Welcome to the website. I created this website to help teach people about Osteoarthritis and explain what happens with the disease and what you can do about it. There are numerous resources on the site including easy to understand guides, how to save money on treatments, the most effective diets, and a great website solely focused on weight loss that will help you manage your disease. Much of the information on this site is based on my experience in working with patients in a 5 year Osteoarthritis clinical trial I did as well as other research I have done.
Sooooooo…………What is Osteoarthritis?
Osteoarthritis (OA)-(OS-tee-oh-are-THRY-tis) is a specific type of Arthritis with multiple forms which over time cause both damage and deterioration to the cartilage (KAR-til-ij) and the surrounding bones in affected joints. Although there are more than 100 different types of Arthritis that affect various joints and areas of the body, Osteoarthritis is the most common type of Arthritis and only affects joints.
The word Osteoarthritis originates from the Greek words:
osteo: which means “of the bone”
arthro: which means “joint”
itis: which means “inflammation”
The word “Osteoarthritis” when translated means inflammation of the bones in a joint. Osteoarthritis was originally thought to result from inflammation of the bones. However, it is now known that it’s not the bones that become inflamed but the surrounding tissue in the joint, as a result of the disease process. The symptoms of Osteoarthritis include among others: chronic pain, tenderness, stiffness, tissue inflammation and noise from within the joints.
OA differs from many other diseases due to the fact that OA “appears” to be caused from changes in the body occurring naturally with the aging process. Even though OA can be considered as a part of the aging process, it is still a disease with appropriate treatments available. There is a large misconception by the public that OA is simply a normal part of the aging process and that there is little that can be done to manage the disease. This is why it crucial to educate yourself!
Did You Know? Osteoarthritis is one of the oldest diseases known and has been found in the bones of prehistoric man who lived over 500,000 years ago.
Osteoarthritis Terms or Words Your Doctor May Use
Carpometacarpal (CMC): Joint found between the wrist and the hand.
Cartilage (Articular): A tissue characterized by its firm consistency and found at the end of long bones.
Chronic: A condition of a disease denoting a slow progress and long continuance.
Congestive Heart Failure (CHF): Chronic or acute state that results when the heart is not capable of supplying the oxygen demands of the body.
Distal Interphalangeal (DIP): Joint found at the end of the end of the fingers.
Incidence: The number of new cases of a disease during a specific period of time.
Inflammation: Localized, protective response to tissue injury designed to destroy, dilute, or seal off the infecting agent or injured tissue; characterized by redness, pain, heat, swelling, and sometimes loss of function.
Intervertebral Facet Joint (IVFJ): Joints found in the individual vertebrae of the spine, where two vertebrae join.
Myocardial Infarction (MI): The death of cardiac muscle resulting from inadequate blood supply.
Osteotomy: A procedure that involves surgical cutting of the bone to realign the joint and redistribute weight loads; used in the hip and the knee.
Periarticular: General term referring to anything surrounding a joint.
Periosteum: The membrane that covers bone and is essential for bone growth, repair, and nutrition.
Prevalence: The number of people in a population who have a disease at specific point in time.
Rheumatoid Arthritis: A specific type of Arthritis which is an autoimmune disease in which the immune system of the body attacks its own tissues, in this case its own cartilage and joint linings.
Subchondral Cyst: A sac with a distinct connective tissue wall, containing a fluid or other material, located beneath cartilage.
Synovial Membrane: A vascular tissue lining the joint capsule.
X-ray (radiograph): A photographic image taken to view bones and other hard substances in the body.
The Importance of Diet and losing weight with Osteoarthritis
Can I Do Anything To Improve My Osteoarthritis?
Because there is obviously no way to change ones age, many patients with Osteoarthritis believe that there are no modifications in their behavior or lifestyle, which can improve their health and relieve their symptoms. However, research has shown that changes to both diet and exercise can greatly improve symptoms including reducing pain and slowing the progression of Osteoarthritis. For a comprehensive website dedicated to weight loss with the top rated weight loss books, latest weight loss news, blogs and weight loss supplements, follow this link: www.Not Just Weight Loss Books.com
You need to educate yourself on important lifestyle changes and treatments including diet, specific exercises, and weight control. Since Osteoarthritis cannot be cured, these changes will likely need to be permanent additions to your lifestyle so that you can manage your disease more effectively. However, as with all changes to your diet and activity, it is important to discuss it with your doctor.
