Osteoarthritis is the most common arthritis type, causing pain and stiffness in the joints as cartilage steadily breaks down. It is often referred to as “wear and tear” arthritis, as opposed to rheumatoid arthritis, which is caused by an immune response.
Most commonly affecting a person’s hands, knees, hips, feet, and spine, osteoarthritis symptoms tend to get worse over time. Symptoms of joint swelling and tenderness can come and go over time — or, in some people, they can be constant. The degree of severity varies a great deal between individuals.
It is still not exactly clear why cartilage continues to break down, and what mechanisms underpin the changes. Several interventions can help manage osteoarthritis, including physical therapy, medications, and surgery. To date, however, nothing halts the progression of this debilitating condition.
Risk factors for osteoarthritis include advancing age and obesity, so as the global population becomes older and heavier, the condition is likely to become increasingly prevalent.
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Antioxidants are compounds that inhibit oxidation. Oxidation is a chemical reaction that can produce free radicals, thereby leading to chain reactions that may damage the cells of organisms. Antioxidants such as thiols or ascorbic acid terminate these chain reactions.
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There is no cure for OA, but treatment can help relieve symptoms and maintain joint movement. Interventions include exercise, manual therapy, lifestyle modification, and medication.
Medication cannot reverse damage, but it can help reduce pain. Acetaminophen (paracetamol, Tylenol) can relieve pain in patients with mild to moderate symptoms. High doses can cause liver damage, especially if the patient regularly consumes alcohol, so it is important to follow the recommended dosage. Acetaminophen may also affect how some other medications work, so it is important for patients to tell the doctor if they are taking it.
If acetaminophen is not effective in controlling pain, the doctor may prescribe a stronger painkiller, which may include ibuprofen, aspirin, or diclofenac. Some topical NSAIDs can be applied directly onto the skin of the affected joints and are very effective at reducing pain and swelling in the joints of the knees or hands. Patients should check with their doctor about taking NSAIDs, as they are not suitable for some people, for example, those with asthma or a peptic ulcer.
Tramadol (Ultram) is a prescription analgesic that does not reduce swelling but provides effective pain relief with fewer side effects than NSAIDs. It is typically used for short-term acute flare ups, and it may be prescribed alongside acetaminophen for more powerful pain relief. Codeine may help with more severe symptoms. Though there is a risk of dependence, but in cases of severe pain, this may be an option. Side effects may include constipation and drowsiness.
Capsaicin cream is a medication that blocks the nerves that send pain messages. It may help patients with OA in their hands or knees that does not respond well to topical NSAIDs. Pain relief is not immediate, and it can take 2 weeks to a month for the medication to take full effect.
A tiny amount of capsaicin cream is applied to the affected joints four times daily and no more than once every 4 hours. The first application may trigger a burning sensation, but, after some uses, that sensation goes away. Capsaicin cream is made from chillies. If it comes into contact with the eyes, mouth, nose or genitals, there will be no damage, but it will probably cause pain. It should not be applied to broken or inflamed skin, and hands must be washed after use.
Other therapies include:
- Transcutaneous electrical nerve stimulation (TENS) : applies an electrical current through the skin. It controls pain by numbing some of the nerves endings in the spinal cord. A TENS unit is usually connected to the skin using two or more electrodes.
- Thermotherapy : uses warm and cold temperatures to help reduce pain and stiffness in the joints. A hot water bottle filled with either hot or cold water, or hot and cold packs, can be applied to the affected area. Hot and cold packs can be cooled in a freezer or heated in a microwave. Read more
- Manual therapy : is performed by a physical therapist. Stretching techniques help keep the joints flexible and supple. Not using the affected joint may weaken the muscles, further worsening osteoarthritis stiffness.