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Osteoarthritis

By Staff



3/19/2014

Resources

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 activities.

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 treatment begins.

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 further deterioration.

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.

To comment on this article, contact rdavidson@uspharmacist.com.

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