Osteoarthritis is the commonest articular disease presenting with impairment of the articular cartilage, with thinning, wear and destruction of the cartilage. It is mostly seen in knees, wrists and spine. It is a disease characterized with symptoms and clinical examination findings originating from various factors leading to the impairment of the articular cartilage and the underlying bone. Not only the articular cartilage is involved in the disease process of osteoarthritis, but all the structures of the joint are involved. OA leads to functional inability and disability, and impairment, wear, thinning and even loss of the articular cartilage. Furthermore, bone can enlarge or spur can develop on articular edges as a result of changes in the bone underlying the articular cartilage. In conclusion, osteoarthritis is an articular disease that impairs the normal structures of joints and causing limitation of movements and pain with an incidence increasing with the increasing age. It is twice as frequent in females as the frequency in males. This condition is generally seen after 50 years of age. Cartilage ensuring load-bearing in joints will disappear completely in advanced stages and bone surfaces come into contact. Pain will start in the joint with the advancing bone destruction.
The main complaint in osteoarthritis is joint pain, and severity of pain can change from individual to individual. Pain can display exacerbations in time, and generally increases with articular movement. Joint pain and discomfort can increase with weather changes and cold weather. Particularly, swelling of joints and joint stiffness can be seen after the use of the joint. Small spurs can develop in bones in the distal phalanges of fingers. Restriction of articular movements can develop in advanced stages. Definitive treatment of osteoarthritis is not possible for today. The existing approaches of treatment directs at reducing pain to the lowest level possible, and preservation of articular movements.
What are complaints in patients with osteoarthritis?
Pain: Pain is felt in or around the joint, and can be severe. Excessive or long-lasing movements or remaining in standing position without moving for long periods of time can increase pain. In most of the patients, although there is some stiffness and pain in the morning for a short period of time, pain increases with the advancing day.
Swelling: When the joint capsule surrounding the joint is affected from the changes occurring in the joint, the synovial fluid produced in excessive amounts in the joint can lead to swelling. Furthermore, spurs developing at the tips of bones in response to cartilage damages will lead to swollen and lumpy appearance.
Crepitation (crackling sound): This arises from the bones rubbing onto each other in relation with the narrowing of the articular space.
Factors increasing the risk of osteoarthritis development:
Age; Wearing muscles and joints with increasing age and losses in bone density increase the incidence of osteoarthritis.
Gender: Loss in the bone density as a result of hormonal changes occurring with menopause are included in the factors triggering the development of osteoarthritis, and therefore osteoarthritis incidence is higher in women.
Inheritance: Some genes inherited from the mother or father can increase osteoarthritis tendency.
Being overweight: As the excessive weight increases the load on joints with knees in the first place, leads to cartilage damaging and consequently, osteoarthritis. Complaints of individuals with osteoarthritis will increase when they gain weight. Avoiding to gain too much weight and losing some weight can help reducing complaints as well as to preventing the development of osteoarthritis.
Trauma or Excessive use of the joint: Damage developed within the joint exposed to some severe trauma such as a fracture or infection will increase the development of osteoarthritis. For example, football or volleyball players are more likely to develop osteoarthritis in future as they suffer numerous knee traumas. Again, possibility of osteoarthritis is higher in individuals carrying heavy objects or those who have to squat frequently.
Immobility: Immobility is as harmful for joints as excessive use. Immobility leads to loss of flexibility in joints and weakness of muscles supporting the joint.