Health Break | Published January 31, 2011

Degenerative Joint Disease and Osteoarthritis

Osteoarthritis is not inevitable, but as we age, most people will eventually have some degree of osteoarthritis. The disease results from a degeneration of cartilage in joints, which can be thought of as wear and tear on the joint. As the most common joint disease, osteoarthritis currently affects over 20 million Americans. In addition to damage to the cartilage, a degenerative joint disease can include bony overgrowths and sclerosis (hardening) of the bones at the joint. There may also be deformity of the joints. If the cartilage is damaged or sufficiently worn, the bone on one side of a joint may begin to rub against the bone on the other side, causing pain.The most common form of osteoarthritis occurs in finger joints, which become enlarged from bony overgrowths. Another form happens in the spine, mostly in the neck and lower back. The disease is also common in the knees and hips, and can result in joint replacements.A sign of osteoarthritis is stiffness, especially when getting out of bed or after sitting for a while. If this stiffness is due to osteoarthritis, it gets better as the day goes on. Other signs are a “crunching” feeling in a joint, or swelling in one or more joints, especially the knees. One of the most common signs that patients have osteoarthritis is pain, and sometimes it is a great deal of pain. When you go to see a doctor, they will ask about your symptoms and want to know when and how the symptoms started. To confirm a diagnosis of osteoarthritis, a doctor might request various tests, including X-rays and an MRI. If the symptoms of osteoarthritis include swelling in the knees, the doctor may do a fluid aspiration to check for other causes.Osteoarthritis is a common result of aging, but it can also be caused by an accident, and there is a strong genetic component as to whether the degeneration will occur. While aging is clearly a factor, there are some very elderly people who do not have osteoarthritis.Aside from the normal wear and tear of aging, contact sports that stress the joints will increase the chance of osteoarthritis, though this does not include the exercise of running. Weight has a great deal to do with this illness, because the more the patient weighs, the more stress there is on the weight-bearing joints of the knees and hips.Goals for treatment of osteoarthritis are (1) to control pain, (2) to improve joint function, (3) to maintain a normal weight, and (4) to achieve a healthy lifestyle. Treatment depends on the severity of the condition, and in some cases ice or heat are enough to control the discomfort and allow for normal activities. For pain relief, patients might take acetaminophen, or for both pain relief and swelling, an NSAID (aspirin, ibprofen, naproxen).Treatment will also usually involve exercise, including low-impact aerobics and walking. In general it is important to do exercises that involve a range of motion, to maintain limberness. Some doctors also say that maintaining a healthy lifestyle that includes exercise and keeping body weight in normal ranges will help to prevent osteoarthritis.Valerie Coakley, RN,BSN, is the Orthopedic Case Manager at Mount Nittany Medical Center, State College. More info on osteoarthritis and classes about joint replacement surgery, go to www.mountnittany.org or call Valerie at 814.278.4810.

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