Osteoarthritis

Osteoarthritis (OA) is a degenerative disease of the joints. It causes cartilage in the joints, a type of connective tissue that covers and protects the ends of the bones at a joint, to break down. As cartilage deteriorates the bones no longer have the proper cushioning that help the joint to move smoothly. Thus, the bones in the joint are now rubbing together directly causing friction, pain, stiffness, decreased range of motion, and inflammation. In certain cases osteophytes are created.

Osteophytes are spurs or lumps of bone that appear close to osteoarthritic joints making the joint appear deformed. Another issue is fluid that accumulates in the joints. A third issue is pain, which is sometimes severe. It is caused by deformation of the bones, fluid accumulation in the joints and, often, footwear that no longer fits properly. The pain gets better with rest and grows more severe when weight-bearing and moving.

The causes of OA are classified into primary: OA caused by hereditary factors; and secondary: OA that is the result of trauma, injury, and surgery.

An early sign of OA is early morning stiffness and soreness. As the disease progresses, the pain becomes worse and inflammation develops. Pain is now present even during rest and joint mobility decreases permanently. Unfortunately, this can lead to stress, anxiety, depression, anger, feelings of helplessness, and decreased ability to work.

Radiography, health history, and physical examination are used as means of diagnosing osteoarthritis. During physical examination, affected joints may exhibit the symptoms of warmth, rigidity, enlarged size, loss of agility, and decreased flexibility. The client will have difficulty finding footwear that fits. From the client’s perspective the foot pain is dull, throbbing, aching, grinding, is more severe after use at the end of the day, different every day, and totally debilitating.

To treat OA the client can use professional orthotics, use special footwear with wide heels, and/or wear shoes modified by a certified pedorthist. The use of mobility devices such as canes, as well as gait modification devices, including ankle braces and gait plates, are recommended.

In case of mild OA, the first medication of choice is Paracetamol. Topical medications (used on the skin called nonste)roidal anti-inflammatories (NSAIDs) can also be used in conjunction with Paracetamol. Corticosteroid injections are often done to the joint for short-term pain relief. A newer treatment that involves injection of Hyaluronan into the joint, to bring back viscosity and elasticity of synovial fluid (natural fluid in the joint), is very beneficial.

If OA is advanced and the previous treatments mentioned do not help, it’s useful to make an appointment with an orthopedic surgeon.