OSTEOARTHRITIS – AN OVERVIEW

Osteoarthritis is the most common type of arthritis. Also called degenerative joint disease, it is caused due to wear and tear of the joints resulting in cartilage breakdown.

Cartilage is an important structural component that is a firm yet flexible tissue that covers the ends of the bones at a joint. The major function of the cartilage is to prevent friction in the joints and also to act as a shock absorber.

The cartilage tends to become stiff and lose its flexibility due to osteoarthritis and more prone to damage. When the cartilage breaks down, the ability to act as shock absorber also diminishes resulting in ligament and tendon stretch, which causes pain. As time progresses, there is complete breakdown of the cartilage and bones tend to rub against each other causing severe pain.

Osteoarthritis mostly affects middle-aged and older people, and women are more prone than men. The joints most prone to osteoarthritis are the joints of the hands as well as the weight-bearing joints such as hips, knees, and ankles, and spine, but it can affect any joint. The pain gets worse with activity and gets better with rest.

Causes:

• Obesity: Being overweight puts immense pressure on the weight-bearing joints such as spine, knees, and hips, which results in breakdown of cartilage and rubbing of bones against each other resulting in pain.
• Old age: As you age, the joints undergo normal wear and tear resulting in osteoarthritic pain.
• Injury: Injury to the joint due to accident or sports injury can lead to osteoarthritis.
• Overuse of joints: When certain joints are overused, osteoarthritis tends to develop in those joints.
• Genetics: Genes responsible for formation of cartilage may be defective in some resulting in osteoarthritis.
• Bone deformities: Any deformity in the bone, joint malformation, or deformity in the cartilage can result in osteoarthritis.

Treatment:

Osteoarthritis cannot be cured and the effects cannot be reversed, but symptoms can be effectively managed with medications, lifestyle modifications, physical therapy and other therapies, and surgery. The following are the treatments available:

• Medications:
  • Over-the-counter medications: Multiple pain relieving medications are available over-the-counter such as acetaminophen, aspirin, ibuprofen, and naproxen. These have been effective in management of pain but they all come with several side effects.
  • Topical medications: Medications are also available in the form of rubs, sprays, and creams that can be applied in the area of pain for relief of pain and inflammation.
• Therapy:
  • Ayurveda: Ayurveda recommends a holistic approach in treating this degenerative condition that includes changes in the diet and lifestyle, administering internal medicines that are completely natural and herbal and also using therapies for addressing degenerative joint conditions. There are many medicines in Ayurveda that help to strengthen the joints and reduce the degeneration. A professional Ayurvedic physician can customize and formulate an effective treatment plan that works for each individual. Therapies like Tailadhara (pouring of medicated oils), Nhavarakkizhi (massage with bolus of rice boiled in medicated milk) and Ksheeravasthi are among the most effective therapies for preventing degeneration and to strengthening the joints. It is very important to note that if there is associated inflammation, the anti-degenerative therapy is advised only after the inflammation is brought under control.
  • Physical therapy: A personalized exercise program to strengthen the muscles surrounding the affected joints and also increase range of motion and reduction of pain can be created with the help of a physical therapist or regular gentle exercises such as swimming, walking, jogging that can be done on our own have been effective in management of osteoarthritis.
  • Occupational therapy: Occupational therapistscan help in discovering ways to perform day-to-day activities as well as do the job without straining the already painful joints such as suggest the use of a stool when in shower to relieve from pain caused by standing when affected by osteoarthritis of the knees.
  • Yoga: Yoga has been proven to be very effective in reducing osteoarthritis pain and stiffness. Also yoga involves breathing techniques as well which helps in reducing stress in life.However it is very important to get the help of an instructor before doing yoga to prevent injury and further pain.
• Surgery and other procedures: In case conservative therapies fail,
  • Cortisone injections: Injections of cortisone can relieve pain but it must be limited to three to four as it can worsen the damage to the joint over time.
  • Hyaluronic injections: This injection provides lubrication between the joints, which helps in relief of pain.
  • Bone realignment: When one side is more damaged than the other side, osteotomy procedure might be performed to remove or add a wedge of bone, which helps in shifting of body weight away from the worn out part.
  • Joint replacement: Plastic or metal parts are used in place of the damaged joints in severe cases of osteoarthritis.