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Osteoarthritis is a degenerative disease that impacts the articular cartilage, which is the smooth, cushion-like tissue at the ends of bones. As the disease progresses, the cartilage wears away, leading to the bones rubbing against each other. This can cause pain, stiffness, and limited mobility.
OA predominantly affects the spine and the joints of the limbs. It is characterized by the loss of articular cartilage, which is replaced by new bone tissue, leading to discomfort and restricted movement. The primary lesion's origin, whether it affects the cartilage or the bone beneath it, remains a subject of ongoing research.
The prevalence of osteoarthritis is directly related to age. It is present in the majority of individuals around their fortieth year of age and almost all individuals around the age of seventy, with a peak incidence between 75 and 79 years of age. Despite only a minority of those affected reporting symptoms, osteoarthritis is a leading cause of pain and disability resulting from joint diseases. The disease is more common in males before the age of 45, after which it is more prevalent in females. The prevalence of lesions increases with advancing age.
Osteoarthritis can be classified into two types:
Osteoarthritis progresses in stages. Initially, due to an injury—acute or chronic—or seemingly non-existent, the cartilage loses its characteristic surface smoothness, becoming worn and rough. The damage appears to be caused by the cells that compose it (chondrocytes) which, when damaged, release enzymes that undermine the cartilaginous integrity. This causes small fragments of cartilage to break off, contributing to joint damage.
On the edges of the two bony ends that participate in the joint, beak- or claw-shaped protrusions known as osteophytes appear. These represent a characteristic sign of osteoarthritis. Although they are a defense mechanism of the body, osteophytes are generally painful, especially when they come into contact with each other or compress nerves or blood vessels, causing pain, tingling, changes in sensitivity, and so on.
The final stage of osteoarthritis is characterized by the complete disappearance of the cartilage, accompanied by joint deformity and stiffness, often associated with swelling.
Several factors contribute to the onset of osteoarthritis. The most common of these is excessive use of the joints, often linked to aging. However, younger individuals can also develop osteoarthritis due to traumas, postural anomalies, or continuous use of certain joints.
In some cases, osteoarthritis may result from disorders that disrupt the normal structure and function of the cartilage, such as rheumatoid arthritis or gout. Endocrine-metabolic diseases and infections can also lead to this condition. Additionally, being overweight or obese puts excessive stress on the joints, which can contribute to the development of osteoarthritis.
Osteoarthritis is typically characterized by a dull, deep joint pain that worsens over time. Initially, the pain may be mild and only noticeable during activities that stress the affected joint. As the disease progresses, the pain can become a constant issue, even at rest.
Other symptoms of osteoarthritis include:
It's important to note that osteoarthritis can affect any joint, but it most commonly impacts those that bear the body's weight or are frequently used in daily activities, such as the knees, hips, shoulders, hands, and spine.
Osteoarthritis can affect various joints in the body. Here are some of the most frequently affected areas:
Hand osteoarthritis often leads to the flexion and lateral deviation of the last phalanx, initially affecting the second and fifth fingers before becoming multiple and bilateral. In about a third of cases, the proximal interphalangeal joints are also affected, while the wrist joint is rarely involved.
Hip osteoarthritis can appear in middle age or even earlier when secondary to malformations, trauma, arthritis of the hip, or breakage of the femoral head. The pain is acute when standing upright or deep after prolonged loading. It can cause a limping gait and an abnormally oblique pelvis. Later, a reduction in limb length, severe motor limitation, and lordosis of the lumbar spine can occur.
Knee osteoarthritis is common in women and in professional arthrosis. It causes pain when kneeling, climbing stairs, standing, or sitting. The joint profile becomes irregular due to osteophytosis, and intense pain is felt accompanied by crackles on passive movement. Additional symptoms include a varus or, more rarely, valgus knee, reduced flexion or extension of the leg at the thigh, or loss of the ability to move the patella laterally.
Foot osteoarthritis initially causes bursitis, which is inflammation of the bursa that surrounds and protects the joint. This inflammation is followed by degeneration of the big toe joint, which is particularly subjected to load and trauma due to walking, with evolution towards hallux rigidus or valgus.
Spine osteoarthritis most commonly affects the lower sections of the lumbar and cervical spine due to their greater mobility. It can cause pain, stiffness, and crackling when moving. The osteophytes and the protrusion of the intervertebral disc can compress the roots of the spinal nerves, causing pain radiating to the shoulder blade and arm, accompanied by tingling or difficulty in movements.
The diagnosis of osteoarthritis is primarily based on the patient's symptoms and radiological examinations, such as X-rays. These imaging tests can reveal joint deformities, including the narrowing of the joint space, the presence of bone spurs (osteophytes), and potential bone cysts (geodes).
Effective treatment of osteoarthritis involves addressing the contributing factors. This may include weight loss for overweight individuals, orthopedic correction of skeletal misalignments, and modifications to work activities that may exacerbate the condition.
Targeted physical exercises can help correct improper postures, strengthen supporting muscles, improve joint mobility, and aid in adapting to any physical limitations. Heat application can provide temporary pain relief and ease muscle spasms.
Non-steroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and facilitate joint mobilization during short treatment courses. However, their prolonged use is not recommended due to potential side effects. Surgical interventions may be considered in some cases, particularly for hip osteoarthritis, to restore joint function.
Several medicinal plants and supplements have been identified as potentially beneficial in managing the symptoms of osteoarthritis. Here are a few noteworthy ones:
While the potential benefits of these plants and herbs are promising, it's crucial to remember that they are not a cure for osteoarthritis. They should be used as part of a comprehensive treatment plan under the guidance of a healthcare professional. Always consult with a healthcare provider before starting any new treatment regimen, especially if you're currently on other medications or have any pre-existing conditions.
Prevention strategies for osteoarthritis focus on managing risk factors such as maintaining a healthy weight, avoiding poor postures, and minimizing repetitive joint stress. Contrary to common misconceptions, appropriate physical activity, including low-impact exercises like cycling and swimming, can alleviate pain and enhance joint mobility. It’s also important to warm up muscles properly before exercise and use protective gear to prevent joint trauma.
Diet is crucial in managing osteoarthritis. A balanced diet should include antioxidants, be low in alcohol, and moderate in animal-based foods to support joint health. Consuming fish, dried fruits, and seed oils in moderation along with nutrients like vitamins, omega-3 fatty acids, and minerals is beneficial. Foods rich in collagen, chondroitin, and glucosamine, such as broths and boiled meats, help prevent osteoarthritis.
Additionally, alkalizing foods and limiting protein may help maintain joint health, especially during menopause when hormonal imbalances increase osteoarthritis risk. Supplements like glucosamine and chondroitin sulphate are also prominent in treatment.
In conclusion, osteoarthritis is a complex condition that requires a comprehensive approach for its management. By understanding its diagnosis, treatment options, and the role of lifestyle modifications, individuals can better manage their condition and improve their quality of life.