by Amy Lovern, RN, BSN

 Osteoarthritis (OA) is one of the oldest and most common forms of arthritis.  Known as the “wear and tear” kind of arthritis.  OA is a chronic condition characterized by the breakdown of the joint’s cartilage.

 There isn’t any single known cause of osteoarthritis, but there are several risk factors. These risk factors include:  Age  Obesity  Injury and overuse  Genetics or heredity  Muscle weakness  Other diseases and types of Arthritis

 Incidence of OA increase as you age. Since “wear and tear” does play a part in the development of OA, the older you are, the more you have used your joints.  Although age is an important risk factor, it does not mean that OA is inevitable.

 Increased body weight is a serious factor in the development of OA. For every pound you gain, you add 3 pounds of pressure on your knees and six times the pressure on your hips. Since weight gain gradually increases the stress on joints, the weight you gain the decade before you have OA symptoms plays a big role in determining if you will have OA.

 Athletes and people who have jobs that require repetitive motion, such as typing or operating machinery, have a higher risk of developing OA due to injury and increase stress on certain joints.

 Genetics appear to play a role in the development of OA, especially in the hands.  Inherited abnormalities of the bones that affect the shape or stability of the joints can lead to OA.  It is also more common in joints that don’t fit together smoothly.

 Studies of the knee muscles not only show that weakness of the muscles surrounding the knee can lead to OA, but that strengthening exercises for thigh muscles are important in reducing the risk.

 People with rheumatoid arthritis tend to have a greater chance of developing OA.  People with hemochromotosis, or having excessive iron, can result in damage to the cartilage leading to chronic deterioration.  Acromegaly, or elevated growth hormone, may have adverse affects on the bones and joints and can lead to OA.

 The knees, hips, fingers, neck and lower back are most commonly affected by OA.  OA often develops gradually. It may begin with soreness or stiffness that seems more of a bother than a medical concern.  Pain may be moderate, intermittent or not interfere with your daily activity.

 The most common signs and symptoms if OA are:  Joint stiffness after periods of prolonged use.  Stiffness after periods of rest that go away quickly when activity resumes.  Morning stiffness, lasting approximately 30 minutes.  Deterioration of coordination, posture and walking.  Joint pain is usually less in the morning and worse in the evening after a day’s activity.

 Early diagnosis and treatment is the key to controlling OA.  Your doctor will use four main tools to determine your diagnosis: medical history, a physical exam, X-rays, and joint aspiration.  Your physical exam and medical history will be what he or she bases the diagnosis on, using X- rays and joint aspiration to confirm the diagnosis.

 Early diagnosis and treatment is the first step to the successful management of OA.  The goals of any treatment plan for OA include: controlling pain, improving your ability to function in daily activity, and slowing the disease’s process.  Most treatment plans will include a combination of medication, exercise, weight control, joint protection, and physical and occupational therapy.

 Analgesics- relieve pain without relieving inflammation or swelling.  Topical Analgecis- creams and rubs applied directly over the painful area. Often used in combination with oral medications to relieve pain.  Nonsteroidal anti-inflammatory drugs (NSAIDs)- reduce inflammation and swelling as well as aid in pain relief and are recommended for moderate to severe pain and signs of inflammation.

 Cox-2 Drugs- targeted NSAIDs that don’t cause the stomach irritation associated with traditional NSAIDs (ex. celecoxib and valdecoxib).  Injectable glucocorticoids- steroids that are injected into the joint for fast, targeted pain relief. Recommended for moderate to severe pain.  Viscosupplements- used specifically for knee OA and must be administered by orthopedic surgeon.

 Exercise is the most effective nondrug treatment for reducing pain and improving movement in OA.  Research shows that people with OA can exercise safely. Moderate exercise on a regular basis helps decrease fatigue, strengthens muscles and bones, and increases flexibility and stamina.  Joint flexibility is especially important when you have OA because stiff joints means inability to do daily tasks.

 Weight control is important for people with OA because excess weight directly contributes to the development of OA.  Maintaining your recommended weight or losing weight if you are overweight can lessen your pain by reducing stress on your affected joints.  Weight loss helps ease pressure on weight-bearing joints such as the hips, knees, back and feet.

 You can take steps to protect your joints and manage joint pain and damage before it is severe.  Listen to your body. This is the most important thing you can do to take care of yourself.  Balance rest and activity.  Use good body mechanics. Use your palms instead of your fingers when lifting or carrying things. Use large muscles rather than small ones, to carry things. Lift with your legs instead of your back. Use good posture, which takes stress off your joints.

 Physical therapy works on strengthening your muscles and improving your flexibility and joint mobility.  Physical therapists work on specific exercise programs and other pain management techniques.

 Glucosamine is an amino sugar that appears to play a role in the formation and repair of cartilage.  Chrondrotin sulfate is part of a protein that gives cartilage elasticity.  Vitamins- some research has shown that antioxidants in certain vitamins may help ease certain symptoms of OA.  Chiropractic care involves the manipulation and manual adjustment of the spine, which may relieve OA pain.

 Nearly 27 million Americans are affected by OA.  OA most commonly affects middle-aged and older adults, with most people getting it after age 45. Remember …… “You can’t help getting older, but you don’t have to get old”. George Burns