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Osteoarthritis
Osteoarthritis, the commonest joint disorder, is the result of degeneration and wear-and-tear within joints due to aging and a person's activities. Normally, some damage occurs in the weight bearing joints of most people as they grow older. As a result the cartilage covering the bone ends within the joint space degenerates, the membrane lining the space thickens, and irregular projections grow on bone margins.
Sometimes bony nodules may be seen on the finger joints. There is hardly any inflammation and no ill effects in the rest of the body. Heredity and joint injuries may be predisposing factors. Obesity adds to the problem in the weight bearing joints.
Symptoms of Osteoarthritis
Usually, the small hand joints, the hip, the knee, and joints between the spinal bones (or vertebrae) in the neck or at a level lower are affected. Symptoms include stiffness, pain relieved by rest but worsened by activity, and difficulty in movements and walking. Lab tests and x-rays confirm the diagnosis.
Treatment of
Osteoarthritis
Most of the steps advised by the orthopaedic doctor are simple; follow them regularly - you will get better relief, improve mobility, decrease the requirement of medications and slowdown joint damage.
- Walking and exercises (like grasping and releasing a rubber ball- for the hands) aid joint movement and flexibility. Avoid lifting weights and activities that may further damage the affected joints – like jogging by those with knee problems or a difficult manual job by those with finger joint problems.
- Reduce excess weight to reduce damage to the bigger weight-bearing joints. The doctor may advise periodic physiotherapy. Regular hot fomentation is also useful.
- Applying anti-inflammatory or pain relief ointments like methyl salicylate or capsaicin helps some people. Maintain a normal intake of calcium and vitamin D.
- Take simple medications prescribed by the doctor for as long as possible. Paracetamol helps milder cases. For moderately severe arthritis NSAIDs (the non-steroidal anti-inflammatory drugs like ibuprofen, naproxen and piroxicam) or other drugs are needed. Get a clear idea of drug dosage, side effects and precautions from the doctor.
- A walking stick, 'walker' and rails to hold for support in the bathroom etc. are a boon to more disabled patients. In more severe knee arthritis steroid injections in the joint give relief for a while; it's usually better not to exceed two injections in a year.
- Another useful intra-particular injection is sodium hyaluronate. In severe disability or unmanageable pain a procedure using arthroscopy to view, repair and 'clean' the joint may help. Many patients benefit from knee, hip or other large joint replacement surgeryusing prosthetic materials.
- For surgery, go to a doctor with an excellent track record.
- Good replacement surgery offers a high degree of pain relief; but the patient may not be pain free. Functions improve significantly, but perhaps may not return to normal. Many patients are able to resume most activities in a few months.
- Sitting on the floor and squatting should be avoided. There is risk of infections in an artificial joint.
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