Arthritis

There are several types of “arthritis”, the most common being osteoarthritis, which is a condition of cartilage degeneration from wear and tear on a joint.  There are inflammatory arthritic conditions including rheumatoid disease, psoriatic arthritis, gouty arthritis, etc. Osteoarthritis commonly symptomatically presents in the spine, thumb, hips, knees and ankles.

Causes

Osteoarthritis (also known as degenerative arthritis) is the most common type of arthritis. It may affect one or more joints anywhere in the body. Osteoarthritis usually occurs later in life and commonly affects the hands and larger weight-bearing joints such as hips and knees. Osteoarthritis can cause pain, deformity, and limit the range of motion of the joint.

A number of factors are thought to be important in the development of this disease. Mechanical considerations (eg, joint stability and alignment) affect the distribution of forces across the joint and therefore impact the joint’s life span. Also, certain substances (ie, biochemical factors) in the cartilage itself are thought to play a role in the eventual abnormal changes of this tissue.

Risk factors for osteoarthritis include age, traumatic injuries (such as a broken wrist), joint infections, and possibly overuse. There is a hereditary predisposition as well.

Symptoms

Joint pain is the main symptom of osteoarthritis.  Sometimes, pain will radiate from the joint to a particular anatomic distriution.  For instance, hip osteoarthritis typically sends pain into the groin and proximal leg.

Initially, pain will come and go and made worse when in use (such as when gripping heavy objects). However, pain is relieved with rest. There may be days or weeks without pain, but also periods of constant discomfort. As the disease advances, the pain becomes more constant, even occurring at rest. The pain changes from a dull ache to a sharp pain, which sometimes extends beyond the joint area.

Loss of motion in the joint can occur as arthritis progresses. However, sometimes as motion is lost, pain is lessened.  There can be swelling of the joint.

Weakness can result from pain causing the brain to send inhibitory feedback to shut off muscles controlling the joint.

Treatment

Procedural options include cortisone injections to the arthritic joint.  Lubricating injections (viscosupplementation) are another option that can be healthier to the overall environment of the joint compared to cortisone, which can cause cartilage destruction over time.  Regenerative-type injections (such as platelet-rich plasma [PRP] or stem cell injections) can theoretically provide longer lasting pain relief and improved function by stimulating the body’s own natural healing response when conventional treatments have failed.

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