Osteoarthritis or Wear and Tear Arthritis: Types, Causes, Symptoms, Treatment- Surgery
Osteoarthritis is a very common type of arthritis which affects millions of people all over the world. Osteoarthritis is also called as wear and tear arthritis. Osteoarthritis is often referred to as the progressive disease of the joints.
The cartilage is a hard, slippery tissue that works like a cushion for the bones in the joints of the body and helps the bones to glide easily while performing movements. The cartilage covering helps the joint to perform movements painlessly and smoothly. Osteoarthritis is a condition which results from wearing down of the cartilage. The wearing down of the cartilage usually happens over a period of time. This often makes the slick surface of the cartilage rough and creates difficulty for the bones to glide easily and ultimately leaving them to rub on one another after complete wearing away of the cartilage.
Osteoarthritis is a condition which can affect any of the joints of the body. The disease most frequently affects the joints of knees, hips, hands, lower back and neck.
Osteoarthritis is a disease which develops gradually from mild to severe. Once the condition is severe then the treatment becomes more difficult. Treatment for osteoarthritis may slow down the progression of the disease, improve joint function and relieve pain.
Types of Osteoarthritis or Wear and Tear Arthritis
Osteoarthritis Can Be Classified Into Two Types:
- Primary Osteoarthritis: Primary osteoarthritis is referred to as the first kind of osteoarthritis. Primary osteoarthritis is a perplexing type of condition as this type develops neither by any injury nor by any accurate cause. No specific reason could be found for this type of osteoarthritis. Primary osteoarthritis develops progressively worse leaving the patient incurable. Medicines used for this condition work only to lessen few of the symptoms and help in relieving the pain to some extent, but do not eradicate the disease completely.
- Secondary Osteoarthritis: Secondary osteoarthritis is generally caused due to a disease or by some other disease condition. Secondary osteoarthritis is frequently caused by anatomy problems, inflammatory disease, injuries and metabolic problems. Inflammatory diseases such as septic arthritis generally result in this condition of secondary osteoarthritis. Metabolic problems such as acromegaly usually lead to this condition of secondary osteoarthritis. Anatomic problems also such as bowlegs often result in this condition of secondary osteoarthritis.
Epidemiology of Osteoarthritis or Wear and Tear Arthritis
Osteoarthritis affects around 25 million people in the United States. According to the radiographic criteria of osteoarthritis 50% of people more than 65 years of age are suspected to be very much prone to the disease.
Primary osteoarthritis commonly affects the elderly people. About 80 to 90% of the people more than 65 years of age get affected with osteoarthritis.
Osteoarthritis is more common in women than in men.
Causes and Risk Factors of Osteoarthritis or Wear and Tear Arthritis
- Endocrine Problems: Endocrine problems such as hyperparathyroidism, obesity, hypothyroidism and diabetes may often lead to osteoarthritis.
- Post-traumatic: Traumatic causes such as break in the bone, faulty alignment of the fractured bones, damaged cartilage, loosening of the joints and repetitive movements of the joints may result in osteoarthritis.
- Inflammatory Joint Diseases: Inflammatory joint diseases such as chronic gout, rheumatoid disease and infected joints lead to osteoarthritis.
- Metabolic Problems: Few of the metabolic problems may also lead to osteoarthritis.
- Congenital Problems: Congenital problems such as leg length discrepancy may also cause osteoarthritis.
- Genetic Disorders: Some genetic disorders are also known to cause osteoarthritis.
- Neuropathic Problems: Some neuropathic problems may lead to injuries going unnoticed. These injuries if not treated properly may result in osteoarthritis.
- Nutritional Problems: Nutritional problems or malnutrition may also be a reason for osteoarthritis.
- Older Age: The risk of osteoarthritis often increases with the advancing age.
- Sex: Women easily get affected with osteoarthritis than men for some unclear reasons.
- Bone Deformities: Few individuals are born with defective cartilage or malformed joints which often increases the risk of osteoarthritis.
