Arthritis

Arthritis

Overview: Arthritis is one of the most common causes of joint pain. The term arthritis is actually quite broad and describes over 100 different diseases of the joint. The most common form of arthritis is osteoarthritis, which is also known as degenerative arthritis. Arthritis can affect any joint in the body, from the small joints in the fingers, toes and spine, to the large joints such as the hip, knee and shoulder. A joint that has osteoarthritis will have a breakdown of the cartilage that lines the joint space. This cartilage defect then exposes an area of underlying bone, which can become damaged. There is actually very little inflammation seen in osteoarthritis, with the pathology being caused by the friction between areas of exposed bone where cartilage is absent.

Causes: The most common cause of osteoarthritis is age-related degeneration. Injury to a joint can also lead to accelerated degeneration and arthritis. Obesity and altered biomechanics can also cause additional stress to joints and create tissue breakdown and pain.

Symptoms: The most common symptom of osteoarthritis is pain of the affected joint. This is especially seen after repetitive use of the joint. Swelling of the affected joint later in the day is common, and after periods of inactivity, stiffness and pain can be present upon using the joint. The later stages of osteoarthritis can include joint pain at rest or with limited movement of the joint.

Treatment: The treatment of osteoarthritis varies considerably, depending on the joint and the severity of the disease. For any individual diagnosed with arthritis, education about the disease, an appropriate rehabilitation program, weight loss and injury prevention are important to focus on. Regarding medications, Acetaminophen (Tylenol) usually provides some relief. As inflammation is typically not present in osteoarthritis, anti-inflammatory medications are not quite as beneficial. In a strong physical therapy program, range of motion of the joint can be restored and strengthening of the soft tissues that surround and support the joint can be focused on. Regarding injection therapy, there are several options. The most common joint injection includes a steroid injection, which typically decreases inflammation in order to decrease pain. Again, with limited inflammation in the joint, the full benefits of steroid therapy are typically short-term and can have significant side effects when used in excess. Another injection that can be used for osteoarthritis of the knee is visco-supplementation, which also tends to be short-lived and provides a short-term cushioning effect for the joint. The most advanced form of injection therapy involves Regenerative Medicine. Both platelet-rich fibrin (PRF) and stem cells may be placed into an arthritic joint in an effort to regenerate cartilage, heal damaged bone and decrease pain. When a joint is severely affected by arthritis, when more conservative measures fail and when function is notably limited, surgical replacement of the affected joint can be considered.