What is Osteoarthritis?
Osteoarthritis is a 'wear and tear' arthritis. It mainly affects the joint cartilage and the bone underneath the cartilage.
What happens to the cartilage in Osteoarthritis?
In order to understand Osteoarthritis, let us first understand the structure of a normal joint. A joint is made up of two or more bones. The bones are lined by the cartilage. The joint is lined on the inside by the synovium. This synovium secretes the synovial/ joint fluid. The fluid lubricates the joint. The joint is enclosed by the joint capsule. This capsule along with the overlying muscles & ligaments provide stabiity to the joint.
In Osteoarthritis, the cartilage becomes pitted, rough & brittle. The underneath bone may thicken. Bony outgrowths can develop at the edges. Because of the damaged cartilage the bone ends tend to rub against each other and cause pain.
Which joints are affectd by Osteoarthritis?
Osteoarthritis commonly affects the knee, hip and the finger joints.
What are the symptoms of Osteoarthritis?
Pain in the joints especially on movement is the most common symptom. Pain in the knee that increases on getting up, while climbing the staircase, walking are the common symptoms of osteoarthritis. Pain at rest is quite uncommon.
What causes Osteoarthritis?
Osteoarthritis is a 'wear and tear' arthritis. Development of osteoarthritis is seen as a part of the ageing process. The other contributory factors to the same are obesity and prior injury to the knee joint. The injury by damaging the joint can lead to early osteoarthritis. other arthritis like rheumatoid arthritis , by means of damage to the cartilage, can also hasten the process of osteoarthritis.
What is the outlook for patients with Osteoarthritis?
For some, the changes are subtle and progress very slowly. This type of osteoarthritis may not cause much of a problem and may not progress fast. In others, the problem may continue to worsen over the years. The worsening may be related to inadequate joint protection techniques. Continuing to squat/ sit cross legged tend to worsen the knee osteoarthritis over years. In some patients, part of the damaged cartilage tends to break away and form loose bodies in the joint cavity. This can lead to pain and locking of the joint.
How is Osteoarthritis treated?
Drugs—analgesics are used to take care of the pain. they are best used on an 'as & when required' basis rather than on a regular daily basis.
What is glucosamine and does it help?
Glucosamine and chondroitin sulphate are chemicals that are constituent of the normal cartilage. Evidence shows that some patients of osteoarthitis have modest pain relief with these agents. However, they may not benefit all the patients*
. They may be worth a try.
Do joint injections help in osteoarthritis?
Intrarticular steroids may be given in the inflammatory type of osteoarthritis, the one associated with swelling and continuous pain. Injections of hyaluronnic acid into the joints have been used by some for osteoarthritis. They are hypothesised to help by increasing the lubrication in the damaged joint. However, whether they help in the long run is not proven**
* Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. Clegg DO et al N Engl J Med 2006 Feb 23;354(8):795-808.
** Intra-articular Hyaluronic Acid in Treatment of Knee Osteoarthritis. A metanalysis Grace H. Lo et al JAMA. 2003;290:3115-3121.
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