The rheumatic pathology that directly affects the cartilage of the joints, producing its lesion, is known as osteoarthritis or degenerative osteoarthritis.
Cartilage is what protects the bones that form the joints, as well as allowing them to move and forming part of the joint capsule, the “sac” that covers the joint and contains the synovial membrane. All this makes up a joint, whose stability also depends on the muscles.
The muscles are inserted into the capsule and the periarticular bone through the tendons and ligaments.
How osteoarthritis begins
When the cartilage of a joint deteriorates and loses its resistance, it causes the bones to become unprotected. In this way, they rub against each other when a person moves, causing them to become inflamed and osteophytes (bony spikes in the bones) to form, and sometimes even joint effusion and deformity.
What causes osteoarthritis
There is no specific reason that causes osteoarthritis, but there are a number of factors that make it more likely to appear:
- Age: osteoarthritis usually begins to appear with age, generally from the age of 40, due to joint aging.
- Obesity.
- Work/daily activity.
- Hereditary predisposition.
- Physical exercise, both the lack and the excess of it.
Symptoms of osteoarthritis
- Pain: it is the main symptom of osteoarthritis. It occurs when the affected joint moves. If osteoarthritis is advanced, it can cause pain even at rest.
- Stiffness in the joints when they move after some time at rest, and it improves as they move.
- Limitation of the functions of the joint: with the loss of movement, the musculature eventually atrophies, causing bone to form at the ends and thus deforming the joint.
Which joints are most affected by osteoarthritis?
In general, the joints that tend to suffer most from osteoarthritis are those that move the most and bear the most weight: shoulders, cervical and lumbar spine, fingers, hips, knees and the joint of the first toe.
Diagnosis of osteoarthritis
- The patient’s clinical history is taken: history, physical activity, symptoms, and examination of the affected joints.
- Simple radiography to detect possible radiological signs of osteoarthritis, although this is detected through this test mostly when the osteoarthritis is advanced.
- Arthrocentesis: the synovial fluid of the joint is extracted and analyzed, which in turn serves to alleviate pain.
- Blood and urine tests to rule out possible diseases with symptoms similar to osteoarthritis.
Treatment of osteoarthritis
The treatment of osteoarthritis is aimed at alleviating the patient’s pain and at the same time to provide functional capacity. For this, there are physical treatments, medications and surgery (in cases where it is necessary).
Physical treatment of osteoarthritis
Development of physical exercise and physical tasks of intermittent form that improve the articular mobility and harness the musculature.
- Application of heat and cold to the joint.
- Use of splints and/or orthopedic systems that reduce overload.
Medications for osteoarthritis
Generally, Rheumatology specialists prescribe medications that alleviate the symptoms of osteoarthritis. These can be:
- Analgesics, to combat pain. These can also be applied topically on the skin of the affected joint, with an ointment, cream or spray.
- Anti-inflammatory drugs, to improve joint discomfort and stiffness.
- Arthrocentesis when the joint is very inflamed in order to extract joint fluid and in turn infiltrate corticosteroids.
- Glucosamine sulfate and chondroitin sulfate to nourish the joint cartilage, relieving the symptoms and delaying the evolution of the pathology.
Surgery for osteoarthritis
When osteoarthritis is advanced in the patient, leading to disability, surgery may be performed in order to relieve pain, correct deformities and make the person recover as much function as possible.
Prognosis of osteoarthritis
Osteoarthritis cannot be cured, but it is possible to alleviate the symptoms and delay the progression of the disease. It is a chronic disease that manifests itself over the years, does not have to be progressive and allows the sufferer to lead a normal life.
The evolution of osteoarthritis takes place through outbreaks, so that the symptoms do not always have the same intensity.