Table of contents
What is Osteoarthritis?
Osteoarthritis is the most common form of arthritis. It is one of the leading causes of pain and disability. Osteoarthritis symptoms include stiffness, swelling, and pain. This article will help explain osteoarthritis and explore treatment options.
Define osteoarthritis.
Osteoarthritis is the most common form of arthritis. It affects many joints including the knees, hips, hands, shoulders, and feet. It is one of the leading causes of pain and disability.
What are joints?
Joints occur when two or more bones meet. Healthy bones have thick articular cartilage which pad and protect bones. Joints also have lubrication called synovial fluid. Articular cartilage and synovial fluid help joints move freely and smoothly.
What causes osteoarthritis?
Osteoarthritis is a disease that occurs due to the loss of articular cartilage. Loss of cartilage results in joint space narrowing. This leads to stiffness and pain.
Osteoarthritis advances slowly in most people. It progresses through the following steps.
Damage to articular cartilage.
Release of toxic enzymes into the synovial fluid.
Toxic enzymes lead to inflammation.
Inflammation weakens the articular cartilage.
Articular cartilage is now more susceptible to damage.
The above cycle repeats itself causing more and more loss of articular cartilage. The end result is bone on bone osteoarthritis.
Risk factors for osteoarthritis
Age, genetics, obesity, and repetitive high impact activities are risk factors for osteoarthritis.
Overweight patients are at high risk. Carrying around extra weight results in increased loading of joints. This accelerates the wear and tear of articular cartilage.
Fat tissues release signaling molecules called adipokines. Adipokines have inflammatory properties that cause further damage to joints.
Osteoarthritis diagnosis and severity
X-rays are the best way to confirm the diagnosis of osteoarthritis. They can be used to grade its severity.
Grade 1 represents early damage to articular cartilage. Bone spurs begin to form and can be seen on x-rays.
Grade 2 results in further damage to the articular cartilage. X-rays may show signs of joint space narrowing.
Grade 3 has moderate signs of articular cartilage loss. Cracks and fissures appear along what should be a smooth cartilage surface. X-rays show signs of moderate joint space narrowing.
Grade 4 describes significant loss of articular cartilage. X-rays show severe narrowing of the joint space. Bone may be in contact with bone.
This is an excellent video visualizing the stages of knee osteoarthritis.
Osteoarthritis progression
Osteoarthritis is a progressive disease. The more osteoarthritis you have, the more you’re at risk for getting. Some unfortunate patients can progress from mild osteoarthritis to severe bone on bone in the span of a few years.
Osteoarthritis prevention
Treatment of osteoarthritis should focus on prevention. Physical activity and weight loss help manage osteoarthritis symptoms. Exercise helps reduce pain and improve function (see below for exercises to help osteoarthritis).
Osteoarthritis medications
What if you are in so much pain that you can’t be active?
Oral and topical anti-inflammatory medications can help reduce inflammation and swelling. Supplements with anti-inflammatory properties such as turmeric can also help. These medications don’t stop the progression of osteoarthritis. They help reduce pain and inflammation. This makes exercise and physical activity more manageable.
Osteoarthritis injections
Osteoarthritis pain can be severe. Physicians can give cortisone injections to treat the pain and swelling from osteoarthritis. Cortisone is a steroid that has strong pain relieving effects. It can provide significant short term symptom relief. However, there are concerns for long term side effects.
This study compared physical therapy to cortisone injections for knee osteoarthritis. They found that physical therapy resulted in less pain and disability at 1 year. There is truth to the old adage “use it or lose it.”
Platelet rich plasma injection for osteoarthritis treatment
Researchers continue to look for new ways to treat osteoarthritis. Biologic and cellular based therapies appear promising.
Platelet rich plasma injections contain an enormous amount of bioactive molecules. These signaling molecules help stimulate tissue healing and provide pain relief.
Recall that osteoarthritis results in the release of toxic enzymes and inflammatory proteins.
Damage to articular cartilage.
Release of toxic enzymes into the synovial fluid.
Toxic enzymes lead to inflammation.
Inflammation weakens the articular cartilage.
Articular cartilage is now more susceptible to damage.
Platelet rich plasma injections alter the biochemical signaling within a joint. It decreases the concentration of toxic proteins and initiates anti-inflammatory signaling pathways. This decreases pain and swelling. It can also help slow the progression of osteoarthritis.
These researchers compared platelet rich plasma injections to cortisone injections for mild to moderate knee osteoarthritis. Platelet rich plasma injections outperformed cortisone in reducing pain and improving function. The effects lasted up to 1 year.
This systematic review and meta-analysis compared platelet rich plasma injections to hyaluronic acid injections. Patients who got platelet rich plasma injections had significantly greater improvements in pain and function.
This study compared platelet rich plasma injections to hyaluronic acid and placebo (saline) injections. They found that platelet rich plasma injections had significant improvement in symptoms at up to 1 year.
Exercises to treat osteoarthritis
Shoulder osteoarthritis and pain
Knee osteoarthritis and pain
5 Minute Knee Pain Stretches and Exercises for at Home Relief
Hip osteoarthritis and pain
Ankle osteoarthritis and pain
Hand osteoarthritis and pain
Conclusion
Osteoarthritis is a debilitating disease. Discuss with your doctor the best way to individualize treatment. Physical activity and weight loss are the pillars of prevention. There are many pharmacologic options to decrease pain. Platelet rich plasma injections may provide sustainable and long term pain relief.
