Osteoarthritis

Arthrosis

Osteoarthritis is a chronic degenerative disease affecting the joints and cartilage tissue in bones.

The joints most affected are those on which the weight load is greatest, such as the hips, knees and spine. Hands, as well as feet, are more rarely involved.

The symptoms of osteoarthritis are mainly pain, swelling and stiffness. They begin to manifest around the age of 50 due to deterioration of the cartilage and the consequent rubbing of the bones against each other. In particular, the frequency is higher in women after menopause.

In the case of people affected by the disease before the age of 50, however, there are no differences between men and women. The appearance of symptoms does not actually depend on hormonal changes but on working conditions and activities carried out daily.

This condition can occur in a healthy joint without a clear reason or as a result of congenital deformity, trauma, infection, inflammation or muscle overload.

The difference between osteoarthritis and arthritis

Before describing the disease, it is essential to highlight the difference between arthritis and osteoarthritis, as it is often confusing.

While having some traits in common, arthritis is an inflammatory condition involving the joints, whereas osteoarthritis is a chronic, non-inflammatory degenerative form.

The most striking example is seen in the hands. These are not among the areas most affected by osteoarthritis because the cartilage is not worn out by body weight. On the contrary, the first symptoms of arthritis can occur right on the wrist and hands.

Types of osteoarthritis

There are various forms of osteoarthritis, which differ one from the other mainly according to the area of the body concerned.

This leads to the appearance of slightly different symptoms, but above all involves the use of specific cures and remedies.

We can consider them below.

Cervical osteoarthritis

Cervical osteoarthritis affects the most mobile part of the spinal column. It affects both the surface of the vertebrae on the side of the joints and the cartilage discs between the vertebrae.

The causes of cervical osteoarthritis are due to an irregular lifestyle or incorrect posture, not just ageing. In fact, this is a form of osteoarthritis that can also affect young people.

The main symptoms are a sense of pain and stiffness in the neck and nape. Other possible symptoms are headaches and dizziness, but also nausea, dizziness, vision problems or noise intolerance. In addition, bone protuberances are created on the vertebrae, called osteophytes.

This type of osteoarthritis tends to worsen and spread to other areas, including the shoulders and fingers.

At the moment it is not possible to completely heal cervical osteoarthritis.

The patient may however rely on natural remedies, such as massages and physical rehabilitation therapies, or take pain and anti-inflammatory drugs to alleviate symptoms. Muscle relaxants can also have positive effects in the acute phase of the disease but it is important to maintain a low dosage to avoid side effects.

If the nerve or spinal cord is compressed, then it may be necessary to resort to surgical intervention.

Knee osteoarthritis

Another type of osteoarthritis is that of the knee, a chronic inflammation due to degeneration of the cartilage layer between the femur and tibia.

Major risk factors include age, obesity and any previous surgery, such as meniscus removal (meniscectomy).

The symptoms of knee osteoarthritis are always pain and joint stiffness, redness, swelling, creaking and reduced mobility.

This form of disease is also an irreversible condition. The only possible treatments are aimed at reducing pain and restoring partial knee mobility.

Hip osteoarthritis

Another form of this disease is hip osteoarthritis, also known as cox osteoarthritis. This is the inflammation of the cartilage covering the hip joint.

Inflammation originates due to cartilage deterioration. In particular, the cartilage layer concerned is the one covering the upper end of the femur.

The symptoms are, again, pain and a reduced ability to move. The pain tends to be felt in the groin and in the front of the leg. In the early stages of the disease you can only feel it by making certain movements but over time it gets worse and is perceived even when resting.

Once again, in this case, the patient can take pain-relieving and anti-inflammatory drugs with the sole purpose of relieving pain and not to limit damage to the joint.

Hand osteoarthritis

Although osteoarthritis does not affect the hands as often as arthritis, there is a form of osteoarthritis in the hands (sometimes referred to as “rhizarthrosis” or “carpometacarpal osteoarthritis”).

This is normally due to ageing or a genetic predisposition, but may also depend on trauma, fracture or infection.

Among the main symptoms are hand joint pain, swelling and tingling.

This type of osteoarthritis may be asymptomatic at first but tends to progress to generate pain even when at rest.

Interapophyseal osteoarthritis

Interapophyseal osteoarthritis, also known as posterior vertebral osteoarthritis, affects the spine and in particular the facet joints, i.e. the main joints of the back.

It involves the erosion of the cartilage that these joints are covered with, the reduction of joint space, osteosclerosis and osteophytosis.

The causes are determined by age, gender, genetic predisposition, a sedentary lifestyle and postural vices. For example, menopausal women tend to be more affected by this illness.

The main symptoms are rigidity and back pain, as well as greater difficulty in simpler movements.

At the moment, this type of disease cannot be cured. Therapies, therefore, are aimed at keeping it under control and slowing down the process of cartilage degeneration.

