Osteoarthritis (OA): Causes, Symptoms, Diagnosis, and Treatment

Osteoarthritis is a degenerative joint disease that affects millions of people worldwide. It is the most common form of arthritis and can cause pain, stiffness, and swelling in the affected joints. The condition is caused by the breakdown of cartilage, the cushion that covers the ends of bones, leading to bone-on-bone contact, inflammation, and pain followed by changes in the shape of the bone. While there is no “cure” for OA there are many successful strategies to manage the symptoms.  These include lifestyle changes, medications, injections, braces and surgery. In this article, we will discuss the causes, symptoms, diagnosis, and treatment of osteoarthritis, including the GLA:D therapy program, nutrition, mobility devices, physiotherapy, bracing, and diagnosis.

Causes and Risk Factors of Osteoarthritis

Osteoarthritis is caused by the breakdown of cartilage in the joints. This can occur due to many risk factors which can include:

• Age: As we age, our joints and cartilage become less resilient and more prone to damage and can increase the risk of OA.
• Gender: Osteoarthritis is more common in women than men.
• Genetics: Having family members with osteoarthritis are associated with increased chance that a person will develop osteoarthritis.
• Obesity: Being overweight puts extra strain and stress on the joints, leading to faster wear and tear.
• Joint injuries: Injuries to the joints, such