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What is Osteoarthritis (OA)? Osteoarthritis (OA) is the most common form of arthritis. It’s also known as degenerative joint disease or “wear and tear” arthritis. In patients with osteoarthritis, the cartilage within a joint breaks down, causing changes in the underlying bone. Over time, a patient experiences worsening joint pain, swelling and stiffness. Some people are able to function well, while others find it difficult to do daily tasks. Orthopedics Now The most commonly affected joints include the: - Hands (most often the ends of the fingers and base/ends of the thumbs) - Hips - Knees - Neck - Lower back Local Rheumatologists Dr. Kam Shojania, MD FRCPC, Rheumatologist, discusses the disease osteoarthritis. Dr. Kam Shojania, MD FRCPC, Rheumatologist, discusses osteoarthritis and lifestyle. Symptoms of osteoarthritis Depending on the severity of your osteoarthritis, you may experience a range of symptoms. Some people maintain good mobility and flexibility, while others find it difficult to perform daily tasks. The most commonly affected joints are the knees and the hips, although other joints can also be affected, including the base of the big toe or thumb, the end joints or middle joints of fingers or the neck and low back. Local Physiotherapists For many people, osteoarthritis begins with one or a few joints, and symptoms begin slowly. OA symptoms can include: - Joint stiffness that generally lasts less than 30 minutes, especially in the morning or after periods of rest. - Swelling in the joint. - Decreased range of motion. - Pain when using the joint, which may be worse at night. In some patients, joint pain may get better with rest. - Inability to properly move the joint, or feeling like the joint is “loose”. - Fatigue. Dr. John Watterson, MD, FRCPC, discusses diagnosis and symptoms of osteoarthritis. Who gets osteoarthritis? Osteoarthritis is most common in people who are 50 years or older. It’s more common in women than in men. Other risk factors for OA include: - Being overweight or obese - Joint injury - Excessive use of a joint Although the reason is not well understood, osteoarthritis can run in families, especially when it affects joints in the hands. Local Orthopedic Surgeon. Dr. Kam Shojania, MD FRCPC, Rheumatologist, discusses Management of Osteoarthritis. While you may work with a rheumatologist to manage your osteoarthritis, your family physician may be the one to diagnose it by taking your medical history, doing a physical assessment and sending you for blood tests and x-rays. Common Tests Blood Tests Because there are about 100 different types of osteoarthritis, it can be difficult to distinguish this disease from other forms of arthritis. Blood tests can help rule out other conditions. Scans The changes in joints caused by osteoarthritis can often be identified in x-ray images. Treatments for osteoarthritis When it comes to treating osteoarthritis, the earlier the better, because once a joint is damaged, the damage can’t be reversed. It’s important to keep joints moving in order to stay mobile and decrease joint pain. In many cases, physicians will use a multimodal approach that combines different treatments to treat osteoarthritis. In most cases, the medications used for osteoarthritis help control pain. Medications used to treat OA include: - Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. There are about 20 different NSAIDs available. - Analgesics and opioids (pain killers). Non-prescription analgesic medications such as acetaminophen can help control pain in some patients, and are safe to use long-term. - Opioids. If your osteoarthritis isn’t well controlled with NSAIDs or analgesics, stronger opioids such as morphine or oxycodone may be prescribed. However, patients must use them with caution because they can cause dependence. - Corticosteroid injections directly into the joint for pain and swelling. While they can be effective for some patients, they’re generally limited to three or four per joint per year. Orthopedic Surgeon Other osteoarthritis treatments include: - Local Physiotherapy. Exercises and stretches can help you maintain mobility and prevent further joint damage. - Weight loss. Even losing as few as 10 pounds can relieve OA pain in weight-bearing joints. - In severe cases, surgery can be an option to help people improve mobility and restore functioning. Generally, surgery involves replacing a damaged