US Pharm. 2014;39(3):13-14.
Degenerative Joint Disease
Osteoarthritis is a common type of arthritis that results from the breakdown of the spongy cartilage
that cushions the joints. Because cartilage that keeps joints moving
smoothly wears down over time, this type of arthritis often affects
people in middle age and beyond.
The joints affected by osteoarthritis can be painful,
stiff, and swollen. Although some people with mild osteoarthritis do not
suffer from symptoms, this condition can cause serious pain and
stiffness for others. There is no cure for osteoarthritis, and it slowly
worsens with time. Therapy includes exercises, medications, and
surgical procedures to lessen the impact of this joint disorder on daily
Simple Steps Can Help Relieve Pain and Stiffness
Osteoarthritis is a disorder of the joints that is
sometimes referred to as “wear and tear” arthritis. It usually develops
slowly as people grow older, but it can also affect younger people after
an injury or those born with a joint or cartilage defect.
Causes and Symptoms
People who are overweight often develop osteoarthritis in
the hip, knee, ankle, and foot joints. These joints bear the weight of
the body and wear out more quickly. Osteoarthritis can affect the joints
of the shoulder, elbow, wrist, and hands—especially if these joints are
used repeatedly at home or work over many years.
Without the cushion of cartilage tissue, the space between
bones in the joint becomes narrowed. The ends of the bones eventually
rub together as the joint moves, causing stiffness, pain, and swelling.
Tiny pieces of bone (bone spurs) may form when the ends of bare bones
rub together in the joint. The joints may creak or make a grating noise
as they move. Arthritis joints may not move as freely.
Many people with osteoarthritis have stiffness and pain in
their joints. The stiffness is common when the joint is at rest for a
period of time. Often patients report that their symptoms are worse when
first rising in the morning, a condition known as morning stiffness.
The stiffness improves as the joint is used. Pain can occur at rest or
during activity. Some patients report that the pain awakens them during
the night, when their joints are at rest. Others have more pain when
moving the arthritic joint.
Diagnosis and Treatment
Osteoarthritis can be diagnosed using an x-ray, which will
show a narrow joint space between bones or the presence of tiny bone
spurs. Blood tests are not helpful, but often the physical exam of the
joint will show swelling. Specific causes of arthritis, such as gout,
infection, or rheumatoid disorders, should be investigated before
Although there is no cure, some simple steps can help
relieve pain and stiffness. Many people find that applying heat
alternating with cold packs is soothing to arthritic joints. Gentle
physical activity, including stretching and water exercise, is important
to keep moving without pain. Any exercise that causes an increase in
joint pain should be avoided. Physical therapy may help strengthen the
muscles around the arthritic joints for some patients, which increases
flexibility and decreases pain. Occupational therapy can teach
techniques to help with everyday activities in the home or workplace.
Joints may be supported with a brace or splint, or through the use of a
cane or similar aid. Even a small weight loss in an overweight or obese
person can significantly reduce the stress on arthritic joints and slow
Nonprescription medicines used to relieve symptoms include
acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen and naproxen. Acetaminophen relieves pain, but it should be
used carefully according to the package directions to avoid liver or
kidney damage. NSAIDs relieve pain and swelling, but they can cause
stomach upset and other side effects. Some pain-relief products are in
cream form and can be applied directly to the arthritic joint.
Corticosteroids can be injected into the arthritic joint and repeated a
limited number of times if this treatment helps control pain and
inflammation. Artificial joint lubricant products are also available for
injection into arthritic knee joints if more conservative measures
fail. If symptoms are not improved by medications, there are several
surgical procedures, including joint replacement, that restore movement
to seriously arthritic joints.
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