Osteoarthrosis: Symptoms, Diagnosis and Treatment

Definition:

Osteoarthrosis (OA) is a chronic arthropathy characterized by interruption and possible loss of joint cartilage, along with other changes in the joints, 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 duration at awakening and after inactivity, and inflammation of the joints on several occasions.

The diagnosis is confirmed by radiographs. 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 important to note that only half of patients with pathological changes of OA have symptoms.

Below 40 years of age, most OA occurs in men as a result of 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 to manifest, sometimes described as a deep pain.

It is usually aggravated by the weight load and calms with rest, but over time it can become constant. 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 carpometacarpiana).
  • The intervertebral discs and the Cigapophyseal joints in the cervical and lumbar vertebrae.
  • Hips
  • Knees.

Diagnosis

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.

Treatment

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, discs, sleep in hard beds, remember about the correct posture, stay physically active and reduce stress in the joint and later by using 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, these help to slow down the course of the disease.

Drug therapy

The objectives of drug treatment are to alleviate the pain of osteoarthrosis, the maintenance of joint flexibility, and the optimization of joint function and in general .

Thus, primary treatments include physical measures that involve rehabilitation; support devices; the exercise of strength, flexibility and endurance; patient education; and the modifications in the activities of daily life.