joint with an artificial joint (usually the hip or knee). Dr. John Watterson, MD, FRCPC, discusses diagnosis, symptoms and treatment of osteoarthritis in the hands. Dr. Bassam Masri, MD, FRCSC, Orthopedic Surgeon, discusses Treatment Options for Osteoarthritis of the Knee. Dr. John Wade, MD, FRCPC, discusses osteoarthritis treatments such as acetominophen and NSAIDs. Dr Bassam Masri, MD, FRCSC, discusses Hip Pain Caused by Osteoarthritis. Osteoarthritis (OA) is the most common type of arthritis, affecting millions of people worldwide. Often affecting people in their 50s and 60s, OA is caused when the cartilage on the ends of the bones wears down. Often, the bones rub against each other, causing pain and swelling. Osteoarthritis of the Knee Symptoms Osteoarthritis is most common in the joints of the knees, hips, hands, fingers, neck and spine, although it can affect any joint in the body. OA can even occur in the back, and then it’s also known as degenerative disc disease. Osteoarthritis of the knee symptoms include pain, stiffness and swelling, especially when getting up in the morning. If your OA is severe, you may feel pain for the entire day, or lose your ability to use the joint. OA gets worse over time as the body grows new bone at an attempt to heal the damage. However, this results in bumps of new bone growth around the joint and the breakdown of cartilage. In addition to age, other risk factors for osteoarthritis of the knee include: • Being overweight or obese • Repetitive stress injuries • Heredity • Gender (women) Many individuals will not have symptoms. Others will have quite severe symptoms. If you’re diagnosed with osteoarthritis, your physician will likely refer you to a rheumatologist. Osteoarthritis of the Knee Treatment The treatment for individuals varies from simple over-the-counter analgesic and anti-inflammatory agents to prescription-strength anti-inflammatory drugs. OA medications include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, acetaminophen and pain medications such as opioids. Along with medications to manage your arthritis, lifestyle changes can also help. Before starting off medications, you should consult your general practitioner to make sure there are no contraindications to you utilizing over-the-counter or prescription-strength analgesic or anti-inflammatory drugs. While OA can’t be reversed, it can be effectively treated. An exercise and stretching program can be great for mobility and flexibility. Your rheumatologist may also recommend that you lose weight to reduce the burden on your joints. Even five or ten pounds of weight loss significantly reduces the strain across a weight-bearing joint, and can improve pain and reduce the need for joint replacement in the future. Talk to your rheumatologist if you’d like more information on osteoarthritis of the knee. Visit HealthChoicesFirst.com for more videos and resources on arthritis.
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Osteoartritis (OA) je jedan od najčešćih medicinskih problema u svijetu, glavni je razlog za izgubljeno radno vrijeme i ozbiljan gubitak radne sposobnosti mnogih ljudi. Iako je artritis uglavnom bolest odraslih, mogu oboljeti i djeca. Osteoartritis, ponekad nazvan degenerativni artritis, degenerativna bolest zglobova ili, jednostavno artroza, čini gotovo polovicu svih vrsta artritisa i karakterizira ga uništavanje zglobne hrskavice. Opis bolesti Hrskavica je dio zgloba koji oblaže krajeve kostiju. Uništavanje hrskavice uzrokuje trljanje kostiju jedne o drugu, što uzrokuje bol i gubitak pokreta. U mnogim slučajevima, u osteartritičnim zglobovima mogu se razviti koštane izrasline nalik na mamuze, nazvane osteofiti. Postoje mnogi faktori koji uzrokuju OA. Iako su godine rizični faktor, istraživanja su pokazala da OA nije neizbježan dio starenja. Pretilost može dovesti do osteoartritisa u koljenima. Također, ljudi sa sportskim ozljedama, ozljedama zbog aktivnosti na poslu, te zbog nezgoda imaju povećan rizik od razvoja OA-a. Genetika ima ulogu u razvoju OA-a, pogotovo u rukama. Neki ljudi mogu biti rođeni sa defektnom hrskavicom ili sa malim defektima u načinu na koji su spojeni zglobovi. Kako osoba stari, ti defekti mogu uzrokovati rano uništavanje hrskavice u zglobu. U procesu uništavanja hrskavice, može postojati upala sa oslobađanjem enzima i većim oštećenjima hrskavice. Tko obolijeva? Najčešće pogađa ljude srednje i starije dobi, a žene su češće pogođene nego muškarci. Simptomi