Friday, December 9, 2022

What Can Be Done For Degenerative Arthritis

What Causes Osteoarthritis Or Degenerative Joint Disease

Treating Degenerative Spine Disease, Arthritis and More | Mark Tantorski, DO

One of the main reasons causing degenerative joint disease is the repetitive use of weight-bearing joints, which then causes a breakdown or damage to the cartilage in the joints between the bones. Cartilage is a flexible yet tough substance that cushions the ends of the bones within a joint and prevents them from rubbing directly against each other. If the cartilage breaks down or completely wears away, there is initially friction in joint movement along with a deterioration in the connective tissues between the muscles, joints, and bones. Eventually, the bones move directly on each other causing severe friction, inflammation, and pain, along with other symptoms associated with osteoarthritis.

While any joints are susceptible to this condition, the regions of the hips, hands, knees, and the back or the spine are the most common areas where the onset of osteoarthritis is experienced. Unfortunately, damaged cartilage, unlike several other parts of the body, cannot repair itself as it does not contain blood vessels.

Though very rare, some people also have a genetic defect, which affects the making of collagen, an important component of the cartilage. This can also cause the rapid deterioration of the cartilage, expediting the onset of degenerative joint disease or osteoarthritis.

Spinal Arthritis: What You Need To Know

  • Osteoarthritis is the most common type of arthritis to affect the spine.

  • Arthritis can occur anywhere along the spine, but is more frequent in the lower back and neck.

  • Pain and stiffness are the most common symptoms of spinal arthritis.

  • Causes of spinal arthritis are still largely unknown except for osteoarthritis, which is typically a result of wear and tear.

  • Spinal arthritis treatment may include pain medications, steroid injections, physical therapy and surgery in severe cases.

Who Gets Osteoarthritis Of The Knee

Osteoarthritis is the most common type of arthritis. While it can occur even in young people, the chance of developing osteoarthritis rises after age 45. According to the Arthritis Foundation, more than 27 million people in the U.S. have osteoarthritis, with the knee being one of the most commonly affected areas. Women are more likely to have osteoarthritis than men.

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Arthritis Of The Spine Treatments

While spinal arthritis is not reversible, it is still important to focus on your overall health if you have been diagnosed with this condition. Eating an anti-inflammatory diet, practicing good posture, getting regular exercise, avoiding tobacco products and maintaining a healthy weight can all have a positive effect on the spine, potentially slowing down the natural degenerative process.

For aches and stiffness, or if radiating pain occurs as a result of nerve compression, doctors will generally recommend the following arthritis of the spine treatments:

  • Medication, especially nonsteroidal anti-inflammatory drugs
  • Alternating use of hot and cold compresses
  • Gentle stretches and physical therapy
  • Therapeutic massage
  • Anti-inflammatory facet joint injections

Some patients also attempt alternative therapies, such as acupuncture or chiropractic care, but it is important to keep your primary doctor informed of any new treatments youre attempting to ensure a cohesive plan of care.

What Questions Might A Healthcare Provider Ask To Diagnose Arthritis Of The Knee

Degenerative Joint Disease / Arthritis

Your healthcare provider will interview you when you report your symptoms. Some questions might include:

  • Does anyone in your family have arthritis of the knee?
  • Does your knee swell up?
  • Is your skin often red?
  • Is your skin often warm?
  • Do you have symptoms in one knee or both?
  • How long have you had these symptoms?
  • What medications do you take?
  • How severe is your pain?
  • Do you struggle to walk?
  • Do the symptoms interfere with your daily activities?

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Exercise For Arthritis In The Neck

Physical therapy

If youre experiencing neck pain due to arthritis, your doctor may recommend physical therapy. Physical therapy for neck arthritis entails doing specific exercises to help strengthen and stretch weak or strained muscles. Physical therapy can improve range of motion. Sessions and programs vary in length and frequency and are tailored to your condition.

The foundation of what were trying to do in physical therapy for the neck is often to help improve posture and the way people move, says Dr. Milani. Exercises in physical therapy tend to be focused on strengthening muscles of the back and neck, which puts less strain on structures of the cervical spine.

Youll do exercises during physical therapy and get instructions on ones to do at home.

Regular Physical Activity at Home

You may feel like you dont want to move when your neck hurts. But being inactive may increase stiffness, which can cause you to lose even more mobility. Aches and pains tend to respond better to continued movement than rest, says Dr. Milani. Exercise is often the foundation of treatment.

Exercises that involve stretching, strengthening, and improving range of motion can help reduce pain and keep your neck limber. You want to move gently and smoothly when doing neck exercises, not jerk your neck or make sudden movements. You may feel discomfort at first. Stop if any exercise increases your neck pain.

