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Facts About Osteoarthritis
By peace | June 12, 2006
Osteoarthritis(OA), or degenerative joint disease, is the most common form of arthritis found in the wrist and hand. Osteoarthritis has in the past been considered a predominately degenerative joint disease, affecting more people than any other arthritis. It is characterized by progressive loss of cartilage and bony margin overgrowth.
However, it is now realized that the problem is not simply a degenerative cartilage disorder, but a problem of all the tissues involved in maintaining joint stability - the functional joint unit. In addition, there is no doubt that inflammation and synovitis is present in a significant percentage of patients, and indeed, a more aggressive form, erosive osteoarthritis may occur, associated with significant synovitis, and may be confused with inflammatory arthritis, such as rheumatoid arthritis.
The incidence of OA is not an inevitable consequence of ageing, although it is more prevalent the older one gets, and will affect about 80% of citizens over age 65. Other aggravating factors include obesity, gender - females, post menopause, Caucasian race, trauma, sports injuries, over-use syndromes and most importantly, family history.
Causes Of Osteoarthritis
Osteoarthritis is due to:
1. The normal wear and tear that our joints undergo during our lifetime. Osteoarthritis occurs when the cushioning cartilage that covers the bone surfaces at our joints begins to wear out. As the cartilage becomes worn down, bone rubs against bone producing pain. The saying is true: “If you live long enough, you will develop osteoarthritis.”
2. Or, it may be due to an injury of a joint. This injury can be due to over-utilization of the joint, a fracture, or surgery on a joint. The most commonly affected joints in the hand are: 1. The thumb joint, where the thumb joins the hand (the carpometacarpal joint). 2. The middle finger joints (the proximal interphalangeal joints). 3. The last joint in the finger (the distal interphalangeal joint).
Symptoms Of OA
The most common symptoms that one may experience are:
1. Brief period of morning stiffness (15 minutes or less).
2. Aching pain in one or more joints which increases with use, and is relieved by rest.
3. Pain is not migratory. This means that symptoms are usually experienced in the same joint, rather than in one joint today and a different joint tomorrow.
4. The affected joint usually appears swollen, and this swelling feels “hard.” However, there is no redness or increased warmth around the joint. This hardness is due to nodules that form around the joint.
5. The affected joint is tender when you apply pressure to it.
6. The range of motion of the joint is usually limited.
7. Weather changes may produce stiffness and pain in the affected joint.
8. Osteoarthritic pain of the thumb is most notable with activities that require one to grip and apply pressure to an object with the thumb and fingers.
The pathology of osteoarthritis begins with an uneven wearing down of the joint cartilage, which may be due to over utilization of the joint, an injury to the joint, or the normal aging process. This produces a narrowing of the joint space, and finally bone begins to rub against bone. When bone rubs against bone we may experience pain, stiffness, decreased movement of the joint, swelling, bone spur formation at the edges of the joint surface (nodule formation), and a grinding sound or feeling when the joint is moved.
Treatment of osteoarthritic joints: The most successful treatment is to protect the affected joint by limiting its movement. This is best accomplished by wearing a brace or splint. This is the “gold standard” of medical treatment — the treatment most recognized by all of medicine to be effective, especially in the early stages of osteoarthritis. Protecting the joint/joints will ensure:
1. a reduction in joint pain
2. a slow down in the progress of the disease within the affected joints
3. a reduction in the chances of injuring other joints in the hand and wrist. If we have a painful joint, or joints, we subconsciously force ourselves to use our wrist, fingers, and thumb in an abnormal way, so as to try and keep all pressure off of the painful joint. When we do this, we apply abnormal and excessive pressure on other joints of the hand. This is called compensation. This compensation leads to over-utilization of these joints, and new sites of osteoarthritis.
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