestyle changes and modifications, and painkillers to lessen or manage the pain. If the pain experienced becomes overpowering, patients who have less risk often undergo joint replacement surgery such as hip replacement, knee replacement of the joint with osteoarthritis.

Osteoarthritis is a very common form of arthritis, and a big cause of long term impairment and disability.

Signs And Symptoms

Symptoms include pains (aching, pulling, burning) in joint and surrounding joint structures, loss of mobility and function, as well as decreased use. Sometimes movements will cause a cracking noise (known as crepitus), and accompanied by muscle spasms. Our patients also will often complain that the differences in weather e.g. moving from a cold room to a hot room or vice versa will result in a cramping ache.

OA often affects mobile and more weight bearing joints, such as the mobile hands, or the larger weight bearing hips and knees. As it progresses, the joints enlarge, becoming increasingly more painful and decreasing in mobility, as the day progresses. This distinguishes it from its related cousin,rheumatoid arthritis, that often gets better as time goes by.

In smaller joints such as the joints of the hands and fingers, Heberden's nodes can form on the end finger joint, and Bouchard's nodules can form on the joints just after the knuckles (refer to the picture by Drahreg01). They are not always painful, but they do restrict the movement of the fingers.

Causes Of Osteoarthritis

There are two types of OA classified: primary and secondary. Primary OA is the chronic degenerative disorder that is related by is not primarily caused by aging (some people in their 80+ or 90+ have no OA at all). Over time, the cartilages in our joints shrink, and becomes less resilient.

Secondary OA is caused by a variety of factors, but ends up with the same pathological results as of the primary OA. Some of the causes are listed here:
1. Joint disorders.
2. Diabetes mellitus.
3. Any/all forms of inflammatory/arthritic diseases.
4. Direct trauma.
5. Joint infections.
6. Ligamental laxity or instability.
7. Obesity.
8. Other syndromes such as marfan's syndrom and wilson's disease.

Treatments

A combination of treatment approaches and modalities for a more effective outcomes are recommended. Lifestyle changes and modification such as adopting a more active lifestyle of healthy eating, exercise and weightloss), coupled with painkillers are some of the long term solutions.
Physical therapy helps to improve function, increase strength and mobility, decrease pain and delay the need for surgery. The exercise therapy that is prescribed by physiotherapists is documented to be more effective than that of a pure pharmaceutical approach. Some of the targeting areas include balance training, gait correction re-training, and functional mobilization. Hand therapists often prescribe custom-made splints to prevent aggravation and deformities.

This article was contributed to Tab A Doctor by,
Ms Louise Yow, Physiotherapy, UrbanRehab Pte Ltd, Physiotherapy & Rehabilitation Specialists