What to Know About Generalized Osteoarthritis

Osteoarthritis: Causes, symptoms, and treatment

What to Know About Generalized Osteoarthritis

  • Symptoms
  • Effects
  • Causes
  • Risk factors
  • Diagnosis
  • Treatment
  • Tips
  • Outlook

Osteoarthritis (OA) causes inflammation in the joints and the breakdown and gradual loss of joint cartilage. As the cartilage wears down, a person experiences pain and difficulty with movement.

OA is a common joint disorder. It develops in the hand, for example, in 1 in 12 people over the age of 60, according to the Arthritis Foundation.

OA is a progressive disease, which means that symptoms worsen over time.

There is no cure, but treatment can help manage pain and swelling and keep a person mobile and active.

Share on PinterestOsteoarthritis leads to pain and stiffness in the joints.

OA leads to pain and stiffness in the joints.

In the early stages, a person may have no symptoms. Symptoms may occur in one or more joints, and they tend to appear gradually.

When symptoms develop, they can include:

  • pain and stiffness that worsen after not moving the joint for a while
  • swelling
  • difficulty moving the affected joint
  • warmth and tenderness in the joints
  • a loss of muscle bulk
  • a grating or crackling sound in the joint, known as crepitus

The progression of OA involves:

  • synovitis — mild inflammation of the tissues around the joints
  • damage and loss of cartilage
  • bony growths that form around the edges of joints

Cartilage is a protective substance that cushions the ends of the bones in the joints and allows the joints to move smoothly and easily.

In people with OA, the smooth surface of the cartilage becomes rough and starts to wear away. As a result, the unprotected bones start to rub together, causing damage and pain.

Eventually, bony lumps form on the joint. The medical names for these are bone spurs or osteophytes, and they can lend a knobbly appearance to the joint.

As the bones change shape, the joints become stiffer, less mobile, and painful. Fluid may also accumulate in the joint, resulting in swelling.

The interactive image below shows how OA affects a joint.

While OA can develop in any joint, it commonly affects the knees, hips, hands, lower back, and neck.

The knees

OA usually occurs in both knees, unless it results from an injury or another condition.

A person with the condition may notice that:

  • There is pain when walking, especially uphill or upstairs.
  • The knees lock into position, making it harder to straighten the leg.
  • There is a soft, grating sound when they bend or flex the knee.

The hips

A person with OA in the hips may find that any movement of the hip joint, such as standing up or sitting down, can cause difficulty or discomfort.

Pain in the hips is a common feature of the condition. OA in the hips can also cause pain in the knee or in the thighs and buttocks.

A person may experience this pain while resting as well as while walking, for example.

The hands

In the hands, OA can develop in:

  • the base of the thumb
  • the top joint of the other fingers, closest to the nail
  • the middle joint of the other fingers

A person with the condition may notice:

  • pain, stiffness, and swelling in the fingers
  • bumps that develop on the finger joints
  • a slight bend sideways at the affected joints
  • fluid-filled lumps or cysts on the backs of the fingers, which may be painful
  • a bump that develops where the thumb joins the wrist, which can make it difficult to write or turn a key

For some people, the finger pain decreases and eventually goes away, though the swelling and bumps remain.

Anyone who experiences joint stiffness and swelling for more than 2 weeks should see a doctor.

Doctors do not know the exact cause of OA, but it seems to develop when the body is unable to repair joint tissue in the usual way.

It often affects older people, but it can occur at any age.

Genetic factors

Some genetic features increase the risk of developing OA. When these features are present, the condition can occur in people as young as 20 years old.

Trauma and overuse

A traumatic injury, surgery, or overuse of a joint can undermine the body’s ability to carry out routine repairs and may trigger OA, eventually leading to symptoms.

It can take several years for OA symptoms to appear after an injury.

Reasons for overuse or repeated injury include jobs and sports that involve repetitive movement.

A number of risk factors increase the chances of developing OA.

