AGING CONDITIONS: ARTHRITIS
Introduction to Arthritis
There are over 100 types of arthritis, and not all
are related to age. The most common type – osteoarthritis,
followed by rheumatoid arthritis.
Most joints allow smooth movement between bones and
to absorb shock from movements. The joint is made up
of:
- Joint capsule - a tough membrane
sac that holds all the parts of the joint together.
- Ligaments, tendons, and muscles - hold
the parts of the joint in place and allows the joint
to move in the right directions, preventing movement
in the wrong directions.
- Cartilage - a hard slippery coating
on the end of each bone. This cartilage breaks down
and wears away in osteoarthritis.
- Synovium - a thin membrane inside
the joint capsule.
- Synovial fluid - a lubricating
fluid that assists easy movement and keeps the cartilage
healthy.
More
information on arthritis
Osteoarthritis
Osteoarthritis is the most common of arthritis and
is one of the most frequent causes of physical disability
among adults. It is also known as degenerative joint
disease or the "wear-and-tear" arthritis.
Osteoarthritis is primarily a disease in older people
but can occur as a secondary condition in younger people.
More than half the population over age 65 have a degree
of osteoarthritis in at least one joint. It affects
both men and women, with more men before age 45, having
the disease, but after age 45, it is more common in
women.
Causes & Impact of Osteoarthritis
Any factor that causes wear on the joints, can accelerate
the onset of osteoarthritis. This includes: injury,
excess weight, genetics and occupational factors.
Osteoarthritis mostly affects the cartilage, of the
joint. Healthy cartilage provides a lubricating layer
to help bones articulate with each other and to absorb
energy from the shock of physical movement. In osteoarthritis,
the surface layer of cartilage breaks down and wears
away. This allows bones under the cartilage to rub together,
causing pain, swelling and loss of motion of the joint.
Over time, the joint may also become mishapened.
Osteoarthritis may also be complicated by small growths
on the edges of joints called bone spurs [osteophytes].
Bits of bone or cartilage can break off and float inside
the joint space, causing greater pain and damage.
Osteoarthritis affects each person differently, and
has a highly variable onset rate. Scientists have yet
to determine what causes osteoarthritis, but suspect
a combination of factors, including: the aging process,
being overweight, joint injury and activities putting
excessive stresses on joints.
Osteoarthritis most often occurs at the:
- knees
- hips
- lower back
- neck
- ends of the fingers
- thumbs
The movement restriction and pain that accompany osteoarthritis
has pervasive lifestyle effects that can lead to limitation
of daily and work activities, with depression a not
uncommon result. In spite of this, most people with
osteoarthritis can lead active and productive lives,
controlling the disease and its symptoms.
Usually, osteoarthritis comes on slowly. Early in
the disease, joints may ache after physical work or
exercise. Osteoarthritis can occur in any joint. Most
often it occurs in the hands, knees, hips and spine.
Diagnosis of Osteoarthritis
No single test can diagnose osteoarthritis. Most doctors
use a combination of the following:
- Clinical history - To determine
history of movement restriction and pain, and any
medication taken.
- Physical examination - general
exam including reflexes and muscle strength. Movement
ability is also checked.
- X rays – show much joint
damage has been done to cartilage and bones.
- Blood tests – To rule out
other causes
- Joint aspiration - drawing fluid
from the joint for examination.
The complication in diagnosis of osteoarthritis cases,
is primarily due to the reality that most adults have
some degree of osteoarthritis. Other causes of the symptoms
has to be ruled out before a confirmation of osteoarthritis
as the cause is required.
General Symptoms of Osteoarthritis
- Steady or intermittent pain in a joint –
however, two thirds of those with osteoarthritis don’t
complain of plain.
- Stiffness in a joint after periods of inactivity
- Swelling or tenderness in one or more joints
- A crunching feeling or the sound of bone rubbing
on bone
Joints that feel hot, tender and stiff are generally
due to rheumatoid arthritis, not osteoarthrtitis.
More
Information on Osteoarthritis
Specific Joint Symptoms & Treatments
Hands
Osteoarthritis of the fingers is more common in women
after menopause and appears to have some hereditary
factors. Small, bony knobs appear on the joints of the
fingers, with fingers becoming enlarged and gnarled.
Aching, stiffness, and numbness are common. Osteoarthritis
of the hands can be treated with medications, splints,
or heat treatment.
Knees
The knees are the most commonly affected by osteoarthritis,
being the body's primary weight-bearing joints. Stiffness,
swelling and pain in the knees makes it hard to walk
and manoeuvre. Untreated, osteoporosis in the knees
can lead to disability, requiring knee replacement.
Medications, weight loss, exercise, and walking aids
can reduce pain and disability.