What Are The Types Of Arthritis Of The Knee

There are around 100 types of arthritis. The most common types that might affect your knees include:

  • Osteoarthritis is the most common of the types on this list. Osteoarthritis wears away your cartilage the cushioning between the three bones of your knee joint. Without that protection, your bones rub against each other. This can cause pain, stiffness and limited movement. It can also lead to the development of bone spurs. Osteoarthritis gets worse as time passes.
  • Post-traumatic arthritis is a type of osteoarthritis. The cartilage starts thinning after trauma to your knee . Your bones rub together, and that causes the same symptoms as osteoarthritis: pain, stiffness and limited movement. Your knee arthritis symptoms might not start until years after the trauma.
  • Rheumatoid arthritis is an autoimmune disease. A healthy immune system causes inflammation when it’s trying to protect you from an infection, injury, toxin or another foreign invader. The inflammatory response is one way your body protects itself. If you have rheumatoid arthritis, you have an unhealthy immune system that triggers inflammation in your joints even though theres no foreign invader. The inflammation causes pain, stiffness and swelling of the synovial membrane, which can also wear away your cartilage.

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Who Is More Likely To Develop Osteoarthritis

Things that make you more likely to develop osteoarthritis include:

  • Aging. Osteoarthritis can happen at any age, but the chance of getting it increases in middle-aged adults and older. After age 50, it is more common in women than in men.
  • Being overweight. Extra weight puts more stress on your joints.
  • Having a past injury or surgery on a joint. This is often the cause of osteoarthritis in younger adults.
  • Doing a lot of activities that overuse the joint. This includes sports with a lot of jumping, twisting, running, or throwing.
  • Having a joint that doesn’t line up correctly.
  • A family history of osteoarthritis. Some people inherit genetic changes that increase their chance of developing osteoarthritis.

Nonsurgical Treatment For Osteoarthritis Of The Spine

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If osteoarthritis of the spine is diagnosed early, doctors may recommend nonsurgical treatment to manage symptoms. NYU Langone physicians, physical therapists, and physiatrists, who specialize in rehabilitation medicine, can help you relieve pain and stiffness, improve flexibility, and build strength in muscles that support the spine.

These treatments do not reverse damage to cartilage or bone or prevent the progression of osteoarthritis, but they may make it possible for you to continue an active lifestyle.

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Who Gets Osteoarthritis Of The Spine

In general, osteoarthritis happens as people get older. Younger people may get it from one of several different causes:

  • injury or trauma to a joint
  • a genetic defect involving cartilage

For people younger than age 45, osteoarthritis is more common among men. After age 45, osteoarthritis is more common among women. Osteoarthritis occurs more often among people who are overweight. It also occurs more frequently in those who have jobs or do sports that put repetitive stress on certain joints.

Will I Need Surgery To Treat My Osteoarthritis

In case none of these treatments have proved their efficacy, your physician may recommend that you consult a spinal surgeon or orthopedic surgery for a surgical process known as total joint arthroplasty.

Arthroscopy is a minimally invasive procedure where a fiberoptic endoscope is inserted into the joint through a small incision. A second scope then washes away all the debris that is released from the cartilage as well as any crystals and bone fragments, and smooths rough surfaces and repairs tears. This is considered to be a quick surgery with less recovery time.

A total joint arthroplasty involves replacing diseased or damaged parts of the bones and joints with an artificial joint. This procedure can reduce pain and improve quality of life however, a replacement may be required after 20 years.

There are other surgical procedures such as osteotomy and joint fusion however, the need for surgery as well as the type of surgery is considered only after all other conservative forms of pain treatment have failed to reduce the pain.

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What Causes Osteoarthritis/djd

People with DJD dont maintain enough healthy cartilage as they age, which means movement becomes more painful as bones rub closer to one another, instead of being blocked by the slippery substance thats supposed to act as a buffer between the bones. We need cartilage to help bones glide and also to absorb vibrations or shocks we experience when we move around, which is why most people with degenerative joint disease find it hard to go about normal day-to-day activities.

When the disease progresses enough, bones rub together in a way that causes inflammation, swelling, pain, loss of mobility and sometimes changes to the shapes of joints.

Heres a quick overview of how joints work. Joints are the point where two or more bones are connected, and theyre made up of the following parts: cartilage, joint capsule , synovium and synovial fluid .

In people who dont suffer from DJD or other forms of joint damage , their joints are encased in smooth cartilage and lined with synovial fluid that helps with the sliding of cartilage against bones, bones against muscles and muscles against connective tissues.

What Is Hip Arthritis

Osteoarthritis (OA), also known as degenerative arthritis is a chronic ...

Hip arthritis is deterioration of the cartilage of the hip joint. The hip is a ball-and-socket joint with the ball at the top of the thighbone . The ball is separated from the socket by cartilage. The cartilage acts as a slippery coating between the ball and the socket that allows the ball to glide and rotate smoothly when the leg moves. The labrum, a strong cartilage that lines the outer rim of the socket, provides stability.

When cartilage in the hip is damaged, it becomes rough. Thinning of cartilage narrows the space between the bones. In advanced cases, bone rubs on bone, and any movement can cause pain and stiffness. When there is friction at any point between bones, it can also lead to bone spurs bone growths on the edges of a bone that change its shape.

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How Is Spinal Arthritis Treated

The treatment for spinal arthritis depends on many factors. They may include your age, level of pain, type and severity of arthritis and personal health goals. Because the joint damage caused by arthritis is irreversible, the treatment usually focuses on managing pain and preventing further damage.