  • Sex: OA is more common among females than males, especially after the age of 50.
  • Age: Symptoms are more ly to appear after the age of 40, though OA can develop in younger people after an injury — especially to the knee — or as a result of another joint condition.
  • Obesity: Excess weight can put strain on weight-bearing joints, increasing the risk of damage.
  • Occupation: Jobs that involve repetitive movements in a particular joint increase the risk.
  • Genetic and hereditary factors: These can increase the risk in some people.

Other conditions

Some diseases and conditions make it more ly that a person will develop OA.

  • inflammatory arthritis, such as gout or rheumatoid arthritis
  • Paget’s disease of the bone
  • septic arthritis
  • poor alignment of the knee, hip, and ankle
  • having legs of different lengths
  • some joint and cartilage abnormalities that are present from birth

A doctor will ask about symptoms and perform a physical examination.

No definitive test can diagnose OA, but tests can show whether damage has occurred and help rule out other causes.

Tests may include:

X-rays and MRI: These can reveal bone spurs around a joint or a narrowing within a joint, suggesting that cartilage is breaking down.

Joint fluid analysis: A doctor will use a sterile needle to withdraw fluid from an inflamed joint for analysis. This can rule out gout or an infection.

Blood tests: These can help rule out other conditions, such as rheumatoid arthritis.

While no treatment can reverse the damage of OA, some can help relieve symptoms and maintain mobility in the affected joints.

Interventions include exercise, manual therapy, lifestyle modification, and medication.

Medication

Medication can help reduce pain.

Acetaminophen (Tylenol)

This can relieve pain in people with mild to moderate symptoms. Follow the doctor’s instructions, as overuse can lead to side effects and cause interactions with other medications.

Nonsteroidal anti-inflammatory drugs

If acetaminophen does not help, the doctor may recommend a stronger pain reliever, which may include ibuprofen, aspirin, or diclofenac.

A person can take these orally or topically, applying the medication directly to the skin.

Capsaicin cream

This is a topical medication that contains the active compound in chilies. It creates a sensation of heat that can reduce levels of substance P, a chemical that acts as a pain messenger.

Pain relief can take 2 weeks to a month to fully take effect.

Do not use the cream on broken or inflamed skin, and avoid touching the eyes, face, and genitals after using it.

Intra-articular cortisone injections

Corticosteroid injections in the joint can help manage severe pain, swelling, and inflammation. These are effective, but frequent use can lead to adverse effects, including joint damage and a higher risk of osteoporosis.

Duloxetine (Cymbalta) is an oral drug that can help treat chronic musculoskeletal pain.

Physical therapy

Various types of physical therapy may help, including:

Transcutaneous electrical nerve stimulation (TENS): A TENS unit attaches to the skin with electrodes. Electrical currents then pass from the unit through the skin and overwhelm the nervous system, reducing its ability to transmit pain signals.

Thermotherapy: Heat and cold may help reduce pain and stiffness in the joints. A person could try wrapping a hot water bottle or an ice pack in a towel and placing it on the affected joint.

Manual therapy: This involves a physical therapist using hands-on techniques to help keep the joints flexible and supple.

Assistive devices

Various tools can provide physical support for a person with OA.

Special footwear or insoles can help, if OA affects the knees, hips, or feet, by distributing body weight more evenly. Some shock-absorbing insoles can also reduce the pressure on the joints.

A stick or cane can help take the weight off of the affected joints and may reduce the risk of a fall. A person should use it on side of the body opposite to the areas with OA.

Splints, leg braces, and supportive dressings can help with resting a painful joint. A splint is a piece of rigid material that provides joint or bone support.

Do not use a splint all the time, however, as the muscles can weaken without use.

Surgery

Some people may need surgery if OA severely affects the hips, knees, joints, or the base of the thumbs.

A doctor will usually only recommend surgery if other therapies have not helped or if there is severe damage in a joint.

Some helpful procedures include:

Arthroplasty

This involves a surgeon removing the damaged areas and inserting an artificial joint, made of metal and plastic. Some refer to this procedure as a total joint replacement.

The joints that most often require replacing are the hip and knee joints, but implants can also replace the joints in the shoulder, finger, ankle, and elbow.

Most people can use their new joint actively and painlessly. However, there is a small risk of infection and bleeding. An artificial joint may also come loose or wear down and eventually need replacing.

