Osteoarthritis is a generative joint disease that involves the degradation of joints, articular cartilage and subchondral bone, as a result of mechanical stress on the area.
The word osteoarthritis is derived from the Greek word parts below.
- osteo which means “of the bone”
- arthr which means “joint”
- itis which means “inflammation”
Despite the name of the condition, the inflammation associated with the bones and joints is not a conspicuous feature. Although it can result from the physical damage associated with osteoarthritis, it is not believed to cause the condition. This is a distinguishing factor between osteoarthritis and rheumatoid arthritis, which is more strongly linked to inflammation.
Worldwide, there is estimated to be 250 million people affected by osteoarthritis of the knee, comprising of 3.6% of the total population. It is an extremely common condition, affecting 43.4 million people across the globe in 2004. Approximately 80% of the population is likely to show radiographic evidence of bone degradation in the joints by the age of 65, although only 60% of those are likely to be symptomatic.
Up to one quarter of all consultations with general practitioners are related to osteoarthritis. Additionally, approximately of all NSAID prescriptions are indicated for the treatment of osteoarthritis.
Mechanical stress on the joints is the main reason for the development of osteoarthritis. Obesity is strongly linked to this condition, as it increases the weight that the joints are required to support. Particularly the knees and hips of obese individuals are affected.
There is also a hereditary factor that is seen to predispose people to osteoarthritis, although in most cases there are also other risk factors present.
The condition is characterized by pain, tenderness and stiffness of the affected joints. The joints in the hand, hips and knees are most commonly affected, although it may also occur in the shoulder and jaw or other joints of the body.
As a result of the pain and stiffness, the freedom of the joints is often affected. Individuals may find it difficult to partake in daily activities as usual because of this, particularly if the activities involve fine movements of the joints.
The quality of life can be greatly reduced as the pain can be inhibiting and it may become difficult for people to live their daily lives as usual.
Clinical examination of the affected joints is the first step, which usually appear swollen and the patient reports significant pain in the area.
Confirmation of the diagnosis can be made with X-ray imaging. Characteristic changes to the joints, particularly involving the cartilage and bone in the area are usually evident.
For mild symptoms, treatment usually begins with management of the risks of osteoarthritis and helping to relieve pressure on the joints.
Losing weight is one of the most important first steps, as obesity is a strong risk factor of the condition as the excess weight puts unneeded stress on the joints.
Some physical therapies, such as hot and cold packs, can offer a benefit to help reduce pain or stiffness.
Medical therapy usually addresses the pain associated with osteoarthritis and simple analgesics are the treatment of choice. Paracetamol is the first line choice, as it is associated with less severe side effects. NSAIDs can also be used, particularly for more severe pain, although they carry a greater risk of complications such as GI ulceration and risk of stroke. NSAIDs may provide a suitable option, but the potential risks should be managed effectively.