Arthritis is one of the most common medical problems and the No. 1 cause of disability in America. The word arthritis is a blend of the Greek words arthron, for joint, and itis, for inflammation. In other words, arthritis literally means “joint inflammation.” Although arthritis is often referred to as one disease, it’s not. Arthritis has more than 100 forms.
Osteoarthritis, sometimes called degenerative joint disease or osteoarthrosis, is the most common form of arthritis. Osteoarthritis affects nearly 21 million people in the United States. It’s characterized by the breakdown of joint cartilage and may affect any joint in your body, including those in your fingers, hips, knees, lower back and feet. Initially it may strike only one joint. But if your fingers are affected, multiple hand joints may become arthritic.
There’s no cure for osteoarthritis, but treatments today are far ahead of what was available just a few years ago. In addition, how well you live with arthritis often depends on your actions and attitude. If you actively manage your arthritis, you may be able to gain control over your pain.
Your doctor may use a variety of methods to diagnose osteoarthritis, including a physical examination, blood tests and certain imaging techniques. Doctors use blood tests to diagnose or rule out specific types of arthritis. Fluid may be withdrawn from a joint for analysis (joint aspiration).
Imaging techniques may include X-rays, bone scans, computerized tomography (CT scan) , magnetic resonance imaging (MRI) and arthrography an image taken after dye has been injected into your joint. Imaging techniques can reveal bone spurs, worn-down cartilage and loss of joint space, indicating the presence of osteoarthritis.
With osteoarthritis the problem lies in the cartilage that cushions the ends of bones in your joints. Over time, the cartilage deteriorates, and its smooth surface roughens. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone causing the ends of your bones to become damaged and your joints to become painful.
The exact cause of osteoarthritis isn’t known. Researchers suspect that it’s a combination of factors, including being overweight, the aging process, joint injury or stress, heredity and muscle weakness.
Some scientists believe the cartilage damage may be due to a mechanical stress that results in an imbalance of enzymes released from the cartilage cells or from the lining of the joint. When balanced, these enzymes allow for the natural breakdown and regeneration of cartilage. But too much of the enzymes can cause the joint cartilage to break down faster than it’s rebuilt. The exact cause of this enzyme imbalance is unclear.
Your body goes to work repairing the damage, but the repairs may be inadequate, resulting instead in growth of new bone along the sides of the existing bone, which produces prominent lumps, most noticeable on hands and feet. Each of the steps in this repair process produces pain. The pain and tenderness over the bony lumps may be most marked early in the course of the disease and less evident later on.
Osteoarthritis commonly occurs in the neck or lower back. Hips and knees also are frequently affected because they bear most of your weight. You can have chronic pain or varying amounts of discomfort when you stand and walk. Swelling also may occur, especially in your knees.
The exact causes of osteoarthritis are unclear, but these factors increase your risk:
There’s no known cure for osteoarthritis, but treatments can help to reduce pain and maintain joint movement. Your doctor may recommend a combination of treatments that may include medication, self-care, physical therapy and occupational therapy. In some cases, surgical procedures may be necessary.
Medications are used to treat the pain and mild inflammation of osteoarthritis and to improve your joints’ functioning. They include both topical medications and oral medications. Over-the-counter (OTC) medications may be sufficient to treat milder osteoarthritis, but stronger prescription medications also are available.
Surgical procedures can help relieve disability and pain caused by osteoarthritis.
Osteoarthritis can affect your everyday activities and overall quality of life. As a result, it’s important to adopt coping strategies for dealing with the disease. You might consider the following:
Because many complementary medicine methods haven’t been studied extensively by researchers using mainstream scientific methods, it’s difficult for the scientific community to evaluate their effectiveness and safety. And with much of today’s research funding coming from the pharmaceutical industry, some “low-tech,” nontraditional approaches to manage diseases such as arthritis may not get as much attention from the research community as they deserve. For these reasons, many Western physicians just don’t know enough about these methods to endorse them. Nonetheless a growing body of evidence indicates that complementary medicine practices could have a role in treating and managing some diseases.
Common forms of complementary and alternative medicine for treatment of osteoarthritis include:
Some studies have shown positive effects of nutritional supplements such as glucosamine and chondroitin sulfate preparations on osteoarthritis. Studies are ongoing in people who have osteoarthritis to compare results of using glucosamine with those of using chondroitin sulfate and of using a mixture of the two. Don’t use glucosamine if you’re allergic to shellfish. Glucosamine may raise your blood insulin level if you have diabetes. Chondroitin sulfate may affect blood levels of warfarin (Coumadin) if you’re taking that medication.
Be careful when considering alternative therapies. Many are expensive, and some may be harmful. Before taking any complementary medications or dietary supplements, talk with your doctor to learn about potential dangers, particularly if you’re taking other medications.
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