Arthrodesis

This involves a surgeon realigning, stabilizing, or surgically fixing the joint to encourage the bones to fuse. Increased stability can reduce pain.

A person with a fused ankle joint will be able to put their weight on it painlessly, but they will not be able to flex it.

Osteotomy

This involves a surgeon removing a small section of bone, either above or below the knee joint. It can realign the leg so that the person’s weight no longer bears down as heavily on the damaged part of the joint.

This can help relieve symptoms, but the person may need knee replacement surgery later on.

Complications

Septic arthritis is joint inflammation caused by bacteria. Joint replacement surgery slightly increases the risk of this infection.

This is a medical emergency, and hospitalization is necessary. Treatment involves antibiotic medication and drainage of the infected fluid from the joint.

A range of strategies can help ease the symptoms of OA. Ask the doctor for advice about suitable lifestyle adjustments. They may recommend:

Exercise and weight control

Share on PinterestWater-based exercise helps maintain muscle strength.

Exercise is crucial for:

  • maintaining mobility and range of movement
  • improving strength and muscle tone
  • preventing weight gain
  • building up muscles
  • reducing stress
  • lowering the risk of other conditions, such as cardiovascular disease

Current guidelines recommend that everyone should do at least 150 minutes of moderate-intensity exercise each week.

A doctor or physical therapist can help develop an exercise program, and it is important to follow their instructions carefully to prevent further damage.

Choose activities that will not put additional strain on the joints. Swimming and other types of water-based exercise are a good way to keep fit without putting additional pressure on the joints.

Learn more here about suitable exercises for arthritis of the knee.

Assistive devices and adjustments

A loss of mobility due to OA can lead to further problems, such as:

  • an increased risk of falls
  • difficulty carrying out daily tasks
  • stress
  • isolation and depression
  • difficulty working

A physical or occupational therapist can help with these issues. They may recommend:

Assistive devices: Using a walker or cane can help prevent falls.

Adjustments to furniture and home fittings: Higher chairs and devices such as levers that make it easier to turn faucet knobs, for example, can help.

Talking to an employer: It may be possible to make adjustments to the workplace or arrange for more flexible hours.

Supplements

Some research has suggested that people with low vitamin D levels have a higher risk of OA. Also, in people with a low vitamin C intake, the disease may progress more rapidly.

Low levels of vitamin K and selenium may also contribute, but confirming these findings will require further research.

Some people use supplements for OA, including:

  • omega-3 fatty acids
  • calcium
  • vitamin D

The American College of Rheumatology note that there is not enough evidence to support the safety and effectiveness of these supplements for OA. They recommend asking a doctor before using them.

OA is a common disease that causes joints to deteriorate, leading to pain and stiffness. It tends to appear during middle age or later.

There is currently no cure, but researchers are looking for ways to slow or reverse the damage. Lifestyle remedies and pain relief medications can help manage it.

  • Osteoarthritis
  • Rheumatology
  • Bones / Orthopedics
  • Pain / Anesthetics

Source: https://www.medicalnewstoday.com/articles/27871

What can we do about osteoarthritis?

What to Know About Generalized Osteoarthritis

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Understanding Primary and Secondary Osteoarthritis

What to Know About Generalized Osteoarthritis

Achy, stiff joints brought on by osteoarthritis have been experienced by many millions of people for a very long time. Experts have found skeletons dating to the Ice Age that show signs of osteoarthritis, the Arthritis Foundation says.

Today, doctors classify osteoarthritis by two types: primary or secondary. There’s not much of a difference in the way each type of osteoarthritis feels, but there is a difference in what causes them.

Osteoarthritis: How It Develops

Before you developed osteoarthritis, you probably took it for granted that you could move your joints smoothly and without pain. But when the cartilage at the ends of the bones in your joints begins to break down, the joints don’t move as smoothly. Here’s what happens in osteoarthritis:

  • The breakdown of cartilage causes your bones to react in those areas, often by developing bone spurs, or growths.
  • The cartilage doesn’t stretch as well, and can be injured more easily because of it.
  • Your joints may become inflamed and swollen, which damages the cartilage even more.
  • When the bones touch without that protective cartilage in between, you’ll feel pain and have stiffness. You may notice that the joint can no longer be moved through a range of motions.

