Osteoarthrosis (OA) is a chronic arthropathy characterized by interruption and possible loss of joint cartilage, along with other joint changes, including Bone Hypertrophy (osteophyte formation).
Symptoms are manifested in the gradual development of pain aggravated or caused by physical activity, joint stiffness of approximately 30 minutes at awakening and after inactivity, and inflammation of the joints on several occasions.
Radiographs confirm the diagnosis. Treatment includes physical measures, rehabilitation, patient education, and drugs.
(OA), is the most common joint disorder, often becomes symptomatic at 40 and 50 years of age, and is almost universal (although not always symptomatic) at 80 years of age; it is essential to note that only half of the patients with pathological changes of OA have symptoms.
Most OA occurs in men below 40 years of age due to trauma. However, women predominate between 40 to 70 years of age.
Symptoms and signs
The onset of the disease is gradual, usually from one or a few joints. Pain is the first symptom, sometimes described as deep pain.
It is usually aggravated by the weight load and calms with rest, but it can become constant over time. As Osteoarthrosis progresses, the movement of the joint becomes reduced, and the crepitus or sensations develop.
Pain on palpation and during movement are relatively late signs. Muscle spasms and contractures add to the pain. Deformity and subluxations can also develop.
The joints most commonly affected:
- Distal Interphalangeal (IFD) and Proximal Interphalangeal (IFP) joints (causing Heberden and Bouchard nodes).
- Thumb articulation (causing carpometacarpal).
- The intervertebral discs and the Cigapophyseal joints in the cervical and lumbar vertebrae.
Osteoarthrosis should be suspected in patients with gradual onset of symptoms and signs, especially in older adults. If OA is suspected, plain x-rays should be taken from the most symptomatic joints.
X-rays usually reveal marginal osteophytes, narrowing of the joint space, increased subchondral bone density, formation of subchondral cysts, bone remodeling, and joint effusions.
Conservative treatment includes pharmacological and physiotherapy. Its objective is to reduce symptoms and establish exercise routines.
Patients with osteoarthritis of the hips and knees should avoid sitting in soft, deep chairs. Sit in simple chairs and discs, sleep in hard beds, remember the correct posture, stay physically active, reduce stress in the joint, and later use a cane or crutches.
The well-chosen exercises aim to maintain muscle strength, elasticity, and maximum pain-free mobility to avoid muscle contraction, especially those exercises without weight; this help to slow down the course of the disease.
The objectives of drug treatment are to alleviate the pain of Osteoarthrosis, maintain joint flexibility, and optimize joint function in general.