How Important Is My Weight?
Being overweight or obese is an important risk factor in the progression of Osteoarthritis. Being overweight worsens Osteoarthritis because the extra weight puts additional strain on joints, especially in the lower limbs which bear your weight. If you are overweight, losing weight and eating healthy provides multiple benefits. This is especially true in managing your Osteoarthritis and slowing the progression of the disease.
Can Any Special Diet Help?
Diet is extremely important in the management of Osteoarthritis like all other medical conditions. Research suggests that some specific foods may help with Osteoarthritis. A good book that will show you the ideal foods to eat and how to prepare them to reduce inflammation is “Meals That Heal Inflammation”. If you are looking for a yeast free cooking option, another book is “Yeast Free Cooking”. In general, most of the evidence suggests that a healthy diet and reducing weight, if needed, is important in slowing the progression of the disease.
In addition, how food is prepared is also very important for the management of Osteoarthritis. There are number of options for losing weight to help control symptoms associated with Osteoarthritis but the following are some of the best complete meal programs designed by doctors and based on Medical information:
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Bistro M.D.-Founded by Dr. Caroline J. Cederquist, M.D. one of the few medical doctors in the country who specializes in weight loss, with the belief that a diet plan should be healthy, delicious and convenient. BistroMD™ delivers on that vision by providing chef prepared, doctor-approved meals that help our clients to loose weight safely. It is considered the best quality home delivery Diet Program on the market. For the past 15 years Dr. Cederquist and her team of registered dietitians, trained behavioral therapists and lifestyle counselors has been helping clients lose weight successfully.
Simple, Easy to Follow Plan- The team of dietitians and chefs have worked exhaustively to come up with a complete system that is simple and effective. Customers order from one of our four programs and enjoy tasty, nutritious balanced meals. Just heat, eat and lose weight – – what could be easier?
Medifast-Another option for complete meals based on medical evidence is Medifast which is a quick, easy, and convenient weight loss program that has been used by over a million people for over 25 years. The low-calorie, pre-measured Medifast Meals are vitamin fortified, nutrient-balanced meals that provide an easy weight loss solution.
Lose up to 2-5 lbs per Weeks!
Medifast not only helps people control their weight, but also improves their overall health. The 50 delicious Medifast Meals, which include shakes, bars, soups, oatmeal, chili, drinks, and puddings, offer an average weight loss of 2 to 5 pounds per week. Medifast Meals are clinically proven and have been recommended by over 15,000 physicians
Dr. Siegal’s® Cookie Diet ™-Although the program is called Dr. Siegal’s® Cookie Diet ™, there’s much more to it than eating cookies. It’s a doctor-supervised system of weight loss on which you’ll lose weight on a restricted calorie diet. They help with controlling your hunger with our proprietary cookies, shakes and soup. They will also evaluate your metabolic state to see if you have a sluggish metabolism caused by a condition called hypothyroidism.
Dr. Sanford Siegal’s COOKIE DIET™
The Medical Group is the South Florida medical practice of renowned physician, author, and weight loss expert Dr. Sanford Siegal and the birthplace of the world famous Dr. Siegal’s® COOKIE DIET™ system and hunger-controlling cookies, shakes and soup. They have helped more than a half million people lose weight safely, quickly and affordably.
Why Do I Need To Understand My Osteoarthritis?
The Importance Of Patient Education:
In the most recent edition of the American College of Rheumatology guidelines for the management of OA, education is listed as the critical initial step in the overall approach to the treatment of OA. Education and reassurance for the patient, their family, and caregivers is recognized as an important component of OA therapy. It is essential to understand the benefits of taking an active role in the management of their disease. Some patients have a negative attitude toward their disease, are coping with depression, and fail to utilize therapies that could be beneficial to health. In some cases, uninformed patients may actually worsen their Osteoarthritic conditions like those patients who wrongly believe that it is best to be inactive in order to protect joints affected by Osteoarthritis. The misconception that physical inactivity may have some protective effect on arthritic joints may lead to muscle atrophy, disability, as well as to adverse cardiovascular effects. Because of the harmful effects that may result from actions taken by patients whom are uninformed, it is critical to understand the disease.