RELATED: What to Ask Your Doctor About Osteoarthritis Knee Pain

Osteoarthritis: Primary or Secondary?

The aforementioned chain of events happens in both primary and secondary osteoarthritis. What’s different about the two types is the underlying cause for the cartilage breakdown in the first place.

Primary osteoarthritis. Considered “wear and tear” osteoarthritis, this type of osteoarthritis is more commonly diagnosed. Here's what experts know about primary osteoarthritis:

  • People tend to develop this type of osteoarthritis around age 55 or 60, says Yusuf Yazici, MD, a rheumatologist at New York University Hospital for Joint Diseases in New York.
  • It’s associated with aging — the longer you use the joints, the more ly you are to have this form of osteoarthritis.
  • Experts say that if we live long enough, we’ll all get this type of osteoarthritis to some extent, whether it’s very mild or more severe.

Secondary osteoarthritis. This type of osteoarthritis has a specific cause, such as an injury, an effect of obesity, genetics, inactivity, or other diseases. It tends to strike at an earlier age, around 45 or 50, Dr. Yazici says. Here are the risk factors that can lead to secondary osteoarthritis:

  • An injury: If you fracture a bone playing sports or in a car accident, you’re more ly to later develop osteoarthritis in that joint, and you’re more ly to experience osteoarthritis at a younger age than those who have primary osteoarthritis, Yazici says.
  • Obesity: “Obesity is a big factor,” Yazici says. Extra weight that bears down on the joints day in and day out can cause the joint to wear away faster. According to the Arthritis Foundation, every extra pound you gain adds three pounds of pressure to your knees and six pounds of pressure to your hips.
  • Inactivity. A sedentary lifestyle leads to weight gain, which can lead to osteoarthritis, Yazici says. Also, if you’re inactive, you have weaker muscles and tendons that surround the joint. Strong muscles help keep joints properly aligned and stable. Low-impact activities such as walking and swimming are important for keeping those muscles and tendons strong, he says.
  • Genetics. You may carry genes that put you at risk for osteoarthritis. In particular, experts have found that arthritis of the hands tends to have a genetic link among women. Osteoarthritis in the knee and hip also seems to run in families, Yazici says. “If your mother had it and your aunt had it, you’ll probably have it starting at about the same age,” he says.
  • Inflammation from other diseases. Diseases that cause inflammation, such as rheumatoid arthritis, can increase your risk of getting osteoarthritis later in life.

Whether you have primary or secondary osteoarthritis, the treatment is the same. What’s most important, though, is to avoid the risk factors for secondary osteoarthritis that are within your control. “Stay active to keep muscles and tendons stronger, and lose weight or maintain a healthy weight,” Yazici says.

Source: https://www.everydayhealth.com/arthritis/osteoarthritis/index.aspx

The Basics of Osteoarthritis

What to Know About Generalized Osteoarthritis

Arthritis is a general term that means inflammation of the joints. Osteoarthritis, commonly known as wear and tear arthritis, is the most common type of arthritis.

It is associated with a breakdown of cartilage in joints and can occur in almost any joint in the body. It commonly occurs in the weight-bearing joints of the hips, knees, and spine.

It also affects the fingers, thumb, neck, and large toe.

Osteoarthritis — also called OA — usually does not affect other joints unless previous injury , excessive stress or an underlying disorder of cartilage is involved.

Cartilage is a firm, rubbery material that covers the ends of bones in normal joints. Its main function is to reduce friction in the joints and serve as a “shock absorber.” The shock-absorbing quality of normal cartilage comes from its ability to change shape when compressed (flattened or pressed together).

Osteoarthritis causes the cartilage in a joint to become stiff and lose its elasticity, making it more susceptible to damage. Over time, the cartilage may wear away in some areas, greatly decreasing its ability to act as a shock absorber. As the cartilage deteriorates, tendons and ligaments stretch, causing pain. If the condition worsens, the bones could rub against each other.