Besides natural remedies , it may be useful to perform targeted physical exercises and follow a diet to lose weight.

Pain-relieving, anti-inflammatory and muscle-relaxing drugs, on the other hand, may be used to relieve pain.

Foot osteoarthritis

Foot osteoarthritis affects the cartilage of the foot bone joints.

The causes are the same as those for other forms of osteoarthritis, as well as the use of inadequate shoes or high heels.

The symptoms are also those common to the disease. Since the joints involved are quite numerous, the symptoms can extend to various areas of the foot and make it almost impossible to walk.

With regard to treatment, in this case also the taking of drugs and the carrying out of physical exercises have the sole purpose of alleviating pain and slowing down the degenerative cartilage process.

Shoulder osteoarthritis

Shoulder osteoarthritis is characterised by its slow and gradual evolution.

One of the main causes is ageing, but it may also be linked to rheumatoid arthritis or shoulder fractures.

As far as treatment is concerned, some physical therapies can improve the patient’s condition. In addition, through arthroscopy it is possible to eliminate very small pieces of cartilage and inflamed tissues, reducing pain at least in part.

Lumbar osteoarthritis

Lumbar osteoarthritis affects the vertebrae of the back and males in particular. It also occurs more frequently in older people.

One of the main causes is a sedentary lifestyle or, on the contrary, the frequent performance of heavy lifting. Any trauma or genetic predisposition to contracting the disease can also be determining factors.

In addition to the typical symptoms of osteoarthritis, in some more severe cases the stiffness of the joints can lead to a “blockage” of the entire lumbar region. If the pain also affects the sciatic nerve, the gluteus and the leg, we call it lumbar sciatica. This means that the discs between the vertebrae are compromised.

Again, taking pain relief and anti-inflammatory drugs is prescribed to keep the disease under control and alleviate symptoms.

Ankle osteoarthritis

Ankle osteoarthritis mainly affects the elderly, but in other people it can be a consequence of trauma, such as a fracture, or the condition of obesity.
The main symptoms are, as always, pain and feeling of stiffness but also swelling and a feeling of instability.

Diagnosis

The diagnosis of osteoarthritis is based on various elements and goes through different phases. There is no specific test to diagnose it.

The first step is shown by the anamnesis or medical history, during which patients describe symptoms to their own doctor.

In this phase, the doctor must also reconstruct the clinical history of the patient and family members. For example, to find out if the patient has a genetic predisposition to osteoarthritis.

During the examination, the doctor checks the patient’s overall state of health. Reflexes and muscle strength will be tested, as well as the ability to perform common movements in daily activities. In addition, the condition of the joints will be assessed to see if they are deformed.

Laboratory tests are normally not used as they are not very useful for diagnosis. On the contrary, it is common to make use of radiological investigations. These investigations enable us to see if there is a reduction in the interarticular space or alterations of the bone caused by the formation of osteophytes or lesions.

In particular, X-rays are used to assess damage and loss of cartilage when of a certain magnitude.

In addition to X-rays, the patient is often subjected to magnetic resonance to obtain high-resolution images of the internal tissues.

In any case, the doctor may prescribe blood tests. This is in order to rule out the symptoms and damages suffered by the patient being linked to other causes and diseases.

Causes

We have already seen in the previous paragraphs the triggers for the different forms of osteoarthritis. Therefore, in this paragraph we shall simply summarise them.

The most common causes are therefore:

  • Old age and ageing.
  • Genetic predisposition.
  • A sedentary lifestyle, which often results in weight gain.
  • Wearing activities carried out daily, often at work.
  • Sporting activities that can wear out the joints and cartilage of the feet, ankles and knees.
  • Fractures and joint injuries.
  • Circulatory diseases that cause damage to the joints (e.g. haemophilia).
  • Rheumatoid arthritis and other forms of arthritis which damage the joints and, as a result, increase the chance of damage to the cartilage.

Physical therapy involves the execution of physiotherapy exercises for the treatment and rehabilitation of the hand, hip, knee, foot and limbs in general.

Therapies

As already seen in the previous paragraphs, in the majority of cases treatments for osteoarthritis have the sole purpose of reducing symptoms and slowing down the deteriorating action on cartilage.

For the treatment of osteoarthritis, the use of:

  • Pain medication.
  • Non-steroidal anti-inflammatory drugs (NSAIDs), for a limited period of time to avoid side effects.
  • Muscle relaxant drugs, to a lesser extent than painkillers.
  • Generation of heat, for example through diathermy, ultrasound and application of paraffin baths.

Overweight subjects or subjects with other musculoskeletal problems may also:

  • Follow a diet to lose weight and put less weight on the joints, especially the hips and knees.
  • Exercise to correct posture or scoliosis, strengthen support muscles and recover joint mobility

Follow a diet and do physical activity, preceded by suitable warming up is also useful for the prevention of osteoarthritis.

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