Osteoarthritis - Joint Pain and Stiffness, Osteoarthritis Symptoms and treatment

Osteoarthritis is a joint disease:
most common symptoms include:
joint pain and stiffness;
Restriction of the movement of the limbs.
Eventually leads to loss of joint function.
Osteoarthritis is quite common disease. It affects around 4 % of the population globally.
But, it occurs around 70 % of people aged 65 or more.
Osteoarthritis is the most common form of arthritis in the world.
Symptoms can be very variable; from, merely as an asymptomatic, means no symptoms, to a devastating and permanently disabling disorder.
Symptoms develops gradually, joint pain and stiffness is common;
Patients can also present with muscle weakness and balance problems.
Pain is typically related to activity and resolves with rest.
Morning stiffness is common, lasting less than 30 minutes.
When the disease develops, pain becomes continuous, and begins to affect activities of daily living.
Osteoarthritis typically affects hips, knees, interphalangeal joints, and joints of the lower cervical and lumbar spine.
The site of the junction of bones enlargement and swelling.
Classic physical exam findings in hand osteoarthritis, include Heberden’s nodes.

Osteoarthritis is more common among women.
Other risk factors include:
Obesity;
Age 40 and more.
muscle weakness, anatomical factors, joint injury - for example sport activities.
When osteoarthritis develops absence of predisposing trauma or disease, it is called primary.
But is associated with the risk factors above mentioned.
Osteoarthritis starts with microscopic damage of joint surface, then inflammation of joint develops, inflammation causes symptoms such as pain.
The organism tries to regenerate damaged surface, but incomplete regeneration causes more damage of joint tissues and bone thickening. Eventually Leads to loss of function.

X-rays of the affected joint can show marginal osteophytes, joint space narrowing, subchondral sclerosis, and cysts; however, radiographic findings do not correlate to the severity of disease and may not be present early in the disease.

Treatment:
Weight loss is important if obesity or overweight is presented.
each Kilogram of weight loss can decrease the load across the knee 3 to 6-fold.
Exercise is crucial.
combine both aerobic and resistance training have been shown to decrease pain and improve physical function.
Malalignment of joints should be corrected via mechanical means; such as realignment knee brace or orthotics.
Pharmacological Treatment:
Acetaminophen and oral nonsteroidal anti-inflammatory drugs are the most popular and affordable options for osteoarthritis.
and are usually the initial choice of pharmacologic treatment.
The pain medication paracetamol (acetaminophen) is the first line treatment for osteoarthritis.
Anti inflammatory drugs are initially, should be started as needed, rather than scheduled.
For mild to moderate symptoms effectiveness of acetaminophen is similar to non-steroidal anti-inflammatory drugs. such as naproxen, though for more severe symptoms non steroidal anti inflammatory drugs may be more effective.
Another class of anti inflammatory drugs, COX-2 selective inhibitors (such as celecoxib) are equally effective when compared to nonselective NSAIDs, and have lower rates of adverse gastrointestinal effects, but higher rates of cardiovascular disease such as myocardial infarction.
There are several non steroidal available for topical use, including diclofenac and ketoprofen .

Corticosteroid injections Intraarticular joint injections can also be an effective treatment for Osteoarthritis, especially in a setting of acute pain.
Glucosamine and chondroitin sulfate may help.

In those patients specifically with knee or hip osteoarthritis, who have failed multiple non-pharmacologic and pharmacologic treatment modalities, surgery is the next option.
Failure rates for both knee and hip replacements are quite low, and they can provide pain relief and increased functionality.
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