Ako imate osteoartritis, možete osjetiti ove simptome: - bol u zglobovima za vrijeme ili poslije kretanja - neugodu u zglobu prije ili za vrijeme promjene vremena - oticanje i ukočenost zglobova, pogotovo nakon kretanja - koštane izbočine na sredini ili na kraju zglobova prstiju ili baze palca - gubitak fleksibilnosti zgloba Akutna bol ranog osteoartritisa može izblijediti unutar svoje pojave, ali se može vratiti ako previše koristite pogođeni zglob. Ako niste bili ozlijeđeni ili vam zglob nije bio pod neuobičajenim stresom, neobično je da osteoartritis pogodi čeljust, ramena, laktove, članke ruku ili nogu. Područja koja ovo stanje tipično pogađa Područja koja ovo stanje tipično pogađa su: - Prsti. Koštani čvorovi mogu povećati vaše zglobove na prstima stvarajući kvrgave oblike. U ranoj fazi bolesti, zglobovi mogu biti osjetljivi, bolni i ukočeni. Nakon 1 do 2 godine, bol se često povlači, ostavljajući samo koštane kvrge koje utječu samo na pokretljivost zglobova na krajevima vaših prstiju. Za te kvrge je tipično da su familijarne i češće pogađaju žene nego muškarce. - Kralježnica. Sporo izlizivanje diskova između kralježaka može uzrokovati bol u leđima i vratu te ukočenost. - Zglobovi koji djeluju kao uporišta težine. Dijelovi vašeg tijela koji nose glavninu vaše težine, kukovi, koljena i stopala su najosjetljiviji na osteoartritis. Kako se hrskavica lagano izlizuje tijekom nekoliko godina, kod vas se može razviti hronična bol ili različite količine neugode kada stojite ili hodate. Također se može pojaviti oticanje, posebno u koljenima. Koje pretrage se mogu napraviti? Liječnici postavljaju dijagnozu OA na osnovu kliničkog pregleda, te prisutnih znakova i simptoma. Rendgensko snimanje se koristi za potvrdu dijagnoze. Većina ljudi iznad 60-te pokazuju bolest na rendgenskim snimkama, a jedne trećina njih ima stvarne simptome. Liječenje Ciljevi liječenja su osigurati olakšanje od bolova, povećanje obima kretnji i pojačati snagu. Postoji nekoliko vrsta liječenja: - Lijekovi. Mnogi lijekovi bez recepta, uključujući acetilsalicilnu kiselinu (npr. Andol) ili ibuprofen (česti protuupalni lijekovi), mogu biti korišteni za učinkovitu kontrolu boli i upale kod artritisa. Lijekovi na recept (npr. diklofenak) za liječenje osteoartritisa su također dostupni. Ljekar vrši odabir lijeka uzimajući u obzir tip artritisa, njegovu jačinu i općenito fizičko zdravlje pacijenta. Pacijenti s ilkusom želuca ili dvanaesterca, astmom, bolestima bubrega ili jetre ne bi smjeli uzimati protuupalne lijekove. Injekcije tekućeg kortizona direktno u zglob mogu privremeno olakšati bol ili oticanje. Važno je znati, međutim, da često ponavljanje injekcija u isti zglob nije preporučljivo jer može oštetiti zglob i imati neželjene nuspojave. - Zaštita zgloba. Štapovi, štake, hodalice ili učvršćenja mogu pomoći olakšanju od stresa i napetosti artritičnih zglobova. Metode učenja obavljanja dnevnih aktivnosti koje su manje stresne i bolne za zglobove također mogu biti od pomoći. Određene vježbe i fizikalne terapije mogu i trebaju se koristiti da bi se smanjila ukočenost, i da bi se ojačali mišići oko zglobova. - Operacija. Ortoped će se za operaciju odlučiti kada druge metode nehirurškog liječenja nisu uspjele. Ljekar i pacijent će odabrati tip operacije prema tipu artritisa, njegovoj ozbiljnosti i pacijentovom fizičkom stanju. Hirurške procedure uključuju: • artroskopsku toaletu zahvaćenog zgloba • hirurško ispravljanje angularnih (kutnih) deformiteta zglobova • ugrađivanje totalne endoproteze zgloba (tzv. “umjetni zglobovi”) • spajanje krajeva kostiju u zglobu, kako bi se spriječilo kretanje zgloba, i na taj način olakšala bol u zglobu Prognoza Trenutno, većina tipova artritisa se ne može izliječiti. Znanstvenici nastavljaju napredovati u potrazi za najvažnijim uzrocima glavnih tipova artritisa. U međuvremenu, ortopedi u suradnji sa drugim liječnicima i znanstvenicima razvijaju mnoge učinkovite načine liječenja osteoartritisa. U većini slučajeva, osobe s artritisom mogu nastaviti sa svakodnevnim životnim aktivnostima. Programi vježbanja, protuupalni lijekovi, te redukcija težine za pretile osobe su uobičajene mjere za smanjenje boli, ukočenosti i poboljšanje funkcije. Kod ljudi sa teškim slučajevima artritisa, ortopedska operacija često može osigurati veliko olakšanje boli i uspostaviti izgubljenu funkciju zgloba. Ugrađivanje totalne endoproteze obično omogućava osobi s teškim artritisom u kukovima ili koljenu hodanje bez boli ili ukočenosti.