Osteoarthritis, sometimes referred to as degenerative joint disease or degenerative arthritis and osteoarthritis (OA), is the most common chronic joint disease. Osteoarthritis affects every joint; But it often occurs on the knees, thighs, lower back, little finger joints, and the thumb and big toe base.
In healthy joints, a rubbery substance called cartilage covers the end of each bone. Cartilage provides a smooth, slippery surface for joint movements and is placed between the bones like cushions. In osteoarthritis, the cartilage breaks down. This causes pain and swelling, and difficulty moving the joint. Over time, as osteoarthritis worsens, the bones may break down and form structures called bone spurs. Pieces of bone or cartilage may come off and float around the joint. An inflammatory process occurs in the body, and proteins called cytokines and enzymes produced further damage cartilage. In the final stages of osteoarthritis, the cartilage is destroyed, and the bones are pulled together, causing more damage and pain. (Diet To Treat Osteoarthritis; Useful And Harmful Foods For Osteoarthritis)
Who is affected by osteoarthritis?
Although osteoarthritis can occur at any age, it is more common in people over 65. Common risk factors include age, obesity, a history of joint damage, overuse of joints, weak thigh muscles, and genetic predisposition.
What are the symptoms of osteoarthritis?
The symptoms of osteoarthritis vary depending on the joints affected and the severity of the disease. The most common osteoarthritis symptoms are joint pain and dryness, especially early in the morning or after rest. Damaged joints may become swollen, especially after prolonged activity. These symptoms accumulate over time, not suddenly. Some common symptoms of this disease are:
- I feel pain and dryness in the common area after activity or excessive use of the joints, especially in the thighs, knees, and lower back.
- Limiting the range of motion of the joints
- Making noise when bending joints
- Mild swelling around the joint
- Pain that gets worse after activity or at the end of the day
The effect of osteoarthritis on different parts of the body
- Thighs (hip joint): Pain that is felt in the groin or buttocks and sometimes inside the knee or thigh.
- Knees: Feeling worn or scratched when moving the knees.
- Fingers: Bone spurs form at the joints’ edges and cause swelling, redness, thinness, and fingers’ fragility. You may also feel pain in the base of your thumb.
- Feet: Pain and fragility in the big toe joint of the base of the big toe. Sometimes swelling is also seen in the ankle or toe.
- Spine: Osteoarthritis of the spine is a fracture of the joints’ cartilage and discs in the neck and lower back. Osteoarthritis sometimes causes bone spurs that put pressure on nerves that protrude from the spine. This condition can cause weakness and pain in the arms or legs.
Osteoarthritis of the spine
Pain or swelling, or dryness from osteoarthritis makes it difficult to do daily chores at home or work. It is even impossible to do some things such as packing the beds, opening the dish lid, grabbing a computer mouse, or driving. When the lower joints of the body are affected, activities such as walking and climbing stairs, and lifting objects become difficult. When the fingers’ joints become involved, it becomes difficult to grasp and hold objects such as pencils or to do delicate tasks such as working with a needle.
Many people believe that the effects of osteoarthritis are inevitable; So they do nothing to manage it. Osteoarthritis Family, social, and work-life symptoms can be disrupted if steps are not taken to prevent joint damage, manage pain, and increase joint flexibility.
How Does Osteoarthritis Affect Public Health?
Pain, decreased mobility, side effects of medications, and other osteoarthritis-related factors can lead to adverse health effects that are not directly related to joint disease.
Diabetes and heart disease: Knee or thigh pain can cause life inactivity resulting in weight gain and obesity. Being overweight or obese can lead to diabetes and heart disease, and high blood pressure.
Falls: People with osteoarthritis have a 30% higher fall rate and a 20% higher risk of bone fractures than healthy people. People with osteoarthritis have risk factors such as decreased function and muscle weakness, and difficulty balancing, making them more likely to fall. Also, the side effects of medications prescribed to relieve pain may play a role in a person falling. Hypnotic painkillers may cause dizziness and imbalance.
