Osteoarthritis (also known as wear-and-tear arthritis or degenerative arthritis) is the commonest form of arthritis. There are various terms that are used to describe this form of arthritis. You would hear terms like joint degeneration, joint deterioration, joint narrowing, calcium deposits, bone-on-bone, joint diminishment, bone spurs or even arthritis.
It might be difficult for some patients to realize whether they have osteoarthritis due to the terms used by physicians. Without proper description, patients find it harder to realize their health status.
There are also different terms that are used when osteoarthritis attacks the spine. Terms like bulging disc, degenerative disc disease, annular tearing, arthrosis, degenerative or facet joint arthritis or vertebral slipping or spondylolisthesis, foraminal narrowing or spinal stenosis or spinal canal are used.
Normally, OA is a condition that degenerates the articular cartilage that covers the ends of the bone adjacent to each other. After this degeneration is established, it starts to cause loss of more cartilage between those bones leading to a situation known as “bone-on-bone” thus more pain.
OA can remain painless for lots of years and will start to become painless when the loss of cartilage is enough to warranty pain. OA can cause a variety of symptoms depending on the severity of the loss of cartilage. OA is most common in the joints in the middle joints of the hand, fingernails and the thumb base.
OA does not cause any harm to the knuckles of the hand as in rheumatoid arthritis. It can also affect knees, hips and the spine. The neck can also be affected to a lesser effect; it can also affect the shoulders.
OA does not affect shoulders in most cases unless you have developed an advanced impingement syndrome and rotator cuff damage. OA is not responsible for elbow pain unless you have other circumstances like the prior fracture. Basically, OA is a problem for the joint but not a systematic problem.
You can have more joints affected by OA but there would be no symmetry between them. A smaller but repetitive injury can lead to the degeneration of the joint and as a result leading to OA. The damage and symptoms of OA are normally accelerated by carrying extra body weight.
In comparison, there is little inflammation in osteoarthritis than in rheumatoid arthritis. You can develop joint swelling but it does not last for a long period. Swelling occurs because of the overuse of the joint and it often subsides with rest. OA does not have a positive test to blood tests. You can only confirm OA by examination, history and plain x-rays. With X-rays, you can see the narrowing of the joint and bone spurring but with history, a physician can appropriately diagnose OA.
Rationale of Effective Treatment
OA can be treated using anti-inflammatory medications or analgesics. We currently do not have medications that slow down the damage or progression of osteoarthritis. Mostly, all medications are designed to control the symptoms. If you have the earlier signs of a painful condition, you might try to use chondroitin sulfate/ glucosamine sulfate in regular doses.
Treating OA with medication can make you active and more comfortable but it’s important to rehabilitate those painful joints for them to remain functional. Strength is another best way of slowing down the progression of OA, and this can be achieved by engaging in the best workout for your condition.
Other treatments that can help for a long-run include using a cane (viscosupplementation), or if your OA symptoms are extremely worse you might try to undergo reconstructive surgery.
What is Osteoporosis?
People often confuse Osteoporosis with osteoarthritis since they both affect people. While OA is a condition that leads to joint degeneration, Osteoporosis leads to the loss of BONE mass causing risk of fractures. Normally, Osteoporosis is a PAINLESS condition, and if you have pain then you could be having both conditions.
When OA affects the spine, it is called a degenerative disc disease which is part of the arthritic process. On the other hand, Osteoporosis affects the quality of your bones. A test known as dual-energy-x-ray-absorptiometry is used to accurately determine your bone health.
Mostly you won’t feel any pain from Osteoporosis until you sustain a fracture to your bones. Around age 50, Osteoporosis will begin to affect the mass of the bones and can often start to affect women right after menopause.
Options for Improving* Bone Health
It a very simple thing to treat* osteoporosis; it includes:
- sufficient calcium and vitamin D
- weight-bearing exercise
There are safe medications that can be used for all people. The First line of medication treatment includes Boniva, Actonel, Fosamax or Reclast. We have other medications for those people who cannot take the above medications; they can try Forteo which requires a daily injection for a period of 2 years but it works better only when bisphosphonates fail.
You can seek the help of your physician on which medication is fit for you. Remember that osteoporosis is not painful and therefore do not ignore it. Uncontrolled osteoporosis can lead to a fractured bone.
If you find out that you are losing out the bone in spite of what you do with treatment, you ought to consult your endocrinologist or rheumatologist both of whom are specialists in osteoporosis.
You can also try spine specialists because they also treat* osteoporosis of the spine. With a fractured spinal vertebra; the condition will heal a few months. If you are treating the condition, then this is acceptable.
But if the condition leads to painful experience, you can then consider undergoing a surgical procedure called Kyphoplasty; to restore the vertebral height making you stand straight.
It is clear that both osteoporosis and osteoarthritis are very specific diseases that require the doctor to conduct a proper and accurate diagnosis which will lead to the appropriate treatment.
These conditions have very effective options of medications; the most important thing to do is to have a proper diagnosis. After proper diagnosis, a doctor will determine which option is best for your condition.
2. Hart DJ, Mootoosamy I, Doyle DV, Spector TD. The relationship between osteoporosis and osteoarthritis in the general population: the Chingford study. Ann Rheum Did 1994;53:158-62
3. Healey JH, Vigorits VJ, Lane JM. The coexistence and characteristics of osteoporosis and osteoarthritis. J Bone Joint surg [Am] 1985; 67-A: 586-92
4. Dequeker J, Aerssens J, Luyten FP. Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship. Aging Clin Exp Res 2003;15(5):426-439. PubMed PMID: 14703009