What
is Osteoarthritis (OA)? --
Osteoarthritis is a degenerative disease of the joints. It is a
continuing process rather than a disease.
Human joints are continually subjected to various insults e.g. weight
bearing, trauma. To add to this are the metabolic changes that
accompany advancing age.
Which
joints are the common affections of OA ?
In India knee joint is the most common joint involved in
Osteoarthrits.
This is due to our habits of squatting & sitting cross legged.
What
are the joint changes accompanying OA ?--
In the knee joint the bony surfaces are covered with cartilage. With
age there is wear & tear of the cartilage. There is progressive
cartilage loss & damage to its structure leading to functional
deterioration.
What
are the symptoms of OA? --
Pain in the affected joint is the most important
symptom.
There may even be rest pain or night pain.
Sensation of stiffness is present usually after a period of rest.
There may also be a sensation of instability of the joint.
What
are the investigations required for the diagnosis ?
OA is mainly a clinical diagnosis. Xray of the affected joint
can help to ascertain the severity of affection.
What
is the role of weight reduction in OA ?
Obesity is an important risk factor for OA. The knees have to take the
entire weight of the body. Decreasing the weight would decrease the
wear & tear of the cartilage & hence alleviate symptoms.
Are
there any exercises for OA patients ?--
Yes. These are called as quadriceps
strengthening exercises.
Lie flat on beckon the floor or bed.
Keep the knees straight.
To exercise the right knee, first bend the left knee with the foot on
the floor.
Tighten the quadriceps muscles of the right side ( muscles above the
right knee) & lift the leg as far as it will go, then lower it
slowly & hold it off the floor for 5 seconds.
Repeat 10 to 20 seconds.
Exercise the other leg the same way.
Increase the number of repetitions for each leg by 1-2 daily until 25
- 30 is achieved.
Exercises are to be done 2-3 times daily, starting with a low number
of repetitions & eventually working up to a goal of 200 straight
leg raises per day per leg.
What are the drugs used in patients with OA ?
The drugs used for OA are the NSAIDS group of drugs like the
Ibuprofen, diclofenac.
The biggest problem with these drugs is the development of acid peptic
disease (acidity) & it's complications.
Newer drugs like Nimesulide & Meloxicam
are now available that are devoid of this side effect.
When
are steroids used in OA ?
Steroids are used in OA only when there is swelling of the joint &
effusion ( collection of excessive fluid in the joint ).
What
are the various surgeries done in OA ?
Surgery is the modality of treatment when OA is very well established
& causing too much morbidity. The best surgery for the same is replacement
arthroplasty. In this the articulating joint surfaces are
replaced by artificial material.
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