What is Osteoarthritis?
Sometimes called degenerative joint disease or degenerative arthritis, osteoarthritis (OA) is the most common chronic condition of the joints affecting a bigger percentage of Kenyans. OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe.
In normal joints, a firm, rubbery material called cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As OA worsens over time, bones may break down and develop growths called spurs. Bits of bone or cartilage may chip off and float around in the joint. In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone leading to joint damage and more pain.
Who is Affected?
Although OA occurs in people of all ages, osteoarthritis is most common in people older than 65. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genes.
One in two adults will develop symptoms of knee OA during their lives.
One in four adults will develop symptoms of hip OA by age 85.
One in 12 people 60 years or older have hand OA.
Treatment and Cure
There is no cure for OA, but treatment can help relieve symptoms and maintain joint movement. Interventions include exercise, manual therapy, lifestyle modification, and medication. Medication cannot reverse the damage, but it can help reduce pain.
Acetaminophen (paracetamol, Tylenol): These can relieve pain in patients with mild to moderate symptoms. High doses can cause liver damage, especially if the patient regularly consumes alcohol, so it is important to follow the recommended dosage. Acetaminophen may also affect how some other medications work, so it is important for patients to tell the doctor if they are taking it.
Non-steroidal anti-inflammatory drugs (NSAIDs): If acetaminophen is not effective in controlling pain, the doctor may prescribe a stronger painkiller, which may include ibuprofen, aspirin, or diclofenac. Some topical NSAIDs can be applied directly onto the skin of the affected joints. Some over-the-counter (OTC) topical NSAIDs are very effective at reducing pain and swelling in the joints of the knees or hands. Patients should check with their doctor about taking NSAIDs, as they are not suitable for some people, for example, those with asthma or a peptic ulcer.
Tramadol (Ultram): This is a prescription analgesic that does not reduce swelling but provides effective pain relief with fewer side effects than NSAIDs. It is typically used for short-term acute flare-ups, and it may be prescribed alongside acetaminophen for more powerful pain relief.
Codeine: This may help with more severe symptoms. There is a risk of dependence, but in cases of severe pain, this may be an option. Side effects may include constipation and drowsiness.
Capsaicin cream: This medication blocks the nerves that send pain messages. It may help patients with OA in their hands or knees that do not respond well to topical NSAIDs. Pain relief is not immediate, and it can take 2 weeks to a month for the medication to take full effect. A tiny amount of capsaicin cream is applied to the affected joints four times daily and no more than once every 4 hours. The first application may trigger a burning sensation, but, after some uses, that sensation goes away. Capsaicin cream is made from chilies. If it comes into contact with the eyes, mouth, nose or genitals, there will be no damage, but it will probably cause pain. It should not be applied to the broken or inflamed skin, and hands must be washed after use. Avoid having a hot bath or shower before or after applying the cream.
Intra-articular cortisone injections: Severe pain can be treated by injecting a medication, usually a corticosteroid, directly into the site of the joint. These are effective at relieving pain and swelling, but can normally be applied only once every 4 months in a single joint. Too many intra-articular injections can damage the joint, and overuse of corticosteroids increases the risk of osteoporosis and other adverse effects.
Transcutaneous electrical nerve stimulation (TENS) applies an electrical current through the skin. It controls pain by numbing some of the nerves endings in the spinal cord. A TENS unit is usually connected to the skin using two or more electrodes.
Thermotherapy uses warm and cold temperatures to help reduce pain and stiffness in the joints.
A hot water bottle filled with either hot or cold water, or hot and cold packs, can be applied to the affected area. Hot and cold packs can be cooled in a freezer or heated in a microwave.
Manual therapy is performed by a physical therapist. Stretching techniques help keep the joints flexible and supple. Not using the affected joint may weaken the muscles, further worsening osteoarthritis stiffness. Read More About other methods of treating Osteoarthritis. Click Here!
Yes, the cold and humidity can make your joints ache. Can you feel a storm coming in your knees? So can lots of people with arthritis. Some doctors think that these stories of weather causing joint pain are old wives’ tales, but science is backing up the phenomenon. Some people are more sensitive to weather than others. So you may feel more stiff and achy in the cold more than your neighbor. That doesn’t either of you is wrong, it just means that we don’t perceive things the same.
A 2014 study of people with osteoarthritis (OA) published in BMC Musculoskeletal Disorders asked participants if and how weather influenced their pain. Of the 712 people who answered the survey, 469 (67%) said they were weather sensitive. It turns out that weather-sensitive people with OA experience more joint pain overall than their non-weather-sensitive counterparts.
A 2011 article published in European Journal of Pain found similar results in people with rheumatoid arthritis (RA). The researchers looked at nine previously published studies of people with RA and concluded: “pain in some individuals is more affected by the weather than in others, and that patients react in different ways to the weather.”
Which Weather Conditions Are Worst?
If you combine results of the various studies, the general consensus is that cold, wet weather is the worst for inciting arthritis pain. Terence Starz, MD, a rheumatologist at University of Pennsylvania Medical Center in Pittsburgh, may have summed it up best with this quip he shared from one of his patients, “The frost is on the pumpkin and the pain is back in my joints.”
Changes in barometric pressure – a measure that refers to the weight of the air – seem to be more important for pain levels than the actual barometric pressure. Meaning that either a cold front or warm front coming in can ramp up the ache in your fingers. But once the weather has settled in, your pain will even out.
A 2015 study of 810 people with OA published in the Journal of Rheumatology found significant links between humidity, temperature, and joint pain. The effect of humidity on pain was stronger when the weather was colder. In essence, they found that wet, winter days are no fun.
A 2015 study of 133 RA patients published in Rheumatology International found that their disease activity (swollen joints, pain) was lower when their days were sunny and dry.
Why Does Cold Rain Make You Hurt?
Scientists don’t know for sure why changes in weather can make some people hurt, or why it affects some people more than others. But they do have a few theories. Dr. Starz believes at least some of the increased pain comes from decreased activity. “We know that physical activity relieves arthritis pain. And when the weather is unpleasant, people tend to hole up inside. That inactivity can lead to more pain.” Other scientists offer physical reasons behind the pain. Changes in barometric pressure can cause expansion and contraction of tendons, muscles, bones and scar tissues, resulting in pain in the tissues that are affected by arthritis. Low temperatures may also increase the thickness of joint fluids, making them stiffer and perhaps more sensitive to pain during movement. Dr. Starz agrees, “The mind-body connection is strong. If warm sunny weather makes you feel better psychologically, you’ll probably feel better physically as well.”
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