Osteoarthritis

The most common form of arthritis, Osteoarthritis (OA) affects an estimated 40% of the adult population. Of these, only 10% seek medical advice and only 1% are severely disabled.

Osteoarthritis (OA), also called wear and tear arthritis means inflammation of the joints although it is better known as a degenerative disease due to the inflammation of the joints with thinning of the articular cartilage. The cartilage in our joints allows for the smooth movement of joints. When it becomes damaged due to injury, infection or gradual effects of aging, joints movement is hindered. As a result, the tissues within the joint become irritated causing pain and swelling within the joint.

The cartilage wears off and the surfaces of the bones become rough. Rubbing together then causes pain, swelling, and loss of motion of the joint. Pieces of bones or cartilage can also break off and float in the joint space. There is also the possibility of bone spurs or osteophyte formation.

In osteoarthritis, the slick surface of the cartilage becomes rough. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone.

Symptoms

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

• Pain. Your joint may hurt during or after movement.
• Tenderness. Your joint may feel tender when you apply light pressure to it.
• Stiffness. Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity.
• Loss of flexibility. You may not be able to move your joint through its full range of motion.
• Grating sensation. You may hear or feel a grating sensation when you use the joint.
• Bone spurs. These extra bits of bone, which feel like hard lumps, may form around the affected joint.

If you have joint pain or stiffness that lasts for more than a few weeks, make an appointment.
Call +65 6653 5614

Risk factors

Factors that increase your risk of osteoarthritis include:

• Older age. The risk of osteoarthritis increases with age.
• Sex. Women are more likely to develop osteoarthritis, though it isn’t clear why.
• Bone deformities. Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.
• Joint injuries. Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis.
• Obesity. Carrying more body weight puts added stress on your weight-bearing joints, such as your knees.
• Certain occupations. If your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop osteoarthritis.
• Other diseases. Having diabetes, underactive thyroid, gout or Paget’s disease of bone can increase your risk of developing osteoarthritis.

Diagnosis

Osteoarthritis cannot be diagnosed with one single test.
The specialist will begin by taking a detailed history of your problem and past medical problems, followed by a physical examination. He may then proceed to other tests, such as:

X-rays
This is the most commonly performed test to evaluate the status of the affected joint and the alignment of the joint. Normal x-rays are safe, simple and pain-free.

Blood tests
Depending on the clinical findings, blood may be drawn for special testing, to rule out other causes of joint pain, e.g. due to rheumatoid arthritis, gout or infection.

Joint aspiration
Joint aspiration is a process of drawing synovial fluid from the joint with a needle and then examining it under the microscope to find any infection.
Especially when the joint is very swollen, the doctor may choose to suck some fluid out of the swollen joint for special testing. Removal of joint fluid also sometimes relieves pain.

Treatment Options

Medications

There is presently no medication that can cure OA or regrow the cartilage in osteoarthritic joints.
However, osteoarthritis symptoms can be relieved by a variety of medications, including:

Acetaminophen
Acetaminophen (Tylenol, others) can relieve pain, but it doesn’t reduce inflammation. It has been shown to be effective for people with osteoarthritis who have mild to moderate pain. Taking more than the recommended dosage of acetaminophen can cause liver damage.

Non-anti-inflammatory drugs (NSAIDs)
NSAIDs may reduce inflammation and relieve pain. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others). Stronger NSAIDs are available by prescription. NSAIDs can cause stomach upset, ringing in your ears, cardiovascular problems, bleeding problems, and liver and kidney damage. Older people have the highest risk of complications.

Narcotics
These types of prescription medication may provide relief from more severe osteoarthritis pain. These stronger medications carry a risk of dependence, though that risk is thought to be small in people who have severe pain. Side effects may include nausea, constipation, and sleepiness.

Therapy

A combination approach to treatment often works best. Your doctor may suggest:

Physical therapy
A physical therapist can work with you to create an individualized exercise regimen that will strengthen the muscles around your joint, increase the range of motion in your joint and reduce your pain.

Occupational therapy
An occupational therapist can help you discover ways to do everyday tasks or do your job without putting extra stress on your already painful joint. For instance, a toothbrush with a large grip could make brushing your teeth easier if you have finger osteoarthritis. A bench in your shower could help relieve the pain of standing if you have knee osteoarthritis.

Braces or shoe inserts
Consider trying splints, braces, shoe inserts or other medical devices that can help reduce your pain. These devices can immobilize or support your joint to help you keep pressure off it.

A chronic pain class
The Arthritis Foundation and some medical centers have classes for people with osteoarthritis and chronic pain. Ask your doctor about classes in your area or check with the Arthritis Foundation. These classes teach skills that help you manage your osteoarthritis pain. And you’ll meet other people with osteoarthritis and learn their tips and tricks for reducing and coping with joint pain.

Surgical and other procedures

If conservative treatments don’t help, you may want to consider procedures such as:

Cortisone shots
Injections of Cortisone medications may relieve pain in your joint. During this procedure, your doctor numbs the area around your joint, then places a needle into the space within your joint and injects medication. The number of cortisone shots you can receive each year is limited because the medication can worsen joint damage over time.

Lubrication injections
Injections of hyaluronic acid derivatives may offer pain relief by providing some cushioning in your knee. These agents are similar to a component normally found in your joint fluid.

Realigning bones
During a surgical procedure called an osteotomy, the surgeon cuts across the bone either above or below the knee to realign the leg. Osteotomy can reduce knee pain by shifting your body weight away from the worn-out part of your knee.

Joint replacement
In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surfaces and replaces them with plastic and metal devices called prostheses. The hip and knee joints are the most commonly replaced joints. Surgical risks include infections and blood clots. Artificial joints can wear out or come loose and may need to eventually be replaced.