Osteoarthritis

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Arthritis is a painful condition affecting bones, ligaments and joints, causing stiffness, pain and limited mobility.

The condition is the number one cause of disability in the United States, where it affects one in every five adults. In the UK meanwhile, it is a problem for over 10 million adults, six million of which are women and four million, men.

In Spain, over seven million people have osteoarthritis (one type of arthritis), making it the most common articular disease in the country. The majority of adults battling arthritis are of working age (i.e. 18 to 64). The disease is not only devastating from a personal point of view, but also a heavy burden from an economic perspective.

Comprising Over 100 Conditions and Diseases
Arthritis is actually an umbrella term that covers over 100 diseases and conditions, including bursitis (the inflammation of a fluid-filled sac that serves as a cushion between bone and muscle), degenerative disc disease, gout, and even lupus.

The most prevalent version is osteoarthritis, which we shall focus on in this article. The second and third most common types are gout (a painful arthritis caused by the build-up of excessive uric acid in the body) and rheumatoid arthritis (an autoimmune condition in which the body’s own immune system attacks the joints).

Rheumatoid arthritis differs from osteoarthritis in that in the latter, joint pain and stiffness are mainly caused by mechanical wear and tear on joints.

Osteoarthritis

The most common type of arthritis occurs when cartilage is worn away and becomes softer and less resistant; in some cases, cartilage completely disappears in diverse areas.

At a recent conference for rehabilitation specialists entitled Jornadas Nacionales de Actualización para Médicos Rehabilitadores, Dr. Ángel Rubio, Head of the Rehabilitation Unit of the Quirón Hospital of Valencia, noted: “the most affected areas are the knees (30 per cent), followed by the hands, hips and vertebral column. Specific types of osteoarthritis, such as that affecting hands, often run in families.”

Osteoarthritis is degenerative, causing inflammation and neuropathic pain – a chronic type of pain in which the nerve fibres themselves might be damaged or dysfunctional. These nerves send signals to other pain centres, thus eroding one’s quality of life.

Says Dr. Rubio, “The main symptom of arthritis, is insidious, deep pain that increases with movement and improves with rest. As the disease progresses, pain becomes continuous and it is present even during rest. Articular stiffness, deformities and limitations of mobility can also develop.”

Risk Factors
The main risk factors for osteoarthritis include advanced age, sex (it is more prevalent in women), obesity, having suffered joint injuries, genetics, bone deformities and having worked in specific industries, including coal mining, carpet fitting, carpet and floor laying and farming.

Treatment
Currently, osteoarthritis is mainly treated through anti-inflammatory medication. If pain persists, then therapy can be recommended. In the case of neuropathic pain, medication treats the relevant symptoms, which can be difficult to quell.

Rehabilitation and exercise is generally helpful in all cases, since these approaches focus on increasing strength and mobility. Dr. Rubio says that “currently, research is being undertaken on medications that can modify the course of the disease.

For instance, dual immunoglobulin can be directly injected into the affected site, to avoid degeneration. One of the most exciting things about this medication is its ability to stall the progression of the disease.”

Another new treatment is plasma-rich platelets, taken from the patient’s own blood and re-injected into the affected site. These platelets are capable of regenerating tissue in patients with early stage osteoarthritis, and in those for whom other treatments have proven ineffective.

A third treatment showing promise is shockwave therapy, which brings considerable improvement in terms of reducing pain and increasing functionality in patients with plantar fasciitis, achilles tendinitis and calcareous tendinitis of the shoulder (in the latter condition, pain is caused by the formation of crystalline calcium phosphate deposits in the shoulder area).

Alternative treatments for osteoarthritis include acupuncture, massage therapy, Tai Chi and yoga. If you are suffering from the symptoms of osteoarthritis, make sure to see your doctor so you can formulate a strategy together.

The earlier you take steps to reduce symptoms and increase strength and flexibility, the greater your chance of enjoying a good quality of life.

Words Marisa Cutillas

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