Osteoarthritis (OA) is a prevalent and rapidly growing health condition, affecting about 46 million people in the United States or roughly 10 to 12% of the adult population. This degenerative joint disease significantly impacts the quality of life and economic productivity, making it a critical health issue as the global population ages.

According to data from 2010, 2.2% of the global population with disabilities attribute their condition to osteoarthritis. Furthermore, 10% of individuals with disabilities caused by rheumatologic or musculoskeletal disorders suffer from OA. The prevalence of this disease has surged dramatically, with a 64% increase from 1990 to 2010. Consequently, around 17 million patients annually live with disabilities due to OA, which incurs high healthcare costs and leads to significant economic losses from reduced work participation, sick leave, and premature retirement.

Osteoarthritis develops due to mechanical stresses on joints, which are a normal part of daily life. However, several factors increase susceptibility to OA, including:

  • Genetics: Family history of OA increases risk.
  • Age: Advancing age correlates with more joint wear and tear.
  • Ethnicity: For instance, hip OA is more common in the U.S. than in China.
  • Nutrition: Overweight and obesity elevate the risk.
  • Gender: OA of the hands and knees is more common in females.

Osteoarthritis progresses through four distinct stages. In Stage 1, there is minimal cartilage disruption with some joint space loss. Stage 2 involves further narrowing of the joint space and the appearance of cartilage fissures. By Stage 3, there is a moderate reduction in joint space, widening of cartilage gaps, and exposure of the underlying bone. Finally, Stage 4 is characterized by significant cartilage loss leading to bone-on-bone contact.

OA is typically diagnosed through a clinical evaluation that involves assessing patient symptoms and performing a joint examination. Key symptoms of OA include pain that worsens with activity and eases with rest, stiffness, particularly in the morning or after extended periods of inactivity, and reduced function, which can make tasks like handgrip and buttoning shirts difficult. Patients may also experience instability, with joints giving out or locking up, as well as swelling and deformity due to bone spurs and increased synovial fluid. X-rays and sometimes blood tests (to rule out other conditions like rheumatoid arthritis) aid in diagnosing OA.

The treatment of osteoarthritis involves a combination of non-pharmacologic and pharmacologic methods, as well as potential surgical interventions. Non-pharmacologic treatments include physical therapy, which strengthens joints, improves balance, and evaluates orthotics. “Nutrition also plays a key role; a diet rich in fresh fruits, vegetables, whole grains, and balanced protein helps manage osteoarthritis,” says rheumatologist Aitezaz Ahmed, MD, FACR. “Regular low-impact exercises, such as walking, Tai Chi, and water-based activities, are effective in slowing the progression of Osteoarthritis and alleviating symptoms.”

Pharmacologic treatments include topical anti-inflammatory gels, such as diclofenac, which are applied to painful areas. Oral NSAIDs, like ibuprofen and naproxen, are effective for pain relief but may have side effects such as stomach ulcers and cardiovascular risks. Acetaminophen is suitable for patients with contraindications to NSAIDs, though caution is advised for those with liver disease. Opioids, such as tramadol, are used sparingly due to the risk of addiction. Ancillary medications, such as duloxetine, an antidepressant also approved for pain relief in osteoarthritis, can also be used.

In more severe cases, injections and surgery may be considered. Joint injections, typically mixtures of local anesthetic and steroids, provide pain relief. Surgical options include joint replacement and other procedures to remove bone spurs or fuse joints.

Osteoarthritis is a widespread condition causing significant pain and disability. Diagnosis involves clinical evaluation and sometimes imaging. Treatment includes lifestyle changes, physical therapy, medications, injections, and surgery. Effective management improves the quality of life for those affected by OA.

 

Resources:

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