Degenerative joint diseases - Diagnosis and treatment

Joints start degenerating with age progressively after the age of thirty along with other organs of the body.

Degenerative joint disease is also called osteoarthritis (OA) has following components:


*Loss of joint cartilage
*New bone (osteophyte) formation in and around the affected joint.
*Disorganization of the joint.

Injury to a joint hastens the degenerative process. While some degree of osteoarthritic change is inevitable, only 25 per cent persons suffer from pain.

Common joints affected by osteoarthritis:


Commonly affected joints are the weight-bearing and frequently used joints:

*Joints of the fingers
*Knees
*Hip
*Neck (cervical spondylosis),
*Lower back (dorso-lumbar spondylosis).


What are the symptoms of osteoarthritis?


Pain is a constant symptom and usually limited to one or two joints. Pain is caused by irritation of nerves and spasm of muscles and ligaments adjoining the affected joint.

Stiffness in the morning or after rest, which usually relieved by movement or exercise.

Joint mobility may become restricted.

Crepitus (a soft crackling sound) may be felt and/or heard on moving the joints.

Pain and stiffness usually change with changes of weather.

Lumbar spondylosis causes chronic aching pain in the lower back. It sometimes aggravates to severe pain (lumbago). When this pain radiates to the thigh and legs, due to compression of nerves coming out from the spinal cord, it is known as sciatica.

Cervical spondylosis produces similar pain in the neck. Due to compression of nerves pain and spasm radiate to the shoulder and arm. This pain may mimic cardiac pain (heart attack). ECG will be required to distinguish the cardiac pain from the pain of cervical spondylosis.

What factors make one more susceptible to osteoarthritis?


#Obesity
#Sedentary life
#Lack of exercise
#Idleness make muscles weak and flabby; such muscles go into spasm and cause pain more readily than strong ones.

How to get relief from osteoarthritis?



Treatment of acute pain from osteoarthritis

*Rest for two or three days. Prolonged rest may worsen the situation.

*Local heat with hot water bottle, infra-red rays, short-wave diathermy(available in physiotherapy centers),

*External applications such as salicylate or diclofenac ointment.

*Injection of corticosteroid into the affected joint.

*NSAID such as aspirin, ibuprofen other newest NSAID in minimum effective dose for minimum number of days.

*Joint supports such as knee cap, cervical collar, to be used for minimum number of days and only during physical activity;
remove it when resting or not active.


Treatment of chronic pain of osteoarthritis

As soon as the acute pain is relieved, which may take two to three days, start the following.

*Isometric exercises to strengthen the muscles of the affected joint. This is the most important part of the treatment. You can learn the exercises required for you from an experienced physiotherapist or, orthopaedic surgeon.
Reduce weight if you are obese. More weight cause more strain to the weight bearing joints and they fail to recover.

*Maintain physically active lifestyle and exercise regularly. In manual workers and those who regularly exercise the problems connected with OA are less frequent, less troublesome and appear at a later age.

*If you have backache, use a hard bed with three inches thick rubberized-coir mattress for sleep. This provides both support and comfort. Hard bed does not mean you have to sleep on a hard surface.

*If you have cervical spondylosis, better not to use normal pillow. A rolled-up towel under the nape of the neck (not under the head) can be placed instead. Cervical collar is to be used when there is acute pain and not regularly. Cervical traction may be useful. If this is needed the treating surgeon and the physiotherapist will guide about the method and duration of such traction. Exercises to toughen muscles of the neck to start as soon as acute stage is over.

*In the case of weight bearing joints (knee or hip), implantation of an artificial joint may have to be considered if the joint is badly disorganized and patient completely incapacitated.

This article is also published in India Study Channel