Is Osteoarthritis A Progressive Disease?
Osteoarthritis is a condition involving joints and bones participating in it in which there is continuous persistent damage occurring at the site to degrade the functionality of the joint. It is a progressive degenerative disease that also having an inflammatory component that fastens the process of joint degradation by collecting inflammatory mediators at the nearby site.
These inflammatory mediators attract white blood cells and other inflammatory cells at the site and start eating away the area and hereby decreasing the space of the joint. It leads to the compensatory response by the body to cover the denuded area in the form of formation of bony spurs at the loss of cartilage sites.
The disease onset is variable and it may start even at a younger age but usually, the progression is quite slow and goes till the age of more than 60 years. Most of the symptoms start appearing at the age of 65 years and worsens very rapidly till the age of 75 years. There is a steep rise encountered in the progression of the condition after the age of 60-65 years because the cumulative damage that has occurred now gets collected very rapidly and also there is decreased capacity of the body to recover from the further damage occurring.(1)
Alternative Treatments For Osteoarthritis
Treatment for osteoarthritis is mainly pharmacological which includes various drug groups for pain relief and some may act in favor of reduction of progression but there is no conclusive evidence. In the later stages, surgical treatment is also available and is very effective.
Nonsteroidal anti-inflammatory drugs consisting of paracetamol, Ibuprofen, ketorolac, etc. and cyclooxygenase-2 inhibitors like celecoxib, etoricoxib, etc. are the most commonly used drugs to relieve the pain occurring at the joints in osteoarthritis. Vitamins and micronutrients such as various minerals, vitamin C, vitamin E, etc. are also supplemented to reduce the oxidation occurring at the site of inflammation because these have the property to act as an antioxidant agent.
Surgical treatment has been widely used for the treatment of osteoarthritis because of its success in long term elimination of the disease. But the drawback is that it is limited in its usage because of surgical and anesthetic side effects of the operation and the choice of the patient is specific. If the person is an athlete and it is very much in need of the involved joint, then the surgical treatment route can be taken.
Also, when there is the last stage of osteoarthritis in which joint fusion starts occurring then also joint replacement can be done which will last for 10-15 years. But it is not done at an early age because it may be required again after 15 years at the old age which will be very difficult.(2)
The best way to fight this condition is to eliminate the causative factors and minimize the already incurred damage to the joint. Weight reduction and avoiding stressful activities such as running, jumping, professional sporting events, etc. which may aggravate the condition by providing new to the site for inflammation after the recent damage incurred.
Osteoarthritis is a progressive disease but the progression is in itself a good scenario because it occurs very slowly and presents with a hindering effect on the normal lifestyle only after the age of 65 years usually. There is not much progression seen before the age of 50-55 years except in a few cases in which there is a genetic association present for the condition.
The treatment can be both surgical and medical but it depends upon the symptoms of the patient and also on the requirement. The wait and watch approach can be applied if the person is not involved in any professional sports and does not need to maximize the functions of the involved joint.
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