OSTEOARTHRITIS (OA)

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OSTEOARTHRITIS (OA) is a most common form of arthritis. Sometimes it is called degenerative joint disease or “wear and tear” arthritis. Occurs most frequently in the hands, hips, and knees

Pathophysiology

  • Hyaline cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones
  • In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint
  • OA worsens over time, bones may break down and develop growths called spurs. Bits of bone or cartilage may flake off and float around in the joint
  • In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone leading to joint damage and more pain

Causes

Damage or breakdown of joint cartilage between bones.


Risk Factors

  • Joint injury or overuse — Injury or overuse, such as knee bending and repetitive stress on a joint, can damage a joint and increase the risk of OA in that joint
  • Age — The risk of developing OA increases with age
  • Age — Tenderness or a bump (nodule) in the palm at the base of the affected finger
  • Obesity — Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. This stress increases the risk of OA in that joint. Obesity may also have metabolic effects that increase the risk of OA
  • Genetics — People who have family members with OA are more likely to develop OA. People who have hand OA are more likely to develop knee OA
  • Race — Some Asian populations have lower risk for OA


Sign & symptoms

  • Pain and stiffness in the affected joint; exacerbated with activity and relieved by rest
  • Early morning stiffness; typically, <30 mins
  • Joint tenderness
  • Crepitus on movement
  • Swelling due to osteophyte formation or synovial fluid accumulation

OSTEOARTHRITIS (OA) treatment

  • Hot pack / cold pack :
    • Hot pack - is use to relax muscles, stimulates blood flow and improves circulation, helps increases range of motion, and reduces stiffness in painful joints
    • Cold pack - can reduce inflammation, a major cause of arthritis joint pain and stiffness. Placing a cold pack on a swollen joint can also help bring it back down to size, which will also lessen joint pain.
  • Soft tissue manipulation (STM) - is to rehydrate connective tissue, stimulate the production of ground substance, assist in orienting of collagen fibers, and break micro adhesion. The result is improved soft tissue mobility, reduced stress on pain sensitive structures, and better function
  • Knee joint traction therapy - results in muscle relaxation, stimulation of dynamic muscle contractions, and inhibition of protective muscle reflections, all of which are instrumental in decreasing pain. Moreover, the increase in knee joint space due to continuous knee joint traction also helps reduce pain.
  • Exercise (stretching and strengthening exercise) - can strengthen the muscles that support your knee joint. Having stronger muscles can reduce the impact and stress on your knee, and help your knee joint move more easily
  • Patient education - has been shown to be effective in decreasing pain and improving activity in patients with osteoarthritis. Patient education should be individualized to the patient, focus on the latest effective treatments, and emphasize those treatments that can be self-managed by the patient

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