Osteoarthritis

Osteoarthritis, a degenerative disease characterized by inflammation of the joints between bones, usually as a result of wear and tear over the years. Osteoarthritis is the most common of the various kinds of arthritis. It affects joints of the neck, back (joints of the spine), knees, hips, fingers, thumbs, and big toes. Osteoarthritis occurs most often after age 45, and, according to the Arthritis Foundation, affects an estimated 20.7 million Americans.

In a healthy joint, cartilage (smooth, elastic tissue that cushions the joint and allows for ease of movement) protects the ends of the bones. In osteoarthritis, years of joint use may eventually cause the cartilage to deteriorate, changing its surface from smooth to rough. Occasionally, a direct injury to a joint can cause osteoarthritis.

As the cartilage deteriorates, the ends of the bones begin to rub together, causing joint swelling. Eventually, bone may grow along the sides of the joint in the form of lumps, or spurs. These joint changes cause the typical symptoms of osteoarthritis: pain when the joint is used that may remain even after movement has stopped, swelling, a gradual loss of joint flexibility, and weather-induced joint discomfort.

Doctors diagnose osteoarthritis by observing symptoms, by physical examination, and with X rays. The condition may be treated with an exercise program to strengthen muscles and lessen stiffening. Doctors also advise weight loss in overweight patients to ease the pressure on joints, and good posture to strengthen spine muscles. To ease pain and inflammation, doctors most frequently prescribe aspirin or other nonsteroidal anti-inflammatory drugs (NSAID). When inflammation is severe, corticosteroids may be injected into the joint to reduce inflammation. This treatment is most often performed on weight-bearing joints such as ankles or knees. Doctors also advise patients to use hot or cold compresses or topical preparations to relieve inflammation and pain. Sometimes a patient needs a mechanical aid, such as a walker or cane, to help with mobility.

Once damaged, a joint cannot be fully repaired, but when deterioration is extensive, doctors may perform joint replacement surgery (replacement arthroplasty), in which a plastic or stainless steel joint is installed. Doctors most often perform this surgery on hip joints, but it also is used for knee and finger joints.

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