Osteoarthritis (Degenerative Joint Disease)

BAsic information

description

Gradual deterioration (degeneration) of cartilage in a joint. Osteoarthritis is most common in weight-bearing joints (feet, ankles, knees, hips). It also affects fingers, wrists, shoulders, and spine. It can occur at any age, but is more likely in adults over age 45.

frequent signs and symptoms

• Joint stiffness and pain, including backache. Weather changes, especially cold and damp, may increase aching.
• Joints have limited movement and less flexibility.
• No redness, heat, or fever in affected joints (usually).
• May have swelling of affected joints, such as fingers.
• May have cracking or grating sounds in joints.

causes

The cartilage normally forms a soft protective layer between the bones of a joint. When the cartilage deteriorates, it allows the bones to rub together. This causes the pain and limited movement.

risk increases with

• Age. 50% of people over age 60 have some signs of osteoarthritis.
• Obesity.
• Activities that stress joints (e.g., dancers, football players, instrumental musicians, carpet layers, or motocross).
• Injury to the joint.
• Family history of osteoarthritis.

preventive measures

• Maintain normal weight for height and body structure.
• Be physically active, but avoid activities that lead to joint injury, especially after age 40. Try regular stretching or yoga exercises.

expected outcomes

Symptoms can usually be relieved, but joint changes are permanent. Pain may begin as a minor irritant, but it can become severe enough to interfere with daily activities and sleep. The disorder worsens over time.

POSsible complications

• Crippling (sometimes).
• Symptoms can lead to limits in daily activities, affect the ability to work, bring on stress and depression, and restrict social and recreational activities.

diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms and activities. Medical tests may include studies of joint fluid (to rule out inflammatory forms of arthritis) and X-rays of joints.
• Treatment goals are to control pain, slow progression of the disorder, and improve mobility and function.
• Treatment may include lifestyle changes, drugs, self-care, treatments, and surgery.
• Lifestyle changes may involve diet (maintaining appropriate weight), exercises, and using mechanical aids.
• Mechanical aids can include: shock-absorbing or orthopedic shoes, canes, crutches, or walkers. They may include splints, braces, or elastic supports to help joints; neck brace, collar, or corset to help back pain.
• Heat can ease discomfort or pain. Use heating pads or warm soaks several times a day for 10 minutes at a time.
• Cold can help reduce swelling and inflammation. Use an ice pack several times a day for 20 to 30 minutes each time.
• Sleep on your back on a firm mattress, or place 3/4-inch-thick plywood between your box spring and mattress.
• Avoid outdoor activity in cold weather if possible.
• Acupuncture may help some people.
• Surgery for osteoarthritis may be recommended for some patients. There are different options. Your health care provider will discuss the risks and benefits.

medications

• Nonsteroidal anti-inflammatory drugs. These drugs may be nonprescription or prescribed. All have some side effects. You may need to try more than one to see what works best for you and has the least side effects.
• Glucosamine and chondroitin supplements may help. They should be taken at least 6 weeks as a trial.
• Cortisone injections into joints may be prescribed.
• Other drugs may be prescribed as needed.

activity

Exercise is beneficial. Your health care provider can advise you about an exercise program. Swimming or water aerobics are good. They don't stress the joints.

diet

If you are overweight, any weight loss will help joints.

NOTIFY YOUR HEALTH CARE PROVIDER IF

• You or a family member has joint pain or stiffness.
• Symptoms worsen after treatment starts.

Content from: Moore, Griffith's Instructions for Patients. © 2005 Elsevier Inc. All rights reserved.