Q&A: Osteoarthritis of knee and hip
What is arthritis?
Arthritis is not just a single disease. It is a term used to describe more than 100 different conditions that affect the joints in the body. The word arthritis actually means inflammation of the joint. Almost every animal that can walk is susceptible to this inflammation. Although many types of arthritis have some common aspects, each type has its own pattern of symptoms and affects different people in different ways. Two major forms of arthritis are rheumatoid arthritis and osteoarthritis. In cases of rheumatoid arthritis, the body’s immune system appears to go awry and attacks healthy parts of the body, particularly the joints. In severe rheumatoid arthritis, the joints become deformed and internal organs are adversely affected.
What is osteoarthritis?
Osteoarthritis, the most common form of arthritis, is also called degenerative joint disease or "wear and tear" arthritis. In healthy knees and hips, cartilage covers the ends of the bones, creating a cushion between the bones. When you have osteoarthritis, the cartilage has worn away, causing pain when bone rubs on bone.
Almost everyone is affected by osteoarthritis to some extent as they grow older. It most frequently occurs in weight-bearing joints – mainly knees, hips and ankles. This form of arthritis gradually breaks down the cartilage that covers the ends of each bone in a joint. Normally, cartilage acts as a shock absorber, providing a smooth surface between the bones. But with osteoarthritis, the smooth surface becomes rough and pitted. In advanced stages, it may wear away completely. Without their normal gliding surfaces, the bones grind against one another, causing inflammation, pain and restricted movement. Bone spurs may form.
In osteoarthritis of the knee, the shape of the bone and appearance of the leg may change over the years. Many people become bow-legged or knock-kneed and in osteoarthritis of the hip, the affected leg may appear shorter.
What are the symptoms?
The number one symptom is pain, often described as deep and aching. Osteoarthritis pain is typically of slow onset, initially occurring after activity, with relief after rest. As the disease progresses, pain may occur with even minimal motion; in severe cases, there is pain at rest. Joint stiffness is also common, usually occurring upon awakening or after inactivity. The stiffness lasts from 20 to 30 minutes. Other symptoms include crackling of the joint, joint tenderness, joint enlargement and limitation of motion in joints.
How is it diagnosed?
A simple weight-bearing X-ray and examination by your doctor will determine if you have osteoarthritis. Time-consuming and costly diagnostic procedures are not required.
What is the treatment?
There is no cure for arthritis, but the past decade has seen dramatic new ways to manage the pain, lack of mobility and fatigue that are among it most disabling symptoms.
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Hyaluronate - Recently approved by the FDA, Hyaluronate is a natural element of joint fluid. These injections appear to be advantageous for patients with a history of NSAID intolerance, patients who are of advanced age, or those with currently active or a history of ulcer disease.
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Medicines - Coated aspirin helps relieve pain and has few side effects. Non-steroidal anti-inflammatory drugs (NSAIDS), such as Voltaren, Feldene, Naprosyn and Clinoril are prescription drugs for pain and inflammation. Do not take aspirin if you are taking NSAIDS.
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Cortisone shots - Cortisone shots are given for inflammation and may provide pain relief for variable periods of time. Generally, repeat injections should be limited to three or four per joint, per year.
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Thermal therapy - In many cases, the use of either hot or cold therapy, or alternating heat and cold, is a matter of patient preference. Superficial heat such as heating pads, hot water bottles and saunas may relax the muscles to help decrease pain and stiffness. Cold therapy, such as ice packs, may help decrease muscle spasm and the associated pain, and may help raise the pain threshold.
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Diet - There is no evidence that any specific foods will prevent or relieve arthritis symptoms It’s important to keep thin, however, because excess weight aggravates arthritis by putting added pressure on the knee and hip.
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Exercise and rest - Prolonged rest and days of inactivity will increase stiffness and make it harder to move around. Motion is lotion for arthritis! At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage. A balanced routine of rest and exercise is best.
What about surgery?
Sugery is usually done only in severe, disabling cases of arthritis for which other treatments have failed.
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Arthrodesis - This procedure makes the affected joint permanently immobile by inserting a metal or plastic screw or using a special type of plaster to hold the joint in place. It is usually performed on smaller joints, such as those in the toes or fingers.
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Osteotomy - In this surgical procedure, which is not frequently performed, the surgeon removes a small piece of bone near the affected joint. This may be a good solution for younger people with arthritis because it may delay joint surgery for years.
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Athroscopy - "Scoping a joint" is being used increasingly to diagnose and sometimes repair joints. A doctor may use a tube to remove damaged areas of cartilage that may be causing irritation. This may provide temporary relief. However, this may not stop the progression of arthritis.
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Replacing a joint - A successful joint replacement may relieve pain and restore most of the joint’s movement. Damaged bone is removed from the joing and replaced with parts that are cemented to the healthy bone that remains.
How can I learn more?
You can reserve a space at one of our free upcoming knee and hip pain seminars. Call 888.800.7688 today.
