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We’ve mentioned, here at Recall Center, on several occasions that as we experience advances in medicine, our quality of life can improve. These medical advances are accompanied by an increase in life-expectancy; however, as we age we’re also experiencing aches and pains we didn’t experience in our younger years. These aches and pains are more likely due to osteoarthritis (OA). It is estimated that as of 2005, 27 million Americans ages 25 and over suffer from the disease 1 2.
Osteoarthritis is a degenerative joint disease and the most common type of arthritis. Osteoarthritis develops by the breakdown of the cartilage leading to damage of the bones within the joint which ultimately causes pain and stiffness. Cartilage is the flexible connective tissue between the bones allowing them slide back and forth over one another and also acts as a shock absorber. The loss of cartilage causes the bones to rub together leading to pain and loss of motion. The continued use of the joint also leads to damage and change in shape of the bones, inflammation of the joint, and further loss of motion.
Osteoarthritis occurs most commonly in the weight-bearing joints such as the knee and hip, but can also occur in other parts of the body like the hands and feet. Physical stress and other events such as injuries to the affected area gradually lead to damage over time and usually starts to begin in people as they age past 40 3. There is currently no cure for osteoarthritis. Treatment for OA focuses on relieving symptoms and improving function, and can include a combination of patient education, physical therapy, weight control, and use of medications3.
There are two types of osteoarthritis that differ by the underlying events that lead to the breakdown of cartilage and development of the disease. They are referred to as primary and secondary osteoarthritis.
Primary osteoarthritis is sometimes referred to as “wear and tear” osteoarthritis. This type happens over time with age and is more commonly diagnosed. Basically, the longer we use our joints, the more likely we are to damage them. Stress over time with basic day to day function leads to the gradual deterioration of the cartilage.
Secondary osteoarthritis has a specific causes. Although, as mentioned above, age plays a major factor. However, obesity, injury, inactivity, and other diseases are things that lead to secondary osteoarthritis. Carrying extra weight for many years, injuries playing sports, being immobile for long periods and not moving the joints all act as risk factors.
Although there is no cure for osteoarthritis and treatments are the same for relieving pain and symptoms, risk factors for developing secondary osteoarthritis can be avoided by activities such as losing weight and regular exercise.
When diagnosing osteoarthritis, a physician will take a full medical history and do a physical exam to determine if any symptoms are present in the patient. These symptoms include:
The physician will also as ask questions during the physical examination identify possible causes of the pain such as:
A proper diagnosis will also include other tests such as X-rays, other imaging procedures, or even possible laboratory tests to rule out other types of diseases.
There is no one proven treatment for managing osteoarthritis. The goal of treatment is to manage the symptoms, reduce pain, and improve joint function. There are three types of treatment available: physical, medication, and surgical. Depending on the extent of the injury of the joint, one treatment may work better than another and improve the outcome of treatment.
Physical measures that can be taken to improve joint stiffness and reduce stress include regular physical activity, weight loss, and also alternative measures. Regular movement and physical therapy can reduce joint stiffness and improve muscle strength. Weight loss will not only improve the general ability to get around, it will also reduce stress on the joints. Use of general support devices will be helpful in moving around, such as a cane; hot or cold therapy can help with pain and inflammation. Alternative treatments can vary. Spa or hot tubs can be helpful as well as massage or acupuncture. A newer therapy known as Transcutaneous Electrical Nerve Stimulation or TENS. This technique uses a small electronic device to direct mild electric pulses to nerve endings that lie beneath the skin in the painful area.
Drug therapies are more popular to manage pain and inflammation. The forms of drug therapy available:
Topical treatments applied to the skin like capsaicin creams and lidocaine.
Oral pain and anti-inflammatories include both over-the-counter drugs and supplements like chondroitin/glucosamine, acetaminophen, and naproxen. Also, there prescription drugs such as meloxicam (Mobic), celecoxib (Celebrex), and opioid and narcotic analgesics. Injections with corticosteroids can also aid in reducing inflammation.
Surgical treatments are normally only used if other measures fail to work due to other risks involved or if other methods are no longer effective. These surgical techniques include:
It may be difficult and challenging at first caring for a loved one with osteoarthritis according to Everyday Health. There are many things to think about: medication, chronic pain, helping them adjust to the changes in lifestyle to name a few. The important thing to remember is to be aware of some tips that may be helpful in managing their care.
1. One of the first things to think about is to become educated and learn about osteoarthritis in order to become a good care giver. Educating yourself will help ask the right questions to ensure they are getting the best possible care and understand their situation.
2. If the person you care for is elderly, ensure they are taking their medications properly. Often new medications will be involved after the diagnosis. It may be helpful to place medications in easy-to-open containers that are labelled with the proper dose already prepared. Managing other aspects of their medication will also be helpful such as keeping track of when a medication needs to be refilled and the possible side-effects with other medicines they are presently taking.
3. Know when they are in pain. Older people tend not to complain about pain, so recognize the signs. Some facial expressions, irritability and sadness may be indicators they are in pain.
4. Pain and adjusting to a new lifestyle can often lead to depression. Make sure you inform their physician if new medicine will be required to help.
5. Being present can be one of the most important things you can do as a caregiver. Losing their independence can be frustrating and it’s normal for them to get angry. They will need someone to talk to at times.
6. Most importantly, take care of yourself. As mentioned above, taking care of a loved one in a new situation is challenging; don’t be afraid to ask for help.
In the end, it’s important to remember as difficult as your task may be you are not alone. Keep in mind, there are many organizations and resources on the internet available to help. I encourage you to reach out to an organization and get involved. It will make your task much easier and more rewarding. For more information, please see the links below:
National Institute of Arthritis and Musculoskeletal Skin Diseases. Osteoarthritis. Last Updated: August 2013. Available at: http://www.niams.nih.gov/Health_info/Osteoarthritis/default.asp#osteoarthritis. Accessed May 6, 2014. ↩
American College of Rheumatology: Diseases and Conditions. Osteoarthritis. Updated: February 2012. Available at: http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/osteoarthritis.asp. Accessed May 6, 2014. ↩
Centers for Disease Control and Prevention. Osteoarthritis. Last updated: September 1, 2011 Available at: http://www.cdc.gov/arthritis/basics/osteoarthritis.htm. Accessed May 7, 2014. ↩
Everyday Health. Understanding Primary and Secondary Osteoarthritis. Copyright 2014. Available at: http://www.everydayhealth.com/arthritis/osteoarthritis/index.aspx. Accessed May 7, 2014. ↩
American Association of Orthopaedic Surgeons. Osteoarthritis. Last reviewed: July 2007. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00227. Accessed May 7, 2014. ↩
Everyday Health. Caregiving After an Osteoarthritis Diagnosis. Last Updated: March 2, 2009. Available at:
http://www.everydayhealth.com/osteoarthritis/caregiving-after-diagnosis.aspx. Accessed May 7, 2014. ↩