Arthritis and Other Joint Diseases - Osteoarthritis
The most common form of arthritis is osteoarthritis , which is also known by the terms hypertrophic arthritis and degenerative joint disease . It can be said quite accurately that if you live long enough you will experience osteoarthritis. In fact, osteoarthritis is most common in areas of the world where people have the greatest longevity. The first signs of osteoarthritis may appear on X-ray pictures of persons in their 30s and 40s, even though they have not yet felt pain in the weight-bearing joints, the hips and knees, where discomfort usually appears first. Studies show that nearly everybody has at least the beginning signs or symptoms of osteoarthritis after they reach their 50s. It affects both men and women, although women may not experience symptoms until after they have reached menopause.
A somewhat simplified explanation of the cause of osteoarthritis is this: the joints between the bones of a young person are cushioned and lubricated by cartilage pads and smooth lining membranes; normal wear and tear on the joints during a lifetime of activity gradually erodes the protective layers between the bones. In addition, the bones may develop small growths at the joints, a factor that aggravates the situation. There is evidence that heredity plays a role in the development of these bone growths, which are ten times more likely to occur in women than in men.
While hips and knees are among the most likely targets of osteoarthritis, the disease also can involve the hands, the shoulders, or back. Weight-bearing joints are commonly involved when the patient is overweight and spends a great deal of time standing or walking.
Except for the descriptions of aches and pains by victims of osteoarthritis and X-ray examination of the joints, a physician frequently has little information to go on in making a diagnosis of this disease. In some cases, there may be enlargement of the joint and some tenderness. But few cases are marked by the excessive warmth, for example, associated with rheumatoid arthritis. There are no laboratory tests that can distinguish the disorder from other rheumatic or arthritic diseases.
Osteoarthritis seldom causes the degree of discomfort experienced by patients afflicted by rheumatoid arthritis; the disease is not as disabling for most patients, and even the stiffness associated with osteoarthritis is milder, usually lasting only a few minutes when activity is attempted, while the stiffness of rheumatoid arthritis may continue for hours.
Arthritis of the Hip
Although most cases of osteoarthritis are not seriously disabling, arthritis of the hip is a prominent cause of disability in older persons. It produces pain in the hips, the inner thigh, the groin, and very often in the knee. Walking, climbing steps, sitting, and bending become very painful, because the joint is destroyed by degeneration of bone and cartilage. Stress and strain on the hip joint further aggravate the condition, which becomes worse with advancing age.
Surgery to replace the head of the femur or the entire hip joint with metal or plastic parts has brought relief from pain and restored mobility to some patients suffering from severe arthritis of the hip.
Small children sometimes suffer from transient arthritis of the hip, of unknown cause, manifested by pain, limitation of hip movement, and impeded walking. Because the condition usually disappears within six weeks, the only treatment is bed rest. Transient arthritis must not be mistaken for the more serious pyrogenic hip arthritis of children and adults, marked by high fever.
The aging process is the prinicipal cause of spinal arthritis. Other contributing factors are disk lesions and injury. Spinal arthritis causes pronounced bone degeneration and disability. The sufferer experiences severe back pain radiating to the thighs as a result of interference of the nerve roots from osteophytes , or spurs, formed in the joints. In mild cases, physical therapy may be the only treatment required.
Treatment of Osteoarthritis
For most patients, osteoarthritis is not likely to be crippling or disabling. The effects generally are not more serious than stiffness of the involved joints, with occasional discomfort and some pain. When weight-bearing joints are involved, the basic remedies are weight control and adequate rest for the areas affected. In some instances, the patient may have to learn new postural adjustments; symptoms often appear in another joint after the first has been affected because the patient tends to favor the joint that first caused pain and shifts weight or muscle stress to the second joint.
Physical therapy and corrective exercises are helpful. A physician may recommend the use of aspirin or another analgesic for the pain. Steroid drugs may be injected into an injured joint, but usually only for temporary relief. Surgery is sometimes recommended for removal of troublesome bone spurs or to correct a serious problem in a weight-bearing joint, where a metal cup or other device may be inserted as part of an artificial joint.