Causes of osteoarthritis
Although osteoarthritis has long been thought to be caused by joints’ wear and tear over time, scientists now call it “joint disease.” Some of the significant factors in causing osteoarthritis are:
Genes: Some genetic traits increase a person’s risk of developing osteoarthritis. One of these defects is a rare defect in collagen production. Collagen is the protein that makes up cartilage. This disorder can even cause osteoarthritis in your 20s. Some genetic traits may also lead to minor defects in how bones adapt. When the bones are in alignment, the cartilage is destroyed faster than usual. Researchers have found that a gene called FAAH is more common in people with knee osteoarthritis than healthy people.
Weight: Excess weight puts extra strain on the thighs and knees. Tolerating such as excess weight, in the long run, causes the cartilage to disappear faster. Studies have shown that being overweight is associated with a higher risk of developing osteoarthritis of the hand. Excess fatty tissue produces inflammatory chemicals that cause joint damage.
Injury and overuse of joints: Repetitive movements or damage to joints, such as fractures or surgery or ruptured ligaments, can cause osteoarthritis. Some athletes often have injuries to their joints, tendons, and ligaments. This can cause the cartilage to be destroyed. Certain occupations that require prolonged standing, frequent bending, lifting heavy objects, or other movements may cause cartilage destruction more rapidly. Lack of balance or weakness of the muscles that support the joint may also lead to a change in movement and, ultimately, a fracture of the joint’s cartilage.
Other factors: Several other factors may play a role in the risk of developing osteoarthritis. These factors include bone and joint diseases such as rheumatoid arthritis and metabolic disorders.
Diagnosis of osteoarthritis
The physician collects information about the patient’s family and personal medical history and prescribes examinations and diagnostic tests to diagnose atherosclerosis.
Health History and Symptoms: Information needed to help diagnose osteoarthritis includes:
- Description of symptoms
- Details about when and how the pain or other symptoms start
- Details about other existing medical problems
- The location of pain or dryness or other symptoms
- How symptoms affect daily activities
- List of individual medications
Physical Examination: During the examination, the doctor examines the patient’s joints and tests their motion range (how far the joints are moving in their normal range). Your doctor will look for painful or swollen, or delicate areas and signs of joint damage. It also examines the position and alignment of the neck and spine.
Diagnostic Tests: The doctor may suspect that person may have osteoarthritis after learning about their medical history and physical examination. Blood tests usually do not help with this diagnosis. The following tests may help confirm this condition:
1- Joint fluid test: The doctor anesthetizes the affected area and inserts a needle to draw fluid into the joint. This fluid is examined for evidence of joint destruction and the presence of crystalline particles. By doing this test, your doctor can rule out the possibility of other types of arthritis. Osteoarthritis is the most common type of arthritis.
2- X-rays: May show damage and other changes associated with osteoarthritis.
3- MRI: No radiation is used in this imaging technique. This method is more expensive than the X-ray method, But it provides better images of cartilage and other bone structures and helps to diagnose common osteoarthritis abnormalities early.
Treatment of osteoarthritis
Osteoarthritis is a chronic disease, and there is no cure for it, But there are ways to manage the symptoms. Long-term management of the disease consists of several parts:
- Manage symptoms such as pain, dryness, and swelling
- Improves joint mobility and flexibility
- Maintain a healthy weight
- Performing physical activities
Physical activity: One of the most helpful ways to manage osteoarthritis is to “move.” Although it is difficult to think about exercise when a joint is injured, movement is essential. Even simple activities such as walking around the neighborhood or having an easy and fun exercise class can reduce pain and maintain a healthy weight. Muscle-strengthening exercises strengthen the muscles around the joints, making it easier to bear the load and reducing pain. Aerobic exercise helps improve endurance and energy levels, as well as weight loss. A patient with osteoarthritis should consult a physician before beginning an exercise program. The US Department of Health and Human Services recommends that everyone, including those with arthritis, exercise 150 minutes a week.
Weight management: Excess weight puts extra strain on the joints that support the weight; Such as hip joints, knees, legs, and waist. Losing weight helps people with osteoarthritis reduce pain and prevent further joint damage. The constitution is to lose weight, consume fewer calories, and increase physical activity.
Stretching exercises: Gentle stretching of the joints may help strengthen flexibility and reduce dryness and pain. Exercises such as yoga and tai chi are good ways to manage joint stiffness and dryness.
