Osteoarthritis Treatment in Delhi, India

Osteoarthritis can be defined as a wear and tear disease that occurs when cartilage, the firm yet supple connective tissue surrounding the bone heads, in joints starts to degenerate. Cartilage acts as a shock absorber that helps in smooth and frictionless joint movement.

Its absence puts the adjoining bone head-to-head, causing friction and bone damage. As the disease progresses, it alters the bone structure and stretches the ligaments and tendons. Breakdown of the cartilage results in further pain, swelling and deformation.

Though osteoarthritis can affect any bone, the primary affected areas are:

• Hands
• Shoulders
• Knees
• Fingers
• Spine (neck and lower back)
• Hips
• Big toes

Osteoarthritis Causes

Various factors like mechanical stress, injury, and subsequent faulty self-repair of the joint tissue can cause loss of cartilage. The cause of osteoarthritis is still unknown, but it is suspected to be caused by defective signalling processes, inflammation of joints, overuse of joints and gradual erosion of the cartilage.

Genetics also play an important role, as people with skeletal disorders n the family are more prone to osteoarthritis. Congenital disorders like Ehlers-Danlos syndrome (loose joints), alkaptonuria (abnormal substances in urine), hemochromatosis (abnormal accumulation of iron in the body), and Wilson’s disorder (excess of copper in the body) are also contributing factors.

Another important cause is occupational stress, like sportspersons who play a game that puts repeated pressure on the joints. People with physically demanding jobs like construction, climbing, manual lifting, digging, etc., will develop osteoarthritis more easily.

If you have undergone any previous injury or trauma that led to the dislocation of joints, cartilage harm, or ligament tear that may have healed, it will expedite osteoarthritis.

Osteoarthritis Symptoms

Osteoarthritis is a slowly progressive disease that accumulates over time and can be easily confused with other bone diseases or arthritis. The primary symptoms are as follows:

• Chronic pain in the affected joints.
• The joints may feel stiff and inactive, especially after waking up.
• You may feel tenderness when you touch the affected area.
• Loss of full range of mobility of the joint.
• Inflammation of the joint muscles leads to swelling.
• Formation of bony spurs that appear as hard swellings around the joints.
• Crepitus, i.e. a grating or joint cracking sensation when you move the joints. You may even hear a popping or clicking sound.

Osteoarthritis Diagnosis

Diagnosis is made predominantly by medical history and clinical symptoms. Doctors prescribe imaging tests for confirmation.

• X-Ray: X-ray image shows a receding space between joints and developing bony outgrowths, confirming osteoarthritis.
• Magnetic Resonance Imaging or MRI: MRI is done only during advanced stages of osteoarthritis when a ligament/cartilage split is suspected. An MRI provides a detailed image of bones, cartilage and surrounding muscles that help diagnose complicated cases.
• Fluid in joints is analysed to diagnose complementary disorders like gout, joint infections or other arthritic diseases.

Osteoarthritis Treatment

Sadly, no cure for osteoarthritis has yet been discovered. The ailment can only be controlled with medications to reduce pain and swelling.

Medication for Osteoarthritis Treatment

• Acetaminophen is given orally for moderate to mild pain but doesn’t help with swelling.
• Topical painkillers like gels, creams and patches can help with mild pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen are given to decrease pain and swelling but in the recommended dosage, as it has probable side effects.
• Duloxetine, an antidepressant, has currently been approved by the FDA for relieving chronic osteoarthritic pain.

Therapy for Osteoarthritis Treatment

• Weight management is crucial.
• Mild exercise like swimming, walking, yoga or tai chi can improve joint movability and relieve pain.
• An occupational therapist can help you to carry out daily activities with minimum stress and pain.
• Hot and cold therapy for 15-20 minutes daily can help with sore joints.
• Assistive devices like braces, shoe inserts, walking sticks, knee support, orthotics, and crutches help to make regular chores less difficult.
• Injecting lubricants like hyaluronic acid or pain relievers like cortisone for critical patients.

Surgical interventions like joint replacement (replacing the deteriorated joint surface with artificial parts); realignment of bones (cutting a part of the bone to shorten or insert a wedge to increase and align the bones) can be effective when all other treatments are exhausted.

Osteoarthritis is a chronic joint disorder that can only be controlled with lifestyle changes, proper medications, and a positive outlook.

Risk Associated with Osteoarthritis

Although the actual cause is still under study, the evident risk factors are as follows:

• Age: Increasing age has been the primary cause of osteoarthritis as cartilage loses its elasticity and recovery abilities.
• Obesity: Obesity can put unwanted pressure on skeletal muscles and bone joints, disrupting the even distribution of body weight. It also leads to various metabolic disorders, inflammation, and excessive oxidative stress.
• Menopause: Estrogen has a protective function on bone and cartilage tissues. After menopause, a drop in estrogen leads to less recovery of skeletal tissues.
• Diabetes and hyperlipidemia: Diabetes is the presence of excess sugar in the blood. Hyperlipidemia is the presence of excess blood lipid levels. Both are probable triggers for osteoarthritis. Oxidation of lipids leads to deposition on cartilage, hindering blood flow. Excess sugar leads to increased iron deposition and highly reactive oxidative substances leading to cartilage damage.
• Presence of other arthritis: Rheumatoid arthritis, gout and psoriatic arthritis may lead to osteoarthritis.

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