Degenerative arthritis, also referred to osteoarthritis or degenerative joint disease (DJD), is inflammation of the joints caused by the breakdown or degeneration of cartilage in one or more joints. It is estimated that this condition affects more than 25 million people in the United States alone. Although degenerative arthritis may be caused by trauma or injury, most individuals who suffer from this condition are over the age of 55.
Causes of Osteoarthritis
Cartilage, which provides a cushion between the bones of our joints, begins to deteriorate with degenerative arthritis. Osteoarthritis with no known cause (usually the result of aging) is referred to primary osteoarthritis, while injury, disease, obesity or trauma leading to osteoarthritis is referred to as secondary osteoarthritis.
It is expected that osteoarthritis, or the deterioration of cartilage, occurs as we age because water content in the cartilage begins to increase as we age. Repetitive use of worn joints irritates the cartilage, thereby leading to the introduction of water and swelling of the joint. This introduced water results in the deterioration of the cartilage. The cartilage, in fact, actually begins to flake and form tiny holes. As the decrease of cartilage between the joints progresses, osteoarthritis symptoms begin. Advanced osteoarthritis occurs when there is a complete loss of cartilage between the bones of one or more joints.
The pain felt in osteoarthritis is actually caused by the friction between the bones of a joint. Some individuals with advanced osteoarthritis form bone spurs, or outgrowths, around the joints, which are caused by the inflammation of the cartilage.
It is also expected that osteoarthritis has a genetic component, with members of the same family often suffering from this ailment. Further, hormone disorders, gout, and congenital joint abnormalities are thought to lead to osteoarthritis, as well.
Signs and Symptoms of Osteoarthritis
Because osteoarthritis is a disease of the joints and not of the body’s system (like rheumatoid arthritis), other parts of the body are not affected and symptoms are concentrated to the joints.
Most people suffering from degenerative arthritis notice their symptoms become worse as the day progresses (no doubt from the repetitive movement of the joints throughout the day). Further, most people with osteoarthritis report warmth and swelling at the affected joints, and some people actually feel as if their joints are “creaking.” People with degenerative arthritis also often report stiffness after periods of inactivity.
Pain often debilitates people with osteoarthritis, while others may have very little pain, despite x-rays that show advanced cartilage loss. Further, many people with osteoarthritis report that their pain is intermittent, often flaring up at times.
Although osteoarthritis can occur at any joint of the body, this type of arthritis is often a problem on weight-bearing joints, such as the spine, knees and hips. In fact, some people with advanced osteoarthritis of the knees become bowlegged due to deformation of the joints. It is not uncommon for individuals with advanced osteoarthritis of the knees and hips to require hip or knee replacement.
Osteoarthritis of the small joints of the hands often causes bone spur formations around the fingers, resulting in noticeable enlargements of the ends of the fingers. This deformation of the fingers is known as Heberden’s node. Bony nodes on the middle joints of the fingers are known as a Bouchard’s nodes.
Diagnosis of Osteoarthritis
Osteoarthritis, because it is not a systemic disease, cannot be diagnosed through a blood test. Most of the time, osteoarthritis is diagnosed through x-rays; arthrocentesis, a process that removes joint fluid for analysis; or arthroscopy, a surgical technique that involves inserting a viewing tube into the joint space. Arthroscopy is also a common technique for treating damaged cartilage.
Treatments for Osteoarthritis
Although no therapies or treatments exist to stop the progression of cartilage degeneration, individuals may benefit from weight loss or by avoiding weight-bearing or repetitive activities that put stress on affected joints.
Some patients with osteoarthritis have minimal pain and therefore generally do not receive treatment, while patients with moderate pain may benefit from rest, exercise, and diet control. Further, patients with severe pain often seek physical or occupational therapy treatments. They may also need supportive devices, such as walkers, splints or knee braces.
Finally, there is a host of medications that may be used topically or may be taken orally or through injection to decrease pain and inflammation of the joints, including:
- NSAID pain relievers (Aspirin, Ibuprofen, and Naproxen)
- Topical ointments (Capsaicin, Salycin, and Menthol)
- Patches (Diclofenac)
- Injections (Hylauronic Acid)
Surgery may be considered if other conservative measures fail to control pain.
Resources for Osteoarthritis
- Arthritis Foundation
- National Institute of Arthritis and Muscoskeletal and Skin Diseases
- Osteoarthritis Research Society International