As with any other diseases, all people have their own ideas about their disease including what causes it, and what the treatments should be. These individual perceptions that people hold vary significantly across different cultures, races, genders, and socioeconomic classes. An even more important variation is the one that exists between the physician and the patient. Several studies of other diseases have shown a positive correlation between more congruent patient and doctor models of illness and improved treatment outcomes.
As a result of the inherent differences between the educational backgrounds and experiences of the patient and the doctor, it is often the case that the patient’s understanding of his or her disease, its consequences, and the risks and benefits of possible treatment options are different from those of the doctor. The doctor-patient relationship suffers when this situation exists and no measures are taken to bring the patient’s understanding of these issues to a level that again restores the function of the doctor-patient relationship. Equivalence in understanding is not the goal; rather the objective should be for the patient to have a generalized concept of his or her disease and treatment that mirrors the surface of the doctor’s understanding. The end result of a situation where the patient’s understanding is not congruent with the doctor’s understanding may be patient noncompliance with regard to prescribed treatments. Concerns for patient noncompliance and the less than optimal treatment outcomes that results when there are large inconsistencies between a physician’s and a patient’s understanding of OA are the reasons why it is essential for the doctor to have a good understanding of the patient’s knowledge of the disease process. Thus the outcome of the patient’s medical treatment and ultimately his or her disease state is dependent on the patient’s level of awareness as well as the doctor’s recognition of the patient’s level of comprehension.
Does Glucosamine Work For Osteoarthritis?
Do Supplements Work?
There are a number of supplements that claim to be beneficial for the treatment of Osteoarthritis. However, there is very little medical evidence to support most of the claims with the exception of vitamins as a part of a healthy diet and Glucosamine Sulphate. Many of the companies are free to make any claims they choose with marketing etc. because in the U.S., the Food and Drug Administration (FDA) does not review products listed as “supplements”. The two most common supplements for Osteoarthritis which do have some evidence to support their use to relieve pain are Glucosamine and Chondroitin.
What Is Glucosamine and Chondroitin?
Glucosamine and Chondroitin are substances naturally found in healthy cartilage in joints and have been shown to be effective in relieving pain in some studies.
Glucosamine is available in three different preparations:
- Glucosamine Sulphate
- Glucosamine Hydrochloride
- Glucosamine NAS
Only Glucosamine Sulphate along with Chondroitin has been shown to be effective in reducing pain and symptoms. However, people who have an allergy to shellfish should not use either product.
They may need to be taken for several weeks to a number of months before any pain and symptomatic relief is apparent. During this period it is important to continue taking the product to maximize benefits.
The particular brand is very important in providing benefit to patients. Recently, Consumer Reportsdid a review on Glucosamine Sulphate/Chondroitin. The review warned that many brands did not accurately list the amount of Glucosamine in the product and also rated numerous brands on cost/value. In the review, the Vitamin World’s “Joint Soother Double Strength Glucosamine Chondroitin” brand was rated by Consumer Reports as one of the best brands because of its purity and accuracy in listing the amount of Glucosamine in the product. In addition, the Vitamin World’s “Joint Soother Double Strength Glucosamine Chondroitin” was also rated as one of the top values based on price. For convenience, here is a link to find Vitamin World’s “Joint Soother” Double Strength Glucosamine and other related products. It is important to remember that a company can make any claim it chooses on how much Glucosamine is in the bottle etc. so use a reputable brand.
