Osteoarthritis

Disease Process

Osteoarthritis (also called Degenerative Joint Disease – DJD) is the most common type of arthritis. Osteoarthritis is a joint disease that involves the breakdown and eventual loss of the cartilage (the cushion). Osteoarthritis may affect any joint in your body, including those in your fingers, hips, knees, lower back and feet but is most commonly found in the weight-bearing joints. Osteoarthritis occurs gradually over time and symptoms vary from mild to severe. There are several ways that osteoarthritis affects the body. It:

• Changes the shape of the joint so that it does not function smoothly.
• Causes fragments of bone and cartilage to float in the joint causing irritation and pain.
• Causes bony fragments to develop.
• Results in inflammation.
• Changes the property of the joint fluid.

Causes

The following are common causes and/or risk factors for developing osteoarthritis.

• Age (chance of developing OA increases as you age).
• Obesity (increased body weight contributes to wear and tear [especially of the knees] of the joints).
• Injury or overuse (people that do repetitive motion activities or athletes).
• Genetics and Heredity (shape of the bones that form the joints, laxity of the ligaments)
• Muscle Weakness (causes increased load on the joint itself).

Symptoms

Osteoarthritis will present with different symptoms depending on the location and the severity of the disease. They may be mild to severe and may or may not affect daily activities. Typical symptoms may include one or more of the following:

• Soreness or stiffness in the joints, especially after a period of inactivity or overuse.
• Stiffness after rest that decreases with movement.
• Morning stiffness that goes away after about 30 minutes.
• Joint pain that usually increases throughout the day.
• Changes in coordination, posture, ability to walk secondary to pain or stiffness.
• Pain (caused by weakening of the muscles surrounding the joint due to inactivity).
• Swelling and warmth in area.
• ”Creaking” of the affected joint.

Diagnosis

• Medical History
• Physical Examination
• X-rays (common x-ray findings of osteoarthritis include loss of joint cartilage, narrowing of the joint space between adjacent bones, and bone spur formation).
• Blood Tests (to rule out other causes; there is no blood test that diagnoses osteoarthritis).
• Arthrocentesis (a sterile needle is used to remove joint fluid to analyze for excluding gout, infection, and other causes of arthritis).
• Arthroscopy (Abnormalities of and damage to the cartilage and ligaments can be detected and sometimes repaired).

Current Treatment

There is no cure for arthritis. Treatment focuses on decreasing pain and swelling, increasing functional abilities and slowing progression of the disease.

Medication: the use of NSAIDS or Cox-2 drugs help with controlling both pain and swelling in the affected joints.

Weight control: maintaining or achieving an optimum weight will help decrease the pressure placed on the joint and effectively decrease the overall “wear and tear”.

Exercise: increasing the strength of the muscles surrounding the joint will help decrease the load on the joint itself.

Joint Protection: the use of special braces can help “un-weight” the joint, thereby reducing or relieving the pain.

Physical and/or Occupational Therapy

How Can Physical Therapy Help

The goals of physical therapy for people with osteoarthritis include decreasing pain, improving the ability to perform daily functional activities and slowing the progress of the disease. Studies have show that exercise to decrease body weight and increase the strength of the muscles around the joint are two of the best ways to manage arthritis.

A physical therapist can use modalities such as electrical stimulation, ultrasound, heat and joint mobilization to help decrease pain while at the same time assisting patients with creating a custom exercise program that meets their individual needs. They will be able to establish a home exercise program to be continued after therapy is completed. Sometimes depending on the facility, water (aquatic) therapy is available which provides a way for patients to exercise while reducing pressure on the painful joints at the same time.

Physical therapists can also provide assistive devices such as a cane or special braces to help decrease the weight on the affected joint.

Patient Resources

Arthritis Foundation
MedicineNet.com
National Institute of Arthritis and Musculoskeletal and Skin Diseases
MedlinePlus

Disease Process
Causes
Symptoms
Diagnosis
Treatment
Physical Therapy
Patient Resources

Facts

The most common form of arthritis is osteoarthritis. Other common rheumatic conditions include gout, fibromyalgia and rheumatoid arthritis.

In 2005 an estimated 66 million (nearly 1 in 3 adults) people will have arthritis.

Arthritis costs the U.S. economy more than $86.2 billion annually.

There are more than 100 different types of arthritis.

Arthritis and other rheumatic conditions are the leading cause of disability in the United States.

In 1997, there were 256,000 knee replacements (TKR) and 117,000 hip replacements (THR) associated with arthritis hospitalizations.