WHAT CAUSES OSTEOARTHRITIS?

Osteoarthritis is the most common type of arthritis, occurring in up to about 10% of adults, with as many as 50% of the elderly suffering from it. It is basically a degenerative form of arthritis, in which the cartilage, whose function is to cushion the joints, gets worn out with age.

This "wear-and-tear" of the cartilage over time, results in the bone surfaces becoming less protected and increases friction between the bones during movement. This friction eventually results in pain, swelling and loss of mobility. In more advance stages, the joint loses it normal shape and bony spurs may grow on the edges of the joint. Bits of bone or cartilage may break off and float inside the joint space, further causing pain and loss of mobility.


The cause is multi-factorial, but the following would increase your risk:


Being overweight
Getting older
Previous injury to the joint
Mechanical stresses on the joint from high impact sports, certain jobs, pathological or congenital mal-alignment of bones

SYMPTOMS

Symptoms in the initial stages may include pain, tenderness, stiffness, creaking and locking of the affected joint. As the arthritis progresses, there may be swelling of the joint due to collection of synovial fluid within the joint. In the more advanced stages, there is bony deformity (caused by bony spurs) and mal-alignment of the limb (eg. "varus" deformity of the knee). Patients experience increasing pain upon weight bearing, thus limiting walking, and ultimately, even standing.

Osteoarthritis commonly affects the hands, feet, spine and weight-bearing joints, such as the hips and knees. In the smaller joints, such as in the fingers, hard bony swellings called Heberden's nodes and Bouchard's nodes may form. These are typically not painful, but they do limit joint movement.

DIAGNOSIS

Diagnosis can often be made by your doctor with reasonable certainty by a thorough physical examination. X-rays are used to confirm the diagnosis as well as to document progressive X-ray changes (thinning of cartilage, bony spurs, loose bodies, mal-alignment of joint etc) as the condition progresses.

TREATMENT

1. Non-Pharmacological:


Weight loss - Excess body weight puts more strain on the knee joints. A typical vicious cycle exists: (1) Overweight person develops knee osteoarthritis (2) painful knees reduce mobility (3) with reduced mobility, more weight is gained (4) more weight worsens the arthritis.
Regular exercise - regular aerobic, strengthening and range of motion exercises help strengthen muscles that stabilize the joints.
Adequate intake of Calcium and Vitamin D for bone strength.
Warm soaks and heat packs to help relief pain.
Avoid excessive walking during periods of acute pain.
Orthoses and walking aids - splints and braces help with joint alignment and weight redistribution. Walking frames and crutches help take load away from the arthritic knee.
Physiotherapy
Acupuncture

2. Pharmacological Measures:


Pain-killers - paracetamol-based medication, Non-steroidal anti-inflammatory drugs (NSAIDS) etc.
Glucosamine and/or chondroitin sulfate.
Topical rubs with NSAIDS or capsaicin.
Intra-articular joint injections

3. Surgical Treatment:


Joint lavage (wash out) and arthroscopic debridement (clearing)
Osteotomy - a wedge of bone located near the damaged joint is removed to realign the knee. This causes a shift of weight from the area of damaged cartilage to the area where there is more healthy cartilage.
Total Joint Replacement - considered to be the last resort option in which the severely arthritic joint, having failed more conservative methods of therapy, is replaced with a prosthetic joint.

The decision to treat as well the type of treatment appropriate must be individualized according to the needs of the patient.

For example, young athlete with arthritis to the knee from a previous injury, will require treatment because his arthritis impacts his activities. For him, conservative treatment with possible arthroscopic lavage and debridement would be more appropriate than total joint replacement, in view of his young age.

In contrast, severe osteoarthritis of the knee in an elderly gentleman, which when examined in isolation, would lead one to consider total knee replacement. However, if this knee belonged to a bed-bound gentleman, then perhaps simple pain-killers would be all that is needed.

Cold laser therapy.

All forms of arthritis have one common symptom, PAIN. Pain develops as a result of multiple factors including inflammation, joint deformity, and can lead to lack of mobility and partial disability. Chiropractic treatment with cold laser has great results but this is not to discount the possible need for medicines, injections, and surgery. Each has their place and value in helping with arthritis pain, but there is still a need for potentially useful adjunctive modalities that can accelerate the recovery and reduce pain faster.

Beyond arthritis, cold laser therapy is excellent for treating various forms of chronic and acute pain. Chiropractors also use laser therapy for patients suffering from back and neck pain, musculoskeletal pain, fibromyalgia, tendonitis, busiitis, neuropathy, achilles tendon pain, migraine headaches, sinus blockage, sprains and strains, carpal tunnel and other associated pains. Cold laser therapy also treats conditions such as TMJ, reflex sympathetic dystrophy (RSD) and other inflammatory and scarring conditions.

Cold laser therapy is non-thermal and noninvasive. With the proper combination of cold laser and electric stimulation, laser therapy is one of the most effective healing therapies in the medical community today. Completed in ten to twelve sessions, laser therapy is not only significant in reducing treatment times, it is cost effective as well.

How Cold Laser Therapy Works:The laser instrument is applied directly to the area needing treatment. By sending short burst of photon laser light into the skin, it blocks pain transmitted by nerve cells. This in turn reduces/eliminates inflammation preventing further swelling in the joint and stopping the pain. Another benefit of the laser is the ability to assist the body in releasing high levels of pain killing chemicals such as endorphins and enkephalins. The laser therapy also benefits your body by accelerating cellular reproduction and growth.