Osteoarthritis Medications: Osteoarthritis medications are available in tablets, syrups, creams, or lotions, or they may be injected into the joint. These medications include:
- Pain: Relieves pain and includes acetaminophen and narcotic analgesics. Some of these drugs are sold without a prescription and some with a prescription.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): The most commonly used drugs to reduce inflammation and pain are aspirin, ibuprofen, naproxen, and celecoxib.
- Corticosteroids are powerful anti-inflammatory drugs that can be used either orally or by injection into the joint.
- Hyaluronic acid: It is naturally present in joint fluid and acts as a shock absorber and lubricant. This acid seems to be broken down in people with osteoarthritis.
Occupational therapy and physiotherapy: Occupational therapy and physiotherapy specialists offer various treatment options for pain management. Some of these options are:
- Teaching methods for proper use of joints
- Cold therapy and heat therapy
- Movement exercises and flexibility
- Introduction and presentation of auxiliary devices
Auxiliary devices can help improve performance and mobility. Scooters, canes, walkers, splints, special shoes, or accessories such as opener and high-heeled heels are among the auxiliary devices.
Some exercises help to improve the symptoms of osteoarthritis of the fingers.
Natural and alternative therapies: Many people with osteoarthritis use natural and alternative therapies to manage their symptoms and improve their well-being. Some of these include nutritional supplements, acupuncture, massage, relaxation techniques, and hydrotherapy.
Surgery: Joint surgery can repair or replace severely damaged joints, such as hip or knee joints.
Positive Attitude: Many studies have shown that having a positive attitude can strengthen the immune system and increase a person’s ability to control and manage symptoms.
Improving performance and reducing hip pain through physical activity: Most people with osteoarthritis have problems with the thighs and knees, and many surgeries are performed each year to treat this problem. It is predicted that the age of onset of the disease will decrease in the coming years. However, how can a person with osteoarthritis reduce their pain and avoid going to the operating room or delay going there? The answer is “sport.”
One of the primary goals of a thigh exercise program is to strengthen the muscles that support these joints. Deep thigh stabilizing muscles can absorb shock and protect the joint from painful and harmful movements. Therefore, doing pelvic floor exercises can help the patient reduce strength and flexibility, improve pain, and reduce pain. The results of a study of Finnish women with osteoarthritis confirmed this effect. After a 12-week exercise program, the researchers found that pain in 13 women with osteoarthritis was reduced by up to 30 percent. Another study of 210 patients with osteoarthritis of the thighs found that participants in a 12-week exercise program experienced less pain and a more remarkable ability to move.
Types of exercise: Having physical activity is an integral part of an osteoarthritis management program; But if you are not currently active, it is better to start regular exercise. Different types of ground and water sports can strengthen the thigh muscles and improve the pain of osteoarthritis. Physiotherapists can also offer specific programs for flexibility and thigh-strengthening exercises to help control pain.
Joint replacement is sometimes the only treatment for osteoarthritis of the thigh.
Can exercise be helpful in the later stages of osteoarthritis?
If you have advanced osteoarthritis of the thigh and your doctor says you need a complete hip replacement, it cannot be claimed that exercise can prevent you from going to the operating room. This does not mean that you should stop exercising until surgery. Experts say that even people with advanced osteoarthritis should be as active as possible. If you operate in poor condition, you will not get good results. Even if exercise does not affect your thigh pain, it is best to have surgery as soon as possible in a healthier position.
Prevention of osteoarthritis
Osteoarthritis was once considered a disease of burnout and was the inevitable consequence of a long and active life. Research has shown that osteoarthritis is a complex process that has many causes. This disease is not associated with the inevitability of aging; Rather, it results from a combination of different factors, many of which are preventable. Here are some tips from doctors to reduce the risk of osteoarthritis or delay its onset.
Maintaining a healthy weight: Being overweight is one of the most critical risk factors for osteoarthritis, and of course, there is an apparent reason. Weightlifting puts more weight on weight-bearing joints. Over time, this extra load causes the cartilage that supports the joint to disappear; But mechanical stresses are not the only problem. Adipose tissue stimulates inflammation and inflammation throughout the body by producing cytokines. At the joints, cytokines destroy tissue by altering the function of cartilage cells. When you are overweight, your body produces and releases more destructive proteins. Weight loss will be followed by fatigue and constant tiredness and reduce the risk of developing osteoarthritis.
