Living with Osteoarthritis

Various treatments for osteoarthritis can decrease pain and maintain joint mobility.

Osteoarthritis (OA), which is the most common form of arthritis, is a progressive disorder caused by the breakdown of cartilage that cushions the joints. OA involves the entire joint, including the cartilage, joint lining, ligaments, and underlying bone.^1,2 In addition to reducing joint mobility, OA causes pain, stiffness, and weakness that can negatively impact an individual’s ability to perform routine tasks and consequently reduce his or her overall quality of life. According to the Arthritis Foundation, an estimated 27 million individuals in the United States have some degree of OA.¹

Although OA can occur in individuals of any age, its incidence increases with age, especially in those 65 years and older. In fact, OA is considered the leading cause of disability among elderly individuals.^1,2 OA can occur in any joint, but the most commonly affected areas are the joints of the fingers, base of the thumbs, hips, knees, neck, big toes, and lower back.^1-5 The elbows and ankles may also be affected.^1-5 The extent of OA and which joints are affected vary; many individuals experience issues with range of motion. Some patients with OA may need assistance completing daily tasks such as climbing stairs, walking, lifting or grasping objects, and getting up from a seated position.

Osteoarthritis Risk Factors

OA typically develops slowly and worsens over time, especially if left untreated. Risk factors can be classified as genetic, metabolic, or environmental. Common risk factors associated with OA include the following^{1- 5}:

• Increased age
• Gender (OA appears to be more common in women older than 55 years)
• Obesity
• Joint injury
• Overuse of joint
• Genetics
• Repetitive stress on joints due to certain occupations or sports
• Improperly formed joints
• Other medical conditions, such as diabetes or gout

Diagnosing Osteoarthritis

OA symptoms typically develop gradually, with variable severity. The most common signs and symptoms include the following^1-5:

• Pain and stiffness in the affected joint after periods of inactivity such as sleeping or sitting for an extended period of time
• Swelling or tenderness in 1 or more joints
• Loss of flexibility and decreased function of the joint
• Limited range of motion
• Increased pain after exercising or putting pressure on the affected joint
• Crackling or grinding sensation with joint movement
• Bone spur formation around the joint

If you suspect that you have OA, your physician will review your symptoms and medical history. He or she will also perform a physical examination and order other tests such as x-rays, magnetic resonance imaging, and blood tests to confirm a diagnosis or rule out other disorders.

Treating Osteoarthritis

Although there is no cure for OA, a variety of treatment options can help decrease pain and maintain joint mobility. Typically, the main goal of OA treatment is to improve the patient’s overall quality of life by relieving pain and enhancing joint mobility and function. Treatment may require a combination of medication, physical therapy, and lifestyle modifications. Therapy is individualized depending on various factors, including the severity of the OA, the patient’s symptoms, and his or her current medical history, medication profile, and allergy history.

Available medications for OA include oral, topical, or injectable OTC and prescription formulations. Commonly used oral medications include analgesics such as acetaminophen and nonsteroidal antiinflammatory drugs. Supplements for joint health, such as glucosamine and chondroitin, are marketed as well. Topical analgesics such as capsaicin cream are applied directly to the skin. Your physician may also recommend corticosteroid injections for temporary pain relief. To ensure safety and avoid potential drug interactions, always consult your physician or pharmacist before taking any OTC medications, including supplements. Other therapies include physical therapy, transcutaneous electrical nerve stimulation, rest, heat and cold therapy, weight loss, and the use of support devices to take strain off joints, such as canes and splints. In some cases, surgery is warranted.

Living with Osteoarthritis

Individuals with OA can lead normal and active lives, especially if OA is identified early and treated properly. You can become an active partner in your treatment by:

• Staying informed about your condition and available treatments
• Maintaining a healthy weight to reduce stress on weight-bearing joints
• Engaging in regular exercise when appropriate to enhance flexibility and strength
• Eating a balanced, healthy diet
• Getting sufficient rest and relaxation
• Developing means to reduce and manage stress
• Using heat to relieve stiffness and pain
• Using cold to relieve muscle spasms and pain
• Protecting your joints from injury
• Modifying activities if needed to minimize the incidence of pain
• Asking for help when needed

If you have OA, take a proactive role in your health and discuss the various available treatment plans with your primary health care provider so that you can make informed decisions. Although there may be challenges along the way, research results from the National Institutes of Health demonstrate that individuals with OA who take part in their care report less pain and require fewer physician visits.⁵ By empowering yourself with essential information about OA, you can take control of your condition and lead an active and productive life.

Ms Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.

References:

1. Understanding arthritis. Arthritis Foundation website. www.arthritis.org/arthritis-facts/understanding-arthritis.php. Accessed November 29, 2014.

2. Osteoarthritis. American College of Rheumatology website. www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/osteoarthritis.asp. Accessed November 29, 2014.

3. What is osteoarthritis? Arthritis Foundation website. www.arthritistoday.org/about-arthritis/types-of-arthritis/osteoarthritis/what-you-need-to-know/osteoarthritis-is.php. Accessed November 29, 2014.

4. Osteoarthritis and you. Centers for Disease Control and Prevention website. www.cdc.gov/Features/OsteoarthritisPlan/. Accessed November 29, 2014.

5. Handout on health: Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. www.niams.nih.gov/Health_Info/Osteoarthritis/. Accessed November 29, 2014.