Osteoarthritis is a disease that causes stiff and painful joints. It is the most common form of arthritis. Osteoarthritis causes the cartilage cushioning the bones when they meet at joints to wear down over a long period of time. The disease most often affects joints in the hands, hip, and spine, although joints from any part of the body may be affected. Osteoarthritis only affects joints and bones, while some other types of arthritis can affect internal organs. While symptoms of osteoarthritis can be managed, the damage to cartilage cannot be reversed.
Risk Factors for Osteoarthritis
Multiple factors can work together to cause osteoarthritis.
- Aging: Older people are more likely to develop osteoarthritis.
- Gender: Post-menopausal women are more likely to develop osteoarthritis than men.
- Obesity: Increased weight can add stress on joints, increasing the likelihood of osteoarthritis.
- Genetic history: Osteoarthritis can run in the family.
- Joint injuries: Past history of joint injuries can increase the risk of developing osteoarthritis.
- Congenital bone deformities: Certain congenital deformities that affect the bone and cartilage development can increase the risk of osteoarthritis.
- Diabetes and other metabolic diseases: Certain diseases such as diabetes and hemochromatosis can increase the risk of osteoarthritis.
Clinical Features of Osteoarthritis
Osteoarthritis develops slowly over years, the symptoms worsening as time passes. Symptoms of osteoarthritis include:
- Joint pain: Joints affected by osteoarthritis can be painful during movement.
- Stiffness: Joints may be difficult to bend and stiff in the mornings or after a period of inactivity.
- Tenderness: The area around the joints might feel tender under light pressure.
- Loss of flexibility: The person affected may not be able to move the joints to its previous full range of motion.
- Bone spurs: Hard bone spurs may develop around the joints.
- Swelling: The joints may become inflamed and painful.
Diagnosing Osteoarthritis
To diagnose osteoarthritis, a doctor will first ask about the patient’s medical history and conduct a physical exam of the affected joints. They will test the affected joints’ tenderness, flexibility, swelling, and redness. The doctor may then order further tests such as an X-ray or an MRI scan. An x-ray is often sufficient to confirm the diagnosis, but an MRI scan may be requested in complex cases of osteoarthritis. The doctor may also order blood tests and draw fluid from the joint area to rule out other causes of the symptoms, such as rheumatoid arthritis, gout, or infections at the joint.
Treatment and Management of Osteoarthritis
Damage to joints caused by osteoarthritis cannot be reversed. But treatment can help alleviate pain and increase mobility. If osteoarthritis is weight-related, the doctor may recommend lifestyle changes such as exercise and a healthy diet to reduce weight. Medications such as acetaminophen, nonsteroidal anti-inflammatory drugs such as ibuprofen, and duloxetine might be recommended for pain management. Physical therapy can help increase the flexibility of joints and alleviate pain. Occupational therapy can help osteoarthritis patients learn different ways of performing daily tasks without putting strain on their joints.
Treatment Modalities Currently Undergoing Clinical Trials
Fisetin: A clinical trial to test the effectiveness of fisetin, a dietary supplement, to reduce swelling of joints in patients with mild to moderate osteoarthritis is underway. Researchers theorize that fisetin will reduce swelling, pain, and improve mobility of joints. Researchers also want to identify the right dose of fisetin that would be effective in patients with osteoarthritis.
Transcatheter arterial embolization: Embolization is a procedure in which a small catheter is used to introduce various particles into a blood vessel in order to block the vessel. This procedure is highly effective in stopping bleeding or blocking the blood supply to tumors. A clinical trial to test whether transcatheter arterial embolization is effective to manage pain in patients with osteoarthritis in the knee is underway. During the study, investigators will introduce embozene™ microspheres into arteries around the knees with osteoarthritis. Participants will be monitored for 12 months. Researchers believe that this procedure can be an effective way to handle pain in osteoarthritic patients.
Colchicine: A clinical trial to test the efficacy of colchicine for pain management in patients with osteoarthritis in the knee is underway. The study will enroll 120 participants who will be divided into two groups; one group will be administered colchicine orally while the other group will be given a placebo drug for a period of 3 months. Investigators will then monitor the effect of the drug in managing pain.
Mindful walking intervention: Patients with osteoarthritis in the knee usually have very little physical activity, especially walking. They are also likely to walk in a gait that increases pressure on the knees. A study to see the impact of mindful walking intervention to change their walking pattern and increase physical activity in individuals with osteoarthritis in the knee is ongoing. The study will enroll 62 participants who will be divided into two groups. One group will be given training in improving walking technique while the other group will receive education on osteoarthritis and its management. Both groups will be given a wrist-worn activity monitor throughout the study. The participants will be observed for a period of 12 months.
Regenerative cell therapy: To date, no treatment exists that can reverse damage caused by osteoarthritis. A clinical trial to test whether regenerative cell therapy can help in the regrowth of cartilage is underway. The trial will enroll 50 participants with osteoarthritis of the shoulders and hand caused by an injury. Autologous stromed and platelet-rich plasma will be introduced into the affected joints with injections. Participants will be monitored for a period of six months. Researchers hope to test the safety and effectiveness of this treatment modality.
References:
National Institute of Arthritis and Musculoskeletal and Skin Diseases. April 2015.
McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, Hawker GA, Henrotin Y, Hunter DJ, Kawaguchi H, Kwoh K, Lohmander S, Rannou F, Roos EM, Underwood M (March 2014).
"OARSI guidelines for the non-surgical management of knee osteoarthritis"
Vingård E, Englund M, Järvholm B, Svensson O, Stenström K, Brolund A, Hall C, Kedebring T, Kirkeskov L, Nordin M (1 September 2016).
Occupational Exposures and Osteoarthritis: A systematic review and assessment of medical, social, and ethical aspects
Berenbaum F (January 2013).
"Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!)"
Conaghan P (2014).
"Osteoarthritis – Care and management in adults"
Cisternas MG, Murphy L, Sacks JJ, Solomon DH, Pasta DJ, Helmick CG (May 2016).
"Alternative Methods for Defining Osteoarthritis and the Impact on Estimating Prevalence in a US Population-Based Survey"