Blood sugar control: Recent research shows that diabetes, a disease that affects the body’s ability to regulate blood sugar, is a significant risk factor for osteoarthritis. High glucose levels accelerate individual molecules’ formation, which causes more cartilage to become drier and more sensitive to mechanical stress. Diabetes can also trigger systemic inflammation that causes cartilage to break down. This newly discovered link between diabetes and joint damage may explain why many people with diabetes also develop arthritis.
Physical activity: Physical activity is the best treatment available for osteoarthritis. It is also one of the most effective ways to keep your joints healthy. Even an average of 30 minutes of exercise five times a week maintains joint flexibility and muscle strength, strengthening and stabilizing the thighs and arms. Exercise strengthens the heart and lungs, reduces the risk of diabetes, and is an essential factor in weight control. You do not need to go to the club to enjoy these benefits. Walking and gardening (even to the extent of clearing the ground) have positive effects; But most benefits come from a consistent, age-appropriate exercise program. No matter what sport you choose, listen to your body. If you experience pain after exercising that lasts for several hours, do less exercise, and rest at intervals. To avoid injury, move slowly until you understand how your body responds to the new activity.
Safety: Because cartilage does not heal quickly, the risk of developing arthritis in an injured joint is seven times higher than in a joint that has never been damaged. Fractures and dislocations and even rupture and stretching of tendons may increase the risk of developing osteoarthritis. Although this type of injury can not always be avoided, care must be taken in this regard. If you exercise, be sure to wear safety clothing during high-risk exercise. At work and home, use your most vital and largest joints to lift objects and rest at intervals. Maintaining a healthy weight after each injury can prevent further joint damage.
Choosing a healthy lifestyle: Some of the risk factors for osteoarthritis cannot be changed. For example, osteoarthritis increases with age; however, this is not clear why this happens. One idea is that the number of cartilage cells decreases over time. Because the prevalence of osteoarthritis is higher in women than in men, especially after 50, decreased estrogen levels after menopause may play a role. Also, some people inherit genes that predispose them to osteoarthritis. However, we must remember that arthritis is a multifactorial disease, and just because a gene is received does not mean that the person will develop osteoarthritis. Finally, the best defense against any disease, including osteoarthritis, is to have a healthy lifestyle. How you eat, sleep, manage stress, interact with others, and whether or not you drink alcohol and smoke has a profound effect on general health and joint health.
Other complications associated with osteoarthritis
Inflammation and osteoarthritis: These proteins travel throughout the body and cause inflammation everywhere, including joints. This persistent inflammation in the body prevents a person from developing osteoarthritis in the joints directly involved in weight-bearing; Instead, it becomes vulnerable in joints that do not support the load, such as the hands’ joints. The prevalence of osteoarthritis of the hand is twice as high in obese people. Obesity in people with osteoarthritis in one joint also increases the risk of developing osteoarthritis in the other joints. For example, healthy knee osteoarthritis is five times more likely to occur in obese people with another knee osteoarthritis than in healthy-weight people with similar conditions. Excess fatty tissue not only causes inflammation throughout the body; Rather, by placing a mechanical load on cartilage and bone, it activates these structures and encourages them to release inflammatory proteins and other factors that cause joint damage.
Metabolic syndrome and osteoarthritis: Obesity-related injuries in osteoarthritis are not limited to the joints. In a 2015 study, researchers examined the association between obesity and osteoarthritis and metabolic syndrome. People with osteoarthritis were three times more likely to develop the metabolic syndrome (a group of health problems such as high blood pressure, high blood sugar, abnormal cholesterol levels, and excess fat around the waist). Some researchers refer to the combination of obesity and metabolic syndrome as a metabolic illness, a distinct and dangerous subset of osteoarthritis. When these are combined, it is a warning sign that the possibility of heart disease should be considered immediately. When osteoarthritis is associated with metabolic syndrome, it exacerbates metabolic-related cardiovascular diseases such as atherosclerosis. Also, the risk of pain and worsening of osteoarthritis and the need for complete joint replacement surgery increases with each of the metabolic syndrome components.
Fat is debilitating: Overweight or obese exacerbates the debilitating effects of osteoarthritis. The results of a study published in 2015 showed that people with osteoarthritis and obesity who needed to take more medication walked more slowly, were less physically active, and were at greater risk of developing disabilities that disrupted their daily lives.