Osteoarthritis affects an estimated 27 million Americans. The chance of developing the disease increases with age. Most people over age 60 have osteoarthritis to some degree, but its severity varies.

Even people in their 20s and 30s can get osteoarthritis, although there is often an underlying reason, such as joint injury or repetitive joint stress from overuse.

In people over age 50, more women than men have osteoarthritis.

Symptoms of osteoarthritis most often develop gradually and include:

  • Joint aching and soreness, especially with movement
  • Pain after overuse or after long periods of inactivity
  • Stiffness after periods of rest
  • Bony enlargements in the middle and end joints of the fingers (which may or may not be painful)
  • Joint swelling

There are several factors that increase a person's chances of developing osteoarthritis. These include:

  • Heredity. Some people have an inherited defect in one of the genes responsible for making cartilage. This causes defective cartilage, which leads to more rapid deterioration of joints. People born with joint abnormalities are more ly to develop osteoarthritis, and those born with an abnormality of the spine (such as scoliosis or curvature of the spine) are more ly to develop osteoarthritis of the spine.
  • Obesity . Obesity increases the risk for osteoarthritis of the knee, hip, and spine. Maintaining ideal weight or losing excess weight may help prevent osteoarthritis of these areas or decrease the rate of progression once osteoarthritis is established.
  • Injury. Injuries contribute to the development of osteoarthritis. For example, athletes who have knee-related injuries may be at higher risk of developing osteoarthritis of the knee. In addition, people who have had a severe back injury may be predisposed to develop osteoarthritis of the spine. People who have had a broken bone near a joint are prone to develop osteoarthritis in that joint.
  • Joint overuse. Overuse of certain joints increases the risk of developing osteoarthritis. For example, people in jobs requiring repeated bending of the knee are at increased risk for developing osteoarthritis of the knee.
  • Other diseases. People with rheumatoid arthritis, the second most common type of arthritis, are more ly to develop osteoarthritis. In addition, certain rare conditions, such as iron overload or excess growth hormone, increase the chance of developing OA.

The diagnosis of osteoarthritis is a combination of the following factors:

  • Your description of symptoms
  • The location and pattern of pain
  • Physical exam
  • X-rays

Your doctor may use X-rays to help confirm the diagnosis and make sure you don't have another type of arthritis. X-rays show how much joint damage has occurred. An MRI may be necessary to get a better look at the joint and surrounding tissues if the X-ray results do not clearly point to arthritis or another condition.

Sometimes, blood tests will be performed to determine if you have a different type of arthritis.

If fluid has accumulated in the joints, your doctor may remove some of the fluid (called joint aspiration) for examination under a microscope to rule out other diseases.

Osteoarthritis usually is treated by a combination of treatments, including exercise, weight loss if needed, medications, physical therapy with muscle strengthening exercises, hot and cold compresses to the painful joint, removal of joint fluid, injection of medications into the joint, and use of supportive devices such as crutches or canes. Surgery may be helpful to relieve pain when other treatment options have not been effective.

The type of treatment will depend on several factors, including your age, activities and occupation, overall health, medical history, location of your osteoarthritis, and severity of the condition.

Staying at your recommended weight helps prevent osteoarthritis of the knees, hips, and spine, reduces the stress on these weight-bearing joints, and reduces pain in joints already affected. Once you have osteoarthritis, losing weight also can relieve the stress and pain in your knees.

Exercise is important to improve joint movement and to strengthen the muscles that surround the joints.

Gentle exercises, such as swimming or walking on flat surfaces, are recommended, because they are less stressful on your joints. Avoid activities that increase joint pain, such as jogging or high impact aerobics.

Exercises that strengthen the muscles reduce pain in patients with osteoarthritis, particularly with osteoarthritis of the knee.

The first step with medication is often over-the-counter pain relievers as needed. These include acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve). Don't take over-the-counter medications for more than 10 days without checking with your doctor.

Taking them longer than that increases the chance of side effects. If over-the-counter treatments aren't effective, your doctor may decide to prescribe a stronger anti-inflammatory drug or other medication to help ease the pain.

Some medications in the form of creams, rubs, or sprays may be applied over the skin of affected areas to relieve pain. For some people with persistent pain despite these pills or creams, steroids can be injected directly into the joint.