Other Supplements-Commonly used but with little evidence to support their use to treat OA:
- Omega-3 fatty acid-unsaturated fat fatty acids commonly found in fish
- Vitamin B9 (folate) and B12
- Vitamin D
- Antioxidants-including vitamins C and E
- Ginger extract
- Bone Morphogenetic Protein 6 (BMP-6)
- Avocado/soybean extract
- Frankincense-derived from specific trees in India
- Bromelain-enzymes found in the Bromeliaceae family of plants
- Hydrolyzed collagen (hydrolysate) (a gelatin product)
Although Osteoarthritis is painful, uncomfortable and irreversible, in most cases is does not cause permanent disability. There are a number of treatment options available for the management of Osteoarthritis to ease pain and other symptoms including:
Medical Osteoarthritis Treatment Options
Surgical Osteoarthritis Treatment Options
Non-Medical Osteoarthritis Treatment Options
It is very important for patients to have clear discussions with their caregiver (doctors, nurses and physical therapists etc.) on what the various treatment options might include. Research has shown that patients who fully educate themselves on the disease process, what to expect from their disease, and the various treatment options have much better treatment results and can actually slow the progression of the disease process.
Managing Osteoarthritis will vary from patient to patient because the disease and the resulting symptoms vary greatly with each individual. In addition, not all the joints in an individual will be affected in the same manner. The severity of symptoms and damage to the joints will likely vary from joint to joint.
Who Treats Osteoarthritis?
Primary Care Physicians or General Practitioners (GP’s): doctors who treat general conditions for patients before they are referred to other specialists in the health care system.
Rheumatologists: doctors who specialize in treating arthritis and related conditions that affect joints, muscles, and bones.
Orthopedists: surgeons who specialize in the treatment of, and surgery for, bone and joint diseases.
Physiatrists (rehabilitation specialists): medical doctors who help patients make the most of their physical potential and address pain.
Chiropractors: doctors that focus on diseases and treatments of mechanical disorders of the musculoskeletal system and the nervous system.
Physical Therapists: health professionals who work with patients to improve joint function.
Occupational Therapists: health professionals who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
Dietitians: health professionals who teach ways to use a good diet to improve health and maintain a healthy weight.
Nurse Educators: nurses who specialize in helping patients understand their overall condition and implement their treatment plans.
Licensed Acupuncture Therapists: health professionals who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.
Psychologists: health professionals who seek to help patients cope with difficulties in the home and workplace resulting from their medical conditions.
Social workers: professionals who assist patients with social challenges caused by disability, unemployment, financial hardships, home health care, and other needs resulting from their medical conditions.
How Is Osteoarthritis Diagnosed?
The Process of Diagnosing Osteoarthritis:
The onset of Osteoarthritis and the associated symptoms are subtle in nature. Osteoarthritic changes to joint structure occur over a period of time, usually years, and signs and symptoms of the disease appear gradually. A complete history of Osteoarthritic symptoms such as crepitus (thecrackling or popping sounds and sensations in a specific joint), pain, and immobility will only be revealed by patients to their physicians when a thorough case history is taken. An extensive case history is very valuable as it will reveal an accurate representation of the signs and symptoms of OA. Without a thorough case history and a tested pain scale the patient will likely experience inadequate pain management, increased joint degradation, muscle wasting, impaired healing, weakness, and patient suffering can result.
In addition to lab tests, X-rays (radiographs) may also be used in the diagnosis of OA. According to the American College of Rheumatology criteria for the diagnosis and classification of Osteoarthritis, X-Ray (plain radiograph) remains one of the best diagnostic tools in the assessment of the severity of OA. Radiographic evidence of OA is in most cases diagnostic, and is highly consistent with the severity of the disease. More advanced cases of OA will demonstrate greater amounts of cartilage and joint degradation upon X-Ray examination. Some typical X-Ray changes seen in OA, may include cartilage loss resulting and presenting as asymmetrical joint-space narrowing, increases in bone density, subchondral cyst formation, osteophyte formation, and deformities at the end of bones in severe OA. Evidence of cartilage loss resulting in joint-space narrowing, and of the presence of osteophytes and sclerosis or increased bone density, are the two main criteria for the radiographic diagnosis of OA.
