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A Full Guide to Osteoarthritis: How Can It Be Treated?

Osteoarthritis (OA) reigns as the most prevalent form of arthritis in the United States, affecting over 32.5 million adults, as per the Centers for Disease Control and Prevention (CDC). It's characterized by the gradual degradation of joint cartilage, often attributed to life's natural 'wear and tear,' affecting key areas such as the back, hips, knees, and occasionally the hands and feet. Despite lacking a definitive cure, various treatments exist to manage OA's chronic symptoms and promote overall well-being.

What is osteoarthritis?

Osteoarthritis (OA) is a chronic degenerative wear and tear disease. It affects cartilage health, bone remodeling, and the formation of osteophytes (bone spurs), resulting in symptoms like pain, stiffness, swelling, and decreased joint function, typically exacerbated by activity.

Living with osteoarthritis presents challenges beyond the physical symptoms mentioned. It can profoundly impact mental health, disrupt sleep patterns, hinder productivity at work, and impede various other bodily functions.

Osteoarthritis can affect many of the joints such as hip, knee, spine, and foot.

Symptoms of osteoarthritis

The symptoms of osteoarthritis include but are not limited to:

  • Joint pain or aching due to motion; with hip OA, pain can occur in the buttocks and sometimes the inner knee or thigh.
  • Joint stiffness after inactivity or rest.
  • Decreased flexibility and limited range of motion.
  • Bone spurs, which are bony growths on the edge of bones like the fingers.
  • Grating, crackling, or popping when the joint bends.
  • Swelling, usually in the ankles and feet.
  • Tenderness with light pressure, most often in the big toes.
  • Joint buckling, which often occurs in the knee.

Risk factors and causes for osteoarthritis

Understanding the diverse array of risk factors and causes associated with osteoarthritis is essential for comprehensively addressing this prevalent condition. The main risks and causes are provided below:

  • Older age, usually over 50 years of age.
  • Being born as a female.
  • Being overweight, which puts more stress on the hips and knees; fat cells produce proteins that cause joint inflammation.
  • Old injuries of any kind can put you at a greater risk for OA.
  • Repetitive stress on the joint through sports and certain strenuous jobs, such as construction, dancing, textile work, music, and teaching.
  • Genetics, since OA can run in families.
  • Malformed, misaligned bone or joint structures or defective cartilage.
  • Some metabolic diseases, such as diabetes, conditions that cause too much iron in the body, and hormonal disorders.
  • Weak muscles, which don’t support the joints properly.

Diagnosing osteoarthritis: what to expect

Osteoarthritis is typically diagnosed through a comprehensive process that includes a physical examination, various imaging techniques such as X-ray and MRI, as well as a thorough review of medical history, encompassing symptoms and the impact of pain on daily activities and self-care.

During the physical exam, healthcare providers scrutinize the joints and observe your range of motion. Additionally, laboratory tests may be conducted to eliminate the possibility of other conditions resembling osteoarthritis. These tests may involve joint aspiration to check for infections or crystals, which could indicate alternative medical issues.

X-rays are employed to identify any joint damage or alterations, while Magnetic Resonance Imaging (MRI) offers detailed insights into the condition of cartilage and other structures within the affected joint.

Non-surgical treatment options for osteoarthritis

When you have your first diagnosis of osteoarthritis, your doctor will suggest non-surgical treatment options that can relieve pain, stiffness, and swelling. Medications for pain and inflammation relief come in the form of pills, patches, gels, creams, syrups, and injectables. Here is the overview of the pharmacological treatment options that can be prescribed:

  • Over-the-counter pain pills such as acetaminophen; you will need a prescription for medication like opioids.
  • Other over-the-counter products like capsaicin and lidocaine; they aggravate the nerves to distract them from processing pain.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen, and ibuprofen are for inflammation and pain. Those designed primarily for pain are over-the-counter, while those that address both pain and inflammation require a prescription.
  • Prescription corticosteroids are taken orally or are injected into the joint by your physician.
  • Platelet-rich plasma is another injectable medication that can reduce inflammation and pain, but it’s not currently approved by the FDA.
  • Antidepressants such as Cymbalta and Lyrica can also ease pain; these medications are FDA-approved for this use.

Equally important are physical therapy and exercise. Seek the services of a physical therapist. They can instruct you in a specific exercise program for your OA. It will include:

  • Strengthening exercises
  • Range-of-motion exercises and stretching
  • Aerobic or cardiovascular exercises
  • Balance exercises

Surgical treatments for advanced osteoarthritis

Joint replacement surgery can be used to ease pain while enhancing self-care, mobility, and quality of life. The most common procedures are performed on the hips and knees.

Hip replacement surgery

During hip replacement, the damaged hip ball in the socket joint is removed and replaced with ceramic or metal that is bonded to a stem. This stem fits into the thigh bone known as the femur. Eventually, the bone will grow over the material that covers the new ball and socket joint, called a prosthesis.

Sometimes they use cement to attach the prosthesis to the bone. The joint socket is often a metal cup with a plastic liner, which snaps into it and allows the new ball to rotate. Prostheses are individually designed for each person.

The recovery after hip replacement surgery depends on your physical condition and general health; however, the rehabilitation will start 24 hours after surgery with a qualified physiotherapist and last for a few months.

Knee replacement surgery

Knee replacement involves shaving off a thin amount of bone along the bottom surface of the femur and the underside of the kneecap. After shaping the bone surface, an implant is fitted. Like hip replacements, knee replacements can use cement or a special coating into which the bone can grow. Total joint replacement surgery generally takes 1–2 hours with recuperation lasting 1–2 days.

