“What is Osteoarthritis?”
This is probably the most frequent question that I am asked on a daily basis. To put it simply, it is a word that describes the breakdown of the surface of a joint. The breakdown of the joint surface can happen for a number of reasons; including injury, autoimmune disease, infection, or simply wear and tear. Our joints are responsible for our ability to move our limbs. They need to move smoothly and therefore the ends of the bones are covered with smooth cartilage and encased in a joint capsule which makes joint fluid to help lubricate the joint. In the normal state they move easily with little friction. When the cartilage breaks down, friction increases and they can’t move as smoothly. This can be painful because of the bones rubbing together.
The symptoms of arthritis can range from dull aching or soreness to severe pain. It generally results in some loss of motion of the affected joint, and often some swelling. Usually weight-bearing activity will aggravate the condition, and rest will alleviate it. However, it is not uncommon for patients to complain of severe stiffness that occurs first thing in the morning and after sitting for a prolonged period of time.
Treatment generally involves treating the symptoms of inflammation and pain as well as improving the function of the joint. That is why patients often experience some relief with anti-inflammatory medications such as ibuprofen or naproxen. Tylenol (acetaminophen) is an effective pain reliever. Weight loss will reduce the forces that are transferred across the joints and will thus reduce symptoms. Similarly, braces and assistive devices can help to reduce the load experienced by the damaged and degenerative joint. Physical therapy is often employed to strengthen the muscles around the joint and improve the range of motion. When first-line treatments are no longer effective, we often consider injections of anti-inflammatory medications and/or joint lubricants such as hyaluronic acid injections.
We consider surgery when we are not able to control the symptoms enough to permit normal or near-normal function of the joint without significant pain. Sometimes the damage is too great and only a joint replacement can restore function. Other times, less invasive surgery may provide relief and continued function. Not surprisingly, the patient’s age, overall health, and daily functional demands all play a significant role in determining the best options.