Nonsurgical treatments for spinal arthritis may include:

  • Nonsteroidal anti-inflammatory drugs and corticosteroids to reduce pain and swelling

  • Other medications targeting specific symptoms or triggers of inflammatory arthritis

  • Physical therapy to improve back muscle strength and range of motion in the spine

  • Lifestyle changes to reduce inflammation or stress on your spine: losing weight, quitting smoking, changing your posture, etc.

How To Treat Osteoarthritis

The goals in treating osteoarthritis are to relieve pain and restore function. Brief rest either by changing activities or wearing a splint can help. Soft, snug sleeves can help support a joint when rigid splints are too restrictive. Heat can soothe the joints and help keep them mobile. It is important to keep as much finger motion and function as possible. Hand therapists can teach joint protection exercises and activity modification to help protect joints. Anti-inflammatory medication or a steroid injection into the joint can decrease pain, but neither cures osteoarthritis.

Surgery is considered when the non-surgical options above have not helped. In most cases, you will tell your doctor when you are ready for surgery. The goal is to restore as much function as possible and to minimize your pain. One type of surgery is joint fusion. The worn cartilage is removed and the bones on each side of the joint are fused together, which means that the joint will not move but it will not hurt. Another choice is joint reconstruction, where the rough joint surface is removed and either replaced with your own soft tissue or with an implant. The type of surgery depends on the joint involved, your anatomy, and your activities. Your hand surgeon can help you decide which type of surgery is the best for you.

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand.Find a hand surgeon near you.

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Other Types Of Joint Disease

Sometimes osteoarthritis is a result of damage from a different kind of joint disease, such as rheumatoid arthritis or gout.

Two factors that may affect the symptoms of osteoarthritis, but arent a direct cause of it are the weather and diet:

Weather

Many people with osteoarthritis find that changes in the weather make the pain worse, especially when the atmospheric pressure is falling for example, just before it rains. Although the weather may affect the symptoms of your arthritis, it doesnt cause it.

Diet

Some people find that certain foods seem to increase or lessen their pain and other symptoms. However, your weight is more likely than any other specific dietary factors to affect your risk of developing osteoarthritis.

Read more about osteoarthritis of the spine.

How Is Osteoarthritis Diagnosed

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There is no specific test for osteoarthritis. To find out if you have osteoarthritis, your provider:

  • Will ask about your symptoms and medical history
  • Will do a physical exam
  • May use x-rays or other imaging tests to look at your joints
  • May order lab tests to make sure that a different problem isn’t causing your symptoms

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What Are The Symptoms Of Spinal Arthritis

Symptoms of spinal arthritis may differ from person to person. In general, they may include:

  • Back and neck pain, especially in the lower back

  • Stiffness and loss of flexibility in the spine, such as being unable to straighten your back or turn your neck

  • Swelling and tenderness over the affected vertebrae

  • Feeling of grinding when moving the spine

  • Pain, swelling and stiffness in other areas of the body

  • Whole-body weakness and fatigue

  • Pain and numbness in your arms or legs if the nerves are affected

Although back pain is a common symptom, not all people have it, even those with advanced spinal arthritis. On the other hand, some may experience pain even before arthritis can be seen on an X-ray.

In certain types of spondyloarthritis, eye inflammation may occur, causing pain, watery eyes and blurred vision.

How Is Hip Arthritis Diagnosed

Your doctor may use the following diagnostic tools to determine if you have hip arthritis:

  • Medical history and physical examination
  • Blood tests for genetic markers and/or RA antibodies
  • X-rays to determine cartilage loss

You cant see cartilage on X-ray, but you can see the space between the bones of the hip joint. If its narrowing, this could mean that cartilage has been lost. X-rays also show bone spurs and cysts, which develop due to osteoarthritis. MRI of the hip is usually not needed to diagnose arthritis.

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Osteoarthritis Of The Knees

Like hip OA, knee OA can occur in one or both knees. Age, genetics, and knee injury may all play a role in knee OA.

Athletes who concentrate solely on one sport that involves extensive, repetitive motion, such as running or tennis, may be at increased risk of OA. Likewise, if you pursue only one type of physical activity, this may overuse some muscles and underuse others.

Overuse causes weakness and instability in the knee joint. Varying your activities helps to work different muscle groups, allowing all the muscles around your knee to be strengthened.

Who Is Affected By Osteoarthritis

Degenerative Arthritis of the Hip: What You Need to Know

Approximately 80% of older adults, ages 55 years and older, have evidence of osteoarthritis on X-ray. Of these, an estimated 60% experience symptoms. It is estimated that 240 million adults worldwide have symptomatic osteoarthritis, including more than 30 million U.S. adults. Post-menopausal women have an increased incidence of knee osteoarthritis compared to men.

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Is Degenerative Arthritis A Disability

If you have been diagnosed with osteoarthritis and it has impacted your ability to work, you may qualify for Social Security Disability benefits. Osteoarthritis results in the gradual loss of cartilage from your joints. A tough tissue that provides the cushioning between the bones that form the joints, it is needed.

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