Rehabilitation begins 24 hours after knee replacement surgery, with full recovery depending on factors like age and health. By six weeks post-surgery, most usual activities can resume, but physical therapy continues for several months.

Joint replacement surgery: how to know when it is needed?

There are three primary treatment options for joint issues.

  • The first involves rehabilitation with specific physical therapy, as detailed earlier.
  • The second option is arthroscopy and joint reconstruction.
  • The third, more extensive, option is joint replacement surgery.

Your doctor will assess your condition and recommend the most suitable treatment based on your individual needs and the stage of your joint problem.

Surgeons carefully evaluate individuals' capacity to benefit from total joint replacement. Several crucial factors must be carefully evaluated before proceeding with the procedure:

  • Radiographic and clinical presentation
  • Conservative treatment effectiveness
  • Individual risk factors that can affect surgery

After a thorough examination, the surgeon will make the final decision regarding the necessity of joint replacement.

Lifestyle and home remedies for osteoarthritis management

One of the most important lifestyle management for patients with osteoarthritis is regular exercise. Equally significant are maintaining a healthy diet, receiving psychological support, engaging in educational programs, and implementing various lifestyle interventions. These combined efforts play a vital role in managing the condition effectively.

Exercise regularly

Lifestyle management by including regular exercise must be the top priority because a person with OA has weak muscles, poor balance, and impaired proprioception. This leads to higher loads into the joint area, pain perception, and swelling.

Nutrition management

Since obesity is one of the major risk factors for OA, nutrition should be carefully reviewed. Some studies suggest that alongside exercise, nutrition plays a pivotal role in managing arthritic conditions. Therefore, consulting with a healthcare specialist or nutritionist is crucial to developing a well-balanced diet tailored to one's health status.

Mental health

Maintaining good psychological health is vital for those dealing with osteoarthritis. Feelings of pain can be overwhelming, but therapies like psychotherapy and mindfulness can help manage these emotions effectively.

Is it possible to prevent osteoarthritis?

Prevention plays a crucial role in managing and avoiding chronic diseases like osteoarthritis (OA). Modifiable risk factors such as obesity, diabetes, and physical activity are within our control. Making positive changes to these factors can help prevent the onset of OA.

For individuals with non-modifiable risk factors like genetic predisposition or previous injury, discussions with a doctor can help explore ways to decrease the risk of developing OA.

Can supplements help with osteoarthritis?

A meta-analysis showed that there is evidence of pain management when people used curcumin, vitamin D, vitamin E, and omega-3. However, it's important to note that the studies involved small sample sizes, warranting cautious evaluation. It is advisable to discuss with your doctor which supplements would be best suited for your individual health needs.

Exercises for osteoarthritis

Physical therapy and exercise are very important in OA management. As mentioned above, regular exercise can help strengthen muscles and increase balance maintenance and proprioception in the joints.

The recommended physical activities for a person with OA include:

  • Water-based exercises to build endurance and unload your joints because of the water characteristics.
  • Strength training to reduce the stress on painful joints by building the muscle around them.
  • Active range of motion exercise and stretching to warm up joints and maximize their flexibility.
  • Aerobic or cardiovascular exercises to build endurance and assist with weight loss.
  • Balance exercises to help prevent falls by strengthening small muscles in the lower legs.

Sit to stand exercise

Sit to stand exercise

This exercise is vital for your quadriceps, hamstrings, and gluteus strengthening, also challenging your balance.

  1. Start the exercise by using the armrests of your chair.
  2. Keep your feet shoulder-width apart.
  3. Slowly stand up from the chair.
  4. Slowly sit back on the chair using armrests.
  5. Repeat it 10 times.

To continue this exercise, keep your hands on your thighs; later on, do not use your arms to stand up and sit down. Moreover, if you feel comfortable and want more challenging exercise when you sit down, try only to tap your butt on a chair and then stand up.

Side steps exercise

Side steps exercise

Use a resistance band for this exercise. This exercise will help you strengthen all the muscles in the legs and increase the challenge to your balance.

  1. Place the resistance band on your thighs above the knees.
  2. Keep your legs straight while you step to the side.
  3. Repeat it 10 times in each direction.

To challenge yourself, place a resistance band just above the ankles. Step to the side with straight legs.

Dead bug exercise

Dead bug exercise

This exercise will help you maintain and practice a neutral spine position and strengthen trunk muscles.

  1. Lie in a semi-supine position, keep your legs in a tabletop position, raise both arms, and keep a neutral pelvis position.
  2. Move one arm back while lowering the opposite bent leg.
  3. Continue the movement, alternating arms and legs.
  4. Repeat it 20 times.

Living with osteoarthritis: tips for daily living

Daily living with osteoarthritis (OA) can indeed present challenges, particularly when routine activities such as household chores or gardening exacerbate pain levels. However, there are numerous strategies to help manage these difficulties. It's advisable to sit while engaging in certain household tasks and to plan activities earlier in the day if evenings are associated with increased discomfort.

Additionally, opting for lighter weights, like bags, can alleviate strain. Learning neutral joint positions with a physiotherapist can prevent excessive bending, reaching, or twisting, while caution on slippery surfaces is crucial to prevent falls; implementing slip mats in areas prone to slippage, such as the bathroom, is recommended. These simple adjustments and practical suggestions can significantly improve daily living with osteoarthritis.

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