These injections can be given several times a year, though some experts believe this may ultimately accelerate joint damage.

Injections of hyaluronic acid directly into the knee joint can relieve pain in some people with osteoarthritis.

When osteoarthritis pain is severe and other treatments are not working, some doctors will give stronger pain pills, such as narcotics.

Unfortunately, none of these will reverse or slow the progression of joint damage caused by osteoarthritis.

While recent research has questioned their usefulness, some medical research has shown that the supplements glucosamine and chondroitin may relieve pain in some people with osteoarthritis, especially in the knee. There is no evidence that glucosamine can help rebuild cartilage.

SAMe is another supplement with potential benefits for osteoarthritis. In fact, some research has shown it may be as effective an anti-inflammatory drugs.

Remember to always let your doctor know about any supplements you're taking, because they can have side effects and interact with medications.

Acupuncture has also been shown to provide significant and immediate pain relief in some people with osteoarthritis.

Supportive or assistive devices can help to decrease pressure on the joints with osteoarthritis. Knee supports may be helpful for some people to stabilize the ligaments and tendons and decrease pain. Canes or crutches may be helpful to take pressure off certain joints.

In addition to pain relief, assistive devices improve function and prevent falls. A licensed physical therapist or other health care professional is needed to recommend what devices are best for you.

There are also many available devices to help you perform routine daily activities that may be difficult, such as housework or cooking. Ask your doctor about talking to an occupational therapist to give you ideas about which devices may help.

When osteoarthritis pain is not controlled with other treatments, or when the pain prevents you from participating in your normal activities, you may want to consider surgery.

There are several types of surgery for osteoarthritis. They include:

  • Arthroscopy to clean out the damaged cartilage or repair tissues. It is most commonly performed on the knee and shoulder. Recent evidence has questioned its effectiveness for osteoarthritis.
  • Joint replacement surgery to replace the damaged joint with an artificial one. Joint replacement surgery should be considered when the severity of the joint pain significantly interferes with a person’s function and quality of life. Even under the best of circumstances, surgery cannot return the joint to its normal state (artificial joints do not have all of the motion of a normal joint), but movement and function are significantly improved. In addition, an artificial joint will greatly diminish pain. The two joints most often replaced are the hip and the knee. Artificial joints are now also available to replace shoulders, fingers, elbows, and ankles to treat severe pain that has not responded to other treatments.
  • Joint fusion to remove the damaged joint and fuse the two bones on each side of the joint. This is done more often in areas in which joint replacement is not effective.

Talk to your doctor to determine if any of these treatment options are right for you.

SOURCES: 

CDC. 

Arthritis Foundation. 

National Institute of Arthritis and Musculoskeletal and Skin Diseases. 

American Academy of Orthopaedic Surgeons.

© 2018 WebMD, LLC. All rights reserved. Do You Know the Causes of Osteoarthritis?

Source: https://www.webmd.com/osteoarthritis/guide/osteoarthritis-basics

Arthritis in Knee: 4 Stages of Osteoarthritis – IBJI

What to Know About Generalized Osteoarthritis

Osteoarthritis is the most commonly diagnosed type of joint arthritis disease, which can affect hands, knees and hips.

 Knee arthritis is known to affect joint functionality causing knee pain and even leading to disability as it progresses.

There are different stages of knee osteoarthritis (OA), with 0 assigned to a normal, healthy knee right up to the advanced stage 4, that is severe OA.

The Center for Disease Control and Prevention has found that the number of people suffering from knee pain disorder is gradually rising, with approximately 1 in 2 people ly to develop symptomatic knee OA in their lifetime leading to significant impact on health, workplace productivity and economic costs.

OA pain is easily identifiable through diagnostics and common symptoms.

Some people who suffer from immense osteoarthritis knee pain may only show mild changes on x-ray, so it is extremely important to concentrate on the symptoms, rather than just the x-rays.

Here is a look at the stages of osteoarthritis of the knee ranging from normal, minor, mild, moderate and severe stages, with appropriate treatment plans.

