Osteoarthritis : Joint Disorder : Tests & Treatment

Osteoarthritis (OA) is the most common joint disorder. Osteoarthritis is also known as degenerative arthritis or degenerative joint disease or osteoarthrosis, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone.

Tests & Diagnostics
A physical exam can show:

  1. Joint movement may cause a cracking (grating) sound
  2. Joint swelling (bones around the joints may feel larger than normal)
  3. Limited range of motion
  4. Tenderness when the joint is pressed
  5. Normal movement is often painful

No blood tests are helpful in diagnosing osteoarthritis.
An x-ray of affected joints will show a loss of the joint space. In advanced cases, there will be a wearing down of the ends of the bone and bone spurs.

Treatments

The goals of treatment are to:

  1. Increase the strength of the joints
  2. Maintain or improve joint movement
  3. Reduce the disabling effects of the disease
  4. Relieve pain

The treatment depends on which joints are involved.

Mdications
Over-the-counter pain relievers can help with symptoms. Most doctors recommend acetaminophen (Tylenol) first, because it has fewer side effects than other drugs.

If your pain continues, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs help relieve pain and swelling. The prescription drug, Celebrex (a COX-2 inhibitor) may work as well as other NSAIDs. Because of a risk for heart attacks and stroke, it is given only at the lowest possible dose for the shortest possible period of time.

Corticosteroids injected right into the joint can also be used to reduce swelling and pain. However, relief only lasts for a short time.Capsaicin (Zostrix) skin cream may help relieve pain. Artificial joint fluid (Synvisc, Hyalgan) can be injected into the knee. It may relieve pain for 3 – 6 months.

Lifestyle Changes
Exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.
Other lifestyle recommendations include:

  1. Applying heat and cold
  2. Eating a healthy, balanced diet
  3. Getting rest
  4. Losing weight if you are overweight
  5. Protecting the joints

People whose work is causing stress in certain joints should find ways to reduce trauma. You may need to adjust the work area or change work tasks.

Physical therapy
Physical therapy can help improve muscle strength and the motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3 – 6 weeks, then it likely will not work at all.

Braces
Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. You should use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.

Surgery
Severe cases of osteoarthritis might need surgery to replace or repair damaged joints. Surgical options include:

  1. Arthroscopic surgery to trim torn and damaged cartilage
  2. Changing the alignment of a bone to relieve stress on the bone or joint (osteotomy)
  3. Surgical fusion of bones, usually in the spine (arthrodesis)
  4. Total or partial replacement of the damaged joint with an artificial joint (knee arthroplasty, hip arthroplasty)

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