Bone on bone: An overview of osteoarthritis types, risks and treatments
Osteoarthritis develops when the cartilage that covers the ends of your bones breaks down. This causes the ends of the bones to rub against each other, leading to symptoms such as pain, stiffness, and loss of mobility.
More than 32.5 million adults in the United States have osteoarthritis and it becomes more common with age. Mild osteoarthritis can often be treated with weight loss, exercise, and over-the-counter medications while severe arthritis may require surgery.
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An estimated 80% of U.S. adults over 65 have signs of osteoarthritis as seen with an X-ray, but only 60% of these people have symptoms.
Two primary types
Osteoarthritis is divided into two categories: primary and secondary. Primary osteoarthritis occurs as a result of degenerative changes to the cartilage without a known cause. Secondary osteoarthritis occurs in the presence of a preexisting condition.
Primary osteoarthritis is more common than secondary.
It tends to develop over time as a result of joint wear and tear and to affect adults over age 65 often occurring in multiple synovial joints (joints that have a cavity filled with fluid between two bones).
Common areas for the development of osteoarthritis includes: hands, hip, lower back, neck and knees.
Even though the exact cause remains unknown, researchers have identified some risk factors that increase the odds of developing the condition. For example, risk factors for primary hip osteoarthritis include: increasing age, genetics, obesity, previous fracture, repetitive stress, occupation involving heavy manual labor, and high impact sports.
Secondary osteoarthritis generally occurs when a preexisting condition leads to the breakdown of cartilage in a joint. It usually occurs as a result of trauma or misalignment of a joint. Six of the primary categories include: genetic joint conditions, trauma, metabolic conditions, endocrine conditions, neuropathic conditions and other conditions.
Risk factors for osteoarthritis
joint injury or overuse
obesity
being a woman — particularly a woman older than 50
increasing age
family history
ethnicity — some Asian populations have a lower risk
Other factors that may contribute to the development of osteoarthritis include:
muscle weakness
joint injury
overuse
physically strenuous occupation
low quadriceps strength
low sex hormone levels
low bone density
inadequate diet
Follow-up steps for a diagnosis of osteoarthritis
If you receive an osteoarthritis diagnosis, your physician can help you formulate a treatment plan and may refer you to other qualified health care professionals, as deemed appropriate.
This may vary from starting with conservative treatments like non-steroidal anti-inflammatory drugs (NSAIDs) and changing your activity habits, if necessary.
If conservative treatments aren’t improving your symptoms, your doctor may recommend prescription pain medications, injections, or surgery as a last resort.
Here's a summary of osteoarthritis treatments:
Weight loss and exercise
If you are overweight or obese your doctor may recommend that you try to lose weight to take some stress off your joints. Regular exercise can help strengthen your muscles and joints and assist with weight loss.
Medications
Your doctor may recommend OTC medications such as: acetaminophen, NSAIDs and over the counter creams and gels.
If these aren’t effective, they may recommend steroid injections. These injections contain a medication similar to the hormone cortisol that helps reduce inflammation and pain for weeks or months.
Supportive treatments
Other recommended supportive treatments may be recommended by your physician to reduce pain including: transcutaneous electrical nerve stimulation, hot and cold packs and assistive devices such as splints, shock-absorbing footwear, special insoles, or a walking stick or cane
Surgical treatments
When other treatments are not effective and for severe cases of osteoarthritis physicians may employ the following types of surgery to treat osteoarthritis:
Joint fusion (fusing the bones on either side of a joint to reduce pain), joint replacement (a surgeon replaces the affected joint with a prosthesis made of plastics and metal) and osteotomy (used to treat knee and hip osteoarthritis and involves adding a small section of bone from above or below your knee or hip to alleviate symptoms)
Final note
Osteoarthritis is a type of arthritis characterized by the breakdown of cartilage and other tissues in a joint. It can be categorized as either primary or secondary osteoarthritis. Primary osteoarthritis has no known cause, while secondary osteoarthritis is caused by a preexisting disease, injury, or misalignment.
Osteoarthritis becomes more common with age. If you’re dealing with persistent joint pain, it’s a good idea to consult a doctor for a proper diagnosis. Your doctor can recommend treatment strategies including appropriate referrals to other qualified health professionals to help reduce pain and manage your symptoms.
The content provided is for informational purposes only. Please consult your physician or other qualified health care professional with any questions/concerns.
Thanks to Healthline and the CDC for content.
Additional information/resources
The Centers for Disease Control and Prevention CDC) provides a detailed resource covering osteoarthritis (OA) at cdc.gov/arthritis.
Two other resources for covering OA are available through the Arthritis Foundation and The Mayo Clinic arthritis.org and mayoclinic.org.
Mark A. Mahoney, Ph.D. has been a Registered Dietitian/Nutritionist for over 30 years and completed graduate studies in Nutrition & Public Health at Columbia University. He can be reached at marqos69@hotmail.com.
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This article originally appeared on Tallahassee Democrat: Bone on bone: An overview of osteoarthritis types, risks, treatments