Stage 0 – Normal

When the knee shows no signs of osteoarthritis, it is classified as Stage 0, which is normal knee health, with no known impairment or signs of joint damage.

Treatments

There is no treatment required for stage 0 OA.

Stage 1 – Minor

Stage 1 OA patients will develop very minor wear & tear and bone spur growths at the end of the knee joints. However, at this stage it is unly you will feel pain or discomfort.

Treatments

If the patient is not predisposed to OA, orthopedic physicians may not recommend any special treatment for stage 1. However, supplements such as glucosamine and chondroitin may be recommended. Lifestyle considerations regular exercise may also prove to be helpful.

Stage 2 – Mild

In Stage 2, diagnostic images or X-rays of knee joints will show more bone spur growth, and though the space between the bones appear normal, people will begin experiencing symptoms of joint pain.

Typically, the area around the knee joints will feel stiff and uncomfortable, particularly when sitting for an extended period, after rising in the morning, or after a workout.

Though the cartilage and soft tissues remains at a healthy size, there is proteolytic breakdown of the cartilage matrix from an increased production of enzymes, such as metalloproteinases.

Treatments

When your physician detects and diagnoses OA at this early stage, it is easier to follow a plan to stop the progression of this joint disease.

There are different nonpharmacologic therapies to help relieve the pain and discomfort caused in this mild stage. Many patients are recommended a strict regimen of exercise and strength training for increased joint stability.

Additionally, braces, knee supports or shoe inserts may be used to protect the knee from stress.

Stage 3 – Moderate

Stage 3 is referred to as “moderate”, where there is obvious erosion to the cartilage surface between bones and fibrillation narrows the gap between the bones. There are proteoglycan and collagen fragments released into the synovial fluid as the disease progresses, wherein the bones develop spurs at the joints as it becomes rougher.

With the progression of osteoarthritis of the knee, there is obvious joint inflammation which causes frequent pain when walking, running, squatting, extending or kneeling. Along with joint stiffness after sitting for long or when waking up in the morning, there may be popping or snapping sounds when walking.

Treatments

Over the counter NSAIDs or pain-relief therapies may be prescribed. If these methods are not effective, the orthopedic doctor may prescribe stronger pain medicine, such as codeine and oxycodone.

Patients that have not responded positively to physical therapy, weight loss program, use of NSAIDs may require viscosupplementation, which are intra-articular injections of hyaluronic acid into the knee joint.

Moderate knee arthritis can be treated aggressively with three to five injections of hyaluronic acid over 3-5 weeks’ time, which may take several weeks for the treatment to start showing results, but pain relief typically lasts six months.

Stage 4 – Severe

Stage 4 is considered to be severe. In stage 4 the joint space between the bones are considerably reduced, causing the cartilage to wear off, leaving the joint stiff. The breakdown of cartilage leads to a chronic inflammatory response, with decreased synovial fluid that causes friction, greater pain and discomfort when walking or moving the joint.

There is increased production of synovial metalloproteinases, cytokines and TNF that can diffuse back into the cartilage to destroy soft tissue around the knee. The advanced stage of the disease shows development of more spurs causing excruciating pain, which makes even everyday chores, including walking and descending stairs a challenge.

Treatments

In cases of severe OA of the knee, an option is performing osteotomy or bone realignment surgery, wherein the orthopedic surgeon cuts the bone above or below the knee to shorten the length and help realign it for less stress on the knee joint. This surgery helps protect the knee by shifting the weight of the body away from the site of the bone spur growth and bone damage.

Another surgical option is total knee replacement, or arthroplasty. During this surgical procedure, the damaged joint is removed and replaced with a plastic or metal prosthesis device. Recovery from surgery may take several weeks and requires patience and discipline, with continuous physical and occupational therapy to regain full mobility.

If you are suffering from knee pain, contact an IBJI physician for a proper diagnosis and treatment plan. The Illinois Bone & Joint Institute has more than 100 orthopedic physicians, and 20 locations throughout Chicago.

Learn more about Illinois Bone & Joint Institute

Source: https://www.ibji.com/blog/orthopedic-care/arthritis-in-knee-4-stages-of-osteoarthritis/