The Importance Of A Proper Diagnosis:
A complete patient history and a complete physical could prevent unnecessary suffering in both elderly and younger arthritis sufferers. One example of unnecessary suffering that occurs when physicians do not thoroughly investigate patients’ symptoms is in the case of elderly patients. Though the primary symptom that Osteoarthritic patients report to physicians with is pain, older patients tend to underreport the intensity of their pain to physicians. The failure by the elderly to fully disclose the entire scope of their pain to physicians is especially alarming, because studies have found that sensitivity to pain increases with age. Aside from pain management, a complete physical is also necessary for the diagnosis of OA. Other signs including crepitus, bony enlargements, reduced range of motion in affected joints, and tenderness upon the palpation of affected joints can all be detected with a complete physical. Laboratory tests can also be conducted and may assist in the diagnosis of OA, primarily helping to rule out other conditions such as Rheumatoid Arthritis and lupus, which may present with signs and symptoms similar to OA. Although it is not sufficient evidence for the diagnosis of OA, laboratory testing may reveal reduced white blood cells counts and the presence of proteins that contribute to the inflammatory process in the disease.
What Are The Risk Factors For Developing Osteoarthritis?
There Are Numerous Risk Factors
The exact reason that Osteoarthritis occurs is not known. However, there are many combinations of factors (being overweight, the aging process, joint injury or stress, heredity, muscle weakness) that can increase the risk of developing Osteoarthritis. The disease can be classified broadly into two categories based on the factors involved:
- Primary Osteoarthritis- Occurs mostly as a result of aging when degenerative cartilage changes occur within a joint. Heredity is also considered a primary cause of OA.
- Secondary Osteoarthritis- Occurs as a result of another by a disease or condition. The conditions that can cause secondary Osteoarthritis include abnormal joints at birth (congenital abnormalities), possible hormone disorders, obesity, joint damage, excessive stress on joints or surgery to the joint.
These factors are classified as either generalized or localized risk factors.
Generalized Risk Factors: are more systemic in nature, affecting the entire body, and include age, obesity, gender, and genetics/ethnicity.
Age: is the most common generalized risk factor for developing OA. As a person ages, the chances of developing Osteoarthritis in all joints increases until the age of 70. Although age is a strong factor in the development of OA, it is uncommon before the age of 40. The strong association between age and Osteoarthritis may be best explained by the changes in the joint cartilage that occur with time. These changes cause a loss of cartilage function which prevents the normal reparative processes in the joint. This leads to an increased risk for loss of cartilage injury to the joint.
Being Obese: Has been identified as the most important factor in the progression of OA especially of the Knee. An increase in weight places additional stress on load bearing joints such as the knee. This additional weight automatically increases the chance for developing OA. In addition to the physical strain that obesity places on the joints, there is also a metabolic component to obesity, which increases the risk for the progression of OA. Studies have found that excessive amounts of fatty tissue, termed adipose tissue, result in the release of specific hormones and growth factors. Excess fatty tissue may predispose joints to the development of OA and may also cause progression of OA that already exists. Lastly, being obese can make the pain associated with hip and knee Osteoarthritis more severe.
Vitamin Deficiency-Inappropriate Diet: A poor diet can be a risk factor for the progression of Osteoarthritis, because certain vitamin deficiencies can influence the progression of the disease. In studies that examined levels of vitamin D in the blood, it was determined that patients with low levels of Vitamin D had three times the risk for the progression of OA. In another study, low levels of vitamin C were also associated with the progression of OA. However, although studies have found low levels of certain vitamins can affect the progression of OA, this does not mean that low levels of certain vitamins will cause the development of OA.
Being Female: Science has shown that women are more susceptible to obesity the men, and because obesity is an important risk factor for OA, women are therefore at greater risk for developing OA. In addition to obesity, other factors, such as females hormones lead to the development of OA. Because the presence of certain hormones is associated with OA, and the type and amount of hormones differ between men and women, specific types of OA affect only women. For example, Menopausal OA, also known has Nodal Generalized OA, is caused by hormone level fluctuation and its onset is consistent with the beginning of menopause. The tendency of specific types of OA and the prevalence of obesity in women is the reason why being female can be considered a risk factor for OA.
Family History/Genetics: Osteoarthritis can be found in several members of the same family suggesting heredity may play a role. In fact, it has been suggested that up to 60% of OA casesresult from genetic factors. Studies conducted on Nodal Generalized OA have revealed this particular type of OA has a strong hereditary component in the development of OA of the hip and knee. It is believed that mutations in specific genes are linked to the development of OA. However, the particular gene involved had not been identified.
Ethnicity: The occurrence of OA in specific joints also varies according to race. For example, in comparison to Caucasians, Blacks and Asians are less commonly afflicted with OA of the hip, and black Africans and Malaysians are less commonly afflicted with OA of the hand. These differences seen across different races suggest that race may be an important risk factor in developing OA in certain joints.
Allergies and Infections: There has been some research that examined the possibility of an allergy or an infection can lead to the development of OA, however, at this point there is little evidence to support this idea.
Localized Risk Factors: Can result from a congenital (you are born with it) defect, a history of surgery, or a previous injury to the joint.
Wear and Tear:
OA is often referred to as ’wear and tear’ arthritis. However this is not completely accurate because normally joints are exposed to small amounts of stress through daily activities and are able to repair themselves without causing OA. In Osteoarthritis, the body’s natural repair process does not work properly during normal wear and tear activities of daily life. Wear and tear activities will only cause a progression of OA if the joint was abnormal in some way such as a congenital defect, previous injury, etc.
Joint Injury or Surgery:
Osteoarthritis can develop in a joint if it has been previously damaged by injury. If a fracture is not properly set the bones heal badly and the neighbor joints are put to abnormal stress leading to osteoarthritis. Sometimes osteoarthritis is caused by injury and damage from a different kind of joint disease that occurred years before. For example, people with rheumatoid arthritis can develop ‘secondary’ osteoarthritis in those joints in which the rheumatoid inflammation has largely burnt out but where the joint remains damaged by the disease.
Congenital Defect (you are born with it):
People who are born with abnormally formed or misaligned joints, those whom have injured a joint, or those whom have had surgical alteration to a joint are all at greater risk for the development of OA. In a joint that is abnormal, regardless of the cause of the defect, increased mechanical load, whether it is the result of heavy lifting or repetitive movement is a risk factor for OA.
The Anatomy and Joint Disease of OSteoarthritis:
Although the disease process is degenerative over time, otherwise termed the Osteoarthrosis component, it can also present with low-grade inflammation in the periarticular tissues. The disease presents asymmetrically and can affect a number of joints throughout the body. Osteoarthritis is most common in the distal interphalangeal joint (DIP) of the hand, base of the thumb-first carpometacarpal joint (CMC) (yellow and prurple area), intervertebral facet joints (IVFJ), as well as various joints of the knee, ankles, and hip. OA can also affect the wrist, elbow, and shoulder, but these joints are less commonly affected. In joints afflicted with OA, all of the components within the joint and those structures surrounding and supportive of the joint are affected. These include the cartilage, bone, soft tissue, synovium, joint capsule, periarticular ligaments, periosteum of the bone, and the periarticular muscles. The function of articular cartilage is to absorb stress under a mechanical load and to provide a smooth surface for moving joints to course over. The cartilage consists of cells called chondrocytes, which are embedded in a matrix, which consist of substances such as collagen and proteins that function, respectively, to provide strength, and to hydrate and sustain the chondrocytes. The chondrocytes line the joint, creating a cellular layer, and produce a substance called synovial fluid, which provides lubrication between the smooth surfaces of the bones. The joint capsule is a structure that encapsulates the joint space, or synovium. The supporting ligaments and tendons of the joint lie external to the capsule. The matrix of the cartilage is in a constant state of break down and repair, referred to respectively as catabolism and anabolism. This process is ideally balanced or homeostatic and is mechanically driven and chemically mediated.
An imbalance in the homeostatic process of the degradation and rebuilding phases of cartilage is believed to be the primary cause of OA. When joints engage in movement, the production of chondrocytes is stimulated in order to replace those cells lost in degradation. Prolonged disuse of joints causes changes in the makeup of the matrix of cartilage, ultimately resulting in a loss of joint function. Age-related changes in the composition of the matrix, decreased sensitivity of chondrocytes to stimulation and a loss of function of these cartilaginous cells all contribute to the development of OA in a joint. Abnormal reparative processes and inflammation of the cartilage can lead to the formation of anomalous boney structures known as osteophytes or bone spurs, which replace normal flexible, functional cartilage.
Inflammation can occur through the formation of osteophytes and through swelling that is associated with the inflammatory process, contributes to patient pain and discomfort.
The most prominent inflammation, termed synovitis, presents in the form of warmth, swelling, and thickening of the fluid within the joint. Though laboratory testing has identified common signs of inflammation in some Osteoarthritic patients, not all patients with OA present with the inflammatory component of the disease.
Pain involving one or more joints is the most common complaint made by osteoarthritic patients to their physicians. The onset of pain in OA is insidious and its severity is mild to moderate. OA pain in less-advanced disease states is generally worsened with joint use and relieved by joint rest. However, patients exhibiting more advanced OA are more likely to complain of joint pain during rest and throughout the night. The degradation and loss of cartilage in the joint causes pain, as the weight-bearing joints are no longer cushioned at the junction of the two bones. The structural sources of pain include the synovial membrane, joint capsule, periarticular ligaments, periarticular muscle spasm, periosteum, and subchondral bone. The pain mechanism can be the result of one of the many abnormal features that can occur in OA. Possible mechanisms of pain in OA include: increased intracapsular pressure, pressure between bones, microfractures, effects of muscle wasting, and the structural changes within and around the joint.
In addition to pain, stiffness is also a common symptom of OA. Stiffness associated with prolonged periods of immobility, as during sleep, often resolves within thirty minutes of joint use. The stiffness associated with OA is the result of abnormal joint function, and the effect that it has on the structures surrounding the joint. The duration of time for stiffness to resolve lengthens with progression of the disease. In addition to stiffness, patients may also present with crepitus, which is an often audible and palpable grinding between the bones of a joint, secondary to the increased contact between boney surfaces. Additional symptoms resulting from structural changes within the joint include a decreased range of motion in the affected joint, resulting in functional impairment.
Pathophysiology-What Happens In Osteoarthritis?
The main cause of Osteoarthritis is an imbalance in the natural breakdown and repair process that occurs with cartilage. In Osteoarthritis, damaged cartilage cannot repair itself in the normal way. It occurs when the cartilage that covers and cushions the ends of bones in your joints deteriorates over time. Cartilage is composed of water, collagen, and specific proteins.
In healthy cartilage, there is a continual process of natural breaking down and repair of the cartilage in joints. This process becomes disrupted in Osteoarthritis, leading to cartilage deterioration and an abnormal repair response. The reason this normal repair process is disrupted is not known but it is likely caused by several factors.
With aging, the water content of the cartilage increases, and the protein makeup of cartilage breaks down.
Eventually, the smooth surface of the cartilage begins to deteriorate and become worn causing friction between the bones. If the cartilage wears down completely, the result will be bone to bone contact. Repetitive use of worn joints over the years can irritate the cartilage, causing joint pain and inflammation of surrounding tissues. As pieces of cartilage break off, the bones thicken and broaden, causing inflammation. This inflammation may stimulate new bone outgrowths called spurs (also called osteophytes) to form around the joints. As the bones thicken and broaden, joints become stiff, painful, and may be difficult to move. Fluid may also build up in your joints.
Everyone Develops Osteoarthritis…………….Eventually!
It usually affects people in later stages of life, and by age 75, virtually everyone will develop some symptoms of Osteoarthritis. However, OA occurs at a slightly higher rate in women than in men. This occurs since OA generally develops earlier in women and many forms, such as Menopausal OA, only affect women. Overall, in the U.S., the Centers for Disease Control and Prevention (CDC) estimate that approximately 27 million Americans (1 out of every 6 people) have Osteoarthritis. Globally, Osteoarthritis occurs throughout the world in all races and has been common throughout history.