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DEGENERATIVE ARTHRITISDEGENERATIVE ARTHRITISDegenerative arthritis is also called osteoarthritis or "wear and tear" arthritis. It is a form of arthritis that causes the gradual breakdown of the cartilage that cushions the joints. Movement then causes the bones to rub against each other, which is painful. Degenerative arthritis is characterized by inflammation, breakdown and eventual loss of the cartilage of the joints. It commonly affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees. It occurs when the joints receive too much wear. This can be caused by obesity, bad posture, repeated trauma or injury, and overuse. In some cases, degenerative arthritis may be hereditary. This kind of arthritis mostly related to aging. With aging, the water content of the cartilage increases and the protein makeup of cartilage degenerates. Repetitive use of the joints over the years irritates and inflames the cartilage, causing joint pain and swelling. Eventually, cartilage begins to degenerate by flaking or forming tiny crevasses. Loss of cartilage cushion causes friction between the bones, leading to pain and limitation of joint mobility. Inflammation of the cartilage can also stimulate new bone outgrowths (spurs) to form around the joints. The most common symptoms of degenerative arthritis are- • Pain in the affected joint(s) after repetitive use. • Joint pain is usually worse later in the day. • There can be swelling, warmth, and creaking of the affected joints. • Pain and stiffness of the joints can also occur after long periods of inactivity, for example, sitting in a theater. • In severe cases complete loss of cartilage cushion causes friction between bones, causing pain at rest or pain with limited motion. Diagnosis- Blood tests are performed to exclude diseases that can cause secondary osteoarthritis, as well as to exclude other arthritis conditions that can mimic osteoarthritis. X-rays of the affected joints can suggest degenerative arthritis. Simple x-ray testing can be very helpful to exclude other causes of pain in a particular joint as well as assist the decision-making as to when surgical intervention should be considered. Arthrocentesis…….(a sterile needle is used to remove joint fluid for analysis). Joint fluid analysis is useful in excluding gout, infection, and other causes of arthritis. Removal of joint fluid and injection of corticosteroids into the joints during arthrocentesis can also help relieve pain, swelling, and inflammation. Arthroscopy… (is a surgical technique whereby a doctor inserts a viewing tube into the joint space). Abnormalities of and damage to the cartilage and ligaments can be detected and sometimes repaired through the arthroscope. If successful, patients can recover from the arthroscopic surgery much more quickly than from open joint surgery. Finally, a careful analysis of the location, duration, and character of the joint symptoms and the appearance of the joints helps the doctor in diagnosing. Bony enlargement of the joints from spur formations is a characteristic. Treatment - Aside from weight reduction and avoiding activities that exert excessive stress on the joint cartilage, there is no specific treatment to halt cartilage degeneration or to repair damaged cartilage in osteoarthritis. The goal of treatment in degenerative arthritis is to reduce joint pain and inflammation while improving and maintaining joint function. Some patients with this kind of arthritis have minimal or no pain, and may not need treatment. Others may benefit from conservative measures such as rest, exercise, weight reduction, physical and occupational therapy, and mechanical support devices. These measures are particularly important when large, weight-bearing joints are involved, such as the hips or knees. Medication may be taken orally or injected into the joints to decrease joint inflammation and pain. When conservative measures fail to control pain and improve joint function, surgery can be considered. Resting sore joints decreases stress on the joints, and relieves pain and swelling. Patients are asked to simply decrease the intensity and/or frequency of the activities that consistently cause joint pain. Exercise is helpful in osteoarthritis in several ways. First, it strengthens the muscular support around the joints. It also prevents the joints from "freezing up" and improves and maintains joint mobility. Finally, it helps with weight reduction and promotes endurance. Applying local heat before and cold packs after exercise can help relieve pain and inflammation. Swimming is particularly suited for patients with osteoarthritis because it allows patients to exercise with minimal impact stress to the joints. Other popular exercises include walking, stationary cycling, and light weight training. Physical therapists can provide support devices, such as splints, canes, walkers, and braces. These devices can be helpful in reducing stress on the joints. Occupational therapists can assess daily activities and determine additional devices that may help patients at work or home. Recently, the food supplements glucosamine and chondroitin have been shown to relieve symptoms of pain and stiffness for some persons with degenerative arthritis. However you must consult a health care professional before you take any of these supplements. Aside from the conventional treatment methods which, there are also numerous alternative therapies and treatments available, many of which are quite effective. Surgery is generally reserved for severe cases which are unresponsive to the conservative treatments. Arthroscopy, discussed above, can be helpful when cartilage tears are suspected. Osteotomy …….(bone removal procedure that can help realign some of the deformity in selected patients, usually those with knee disease). Arthrodesis…… (Severely degenerated joints are treated by fusion) () Arthroplasty…….(replacement with an artificial joint). Total hip and total knee replacements are now commonly performed in community hospitals throughout the United States. |
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