Hips
Osteoarthritis in the hip can cause pain in the hips,
groin, inner thigh, buttocks, or knees. Pain in the
knees often confuses those into thinking they have knee
problems, when in reality, the disease is in the hips.
This is due to the stiffness in the hips impacting the
normal movement of the limb, causing the knees to strain
when trying to compensate for the misalignment. Walking
aids, such as canes or walkers, can reduce stress on
the hip and knees. Severe cases require hip replacement.
Spine
Weakness or numbness of the arms or legs is a common
symptom of osteoarthritis of the spine. The neck and
lower back are the most common areas of the spine that
experience stiffness and pain. Heat treatments, exercise
programs to strengthens the back and abdominal muscles
and using supportive mattresses provide relief. In severe
cases, surgery is indicated to reduce pain and help
restore function.
General Osteoarthritis Treatments
There are now many nutritional
supplements available containing glucosomine and condrotin
that are proving extremely effective in helping prevent
deterioration of tissue surrounding the joints and erosion
of joint bones.
Osteoarthritis treatment involves a combination of
therapies tailored to the patient's needs, lifestyle,
and health. Osteoarthritis treatment has four general
goals:
- Improve joint care through rest and exercise.
- Maintain an acceptable body weight.
- Control pain with medicine and other measures.
- Achieve a healthy lifestyle.
A typical treatment plan may include:
Exercise Program Guidelines
The amount and form of exercise will depend on which
joints are involved, how stable the joints are, and
whether a joint replacement has already been done. Exercises
used include :
-
Maintain strength and agility in joints –
resistance exercise bands, neck, back and abdominal
- Extend your range of movement – agility exercises,
often using water as a support medium to remove the
impact of weight from the joints during movement.
- Reduce weight – aerobics,
keep supple with stretching
exercises
- Relaxation
Learning to recognize the body's signals, are important
to use as signals when to stop or slow down. Techniques
include simple rest, meditation, biofeedback
Joint Protection and Assistive Devices
Canes, splints and braces can provide extra support
for weakened joints and to keep the joint in the correct
position during sleep or activity. Use should be balanced
with sufficient exercise to prevent stiffness and weakness.
Thermal Treatments
Both warm and cold packs can provide pain relief. Check
with a doctor or physical therapist to as to which treatment
is best for your condition.
Orthotics
For osteoarthritis in the knee, patients may wear insoles
or cushioned shoes to redistribute weight and reduce
joint stress.
Weight Loss
To reduce stress on weight-bearing joints and limit
further injury.
Surgery
Surgery may be performed to:
- Remove loose pieces of bone and cartilage from
the joint if they are causing mechanical symptoms
of buckling or locking
- Resurface (smooth out) bones
- Reposition bones
- Replace joints with artificial joints called prostheses.
These artificial joints can be made from metal alloys,
high-density plastic, and ceramic material and can
last 10 to 15 years or more. Choice of material is
determined by the patients weight, gender, age , activity
level and other medical conditions. The hip or knee
joints are the most commonly replaced.
Medication
Medication is used to eliminate or reduce pain and
to improve functioning. The most common medications
used in treating osteoarthritis are :
Acetaminophen - (Tylenol, Excedrin) to relieve pain.
People with liver disease, people who drink alcohol
heavily, and those taking blood-thinning medicines or
NSAIDs should use acetaminophen with caution.
NSAIDs (non-steroidal anti-inflammatory drugs) –
to reduce inflammation and relieve pain.
Movement Therapy
Joint stiffness associated with arthritis is mostly
because people with arthritis avoid movements that can
increase pain. Two treatment methods of instant benefit
are: physical therapy and occupational therapy.
Physical Therapy - by mobilizing
arthritic joints, using physical therapy, is often of
great benefit for those suffering this disease. The
physical therapist will also teach you exercises that
work out stiffness, without further damaging your joint.
Physical therapy also is useful after an injury, such
as from a fall, and after joint surgery, especially
for artificial joint replacement.
Occupational Therapy – applies
movement to everyday activity. The therapist can teach
you how to reduce strain on your joints by modifying
your home and workplace environments to reduce motions
that may aggravate arthritis. They also may provide
splint type supports for your hands or wrists, and recommend
other devices to aid in tasks such as preparing food,
driving, bathing, dressing, housekeeping and certain
work activities.
Rheumatoid Arthritis
Osteoarthritis affects only joints, rheumatoid arthritis
affects other parts of the body besides the joints.
It begins at a younger age than osteoarthritis, with
swelling and redness in joints, with accompanying symptoms
of feeling sick, tired, and sometimes fever [rheumatic
fever].
NEXT: Cancer
Further Resources
Latest
News on Arthritis and Treatments
Arthritis Foundation
National Institute
of Arthritis Muscoskeletal and Skin [NIAMS]
Arthritis
Care [UK]
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