- Joint Injuries: Injuries occurring from accidents or sports may also lead to the condition of osteoarthritis.
Signs and Symptoms of Osteoarthritis or Wear and Tear Arthritis
Osteoarthritis symptoms may be mild to severely disabling based on the extent of the disease.
Given Below Are Few Of The Common Signs And Symptoms Faced By The Patients-
- Pain and inflammation is experienced in the affected join.
- Dull ache and pain, which often progresses slowly over time.
- Severe pain may be experienced in the morning on getting up from bed, which may improve with activity as the day progresses.
- Exacerbation of pain on performing vigorous activity may also be experienced.
- Stiffness in the joint.
- Joint may also become swollen and enlarged.
- Development of a bump over the joint may also be noticed.
- Difficulty in bending the joint, which may lead to limited motion of the joint.
- Sticking or locking of the joint is also experienced during movements.
- A click, creak sound, grinding noise or an audible snap may also be experienced.
- Weakness in the joint is often experienced.
Treatment of Osteoarthritis or Wear and Tear Arthritis
- Generally nonsurgical treatment is done for slowing down the progression of osteoarthritis, which also helps in improving strength and increasing range of motion. The treatment may involve medication, physical therapy, and lifestyle modifications.
- Medications: Non-steroidal anti-inflammatory drugs help in reducing inflammation. In some cases strong anti-inflammatory agents such as corticosteroids are also prescribed. Corticosteroids are directly injected into an affected joint. Corticosteroids provide temporary relief from swelling and pain.
- Dietary Supplements known as glucosamine and chondroitin also help in relieving the pain of osteoarthritis.
- Physical Therapy (PT) is an important element of treatment for osteoarthritis. Performing exercises often improves range of motion, reduces pain, and improves joint flexibility. It also strengthens cartilaginous tissues, bone and the joints surrounded by the muscles. Assistive and supportive devices like splints, braces, cane, walker, crutches and elastic bandages may also be used. Heat or ice is also applied to the affected joints periodically during daytime.
- Change in Activities and taking rest is highly recommended in order to avoid provoking pain of osteoarthritis. This often involves alteration in activities relating to work and sports. Replacing high impacting activities like jumping, competitive sports, aerobics, etc., with low-impact workouts like, swimming, cycling, stretching and walking may also help in the healing process of osteoarthritis. In some of the cases when osteoarthritis affects weight-bearing joints like spine, ankle, hip and knee, weight loss program may also contribute in reducing the problem.
Surgery is performed only in severe cases when conservative measures fail. Age plays an important role in deciding whether the patient can be approved for surgery. Given below are four surgical methods that can be considered for treatment of osteoarthritis based upon the patient's condition.
- Joint fusion
- Joint replacement
- Arthroscopy: Arthroscopy is done by using pencil-sized, flexible, fiberoptic instrument called arthroscope. Two or three small incisions are made for inserting the arthroscope and removing loose fragments in the joint, bone spurs, damaged lining, or cysts.
- Osteotomy: Osteotomy is performed for realigning the long bones of the leg or arm in order to release the pressure off of the affected joint.
- Joint Fusion: As the name itself suggests, this procedure is performed by fusing or combining the bone ends with the help of screws, pins, rods, or plates which hold the bones in their place during the healing process. Joint flexibility will get eliminated with joint fusion.
- Joint Replacement: This procedure is performed by removing an affected joint in order to replace it with an artificial joint made up of plastic or metal components. Joint replacement can either be partial or total depending on the condition of the affected joint.
Investigations for Osteoarthritis or Wear and Tear Arthritis
A complete subjective and physical examination is necessary to diagnose the condition of osteoarthritis. Typically an x-ray is required for confirming the severity. Other diagnostic tests may include:
- CT scan
- Joint fluid analysis is done in the case of infection.
- Blood test is done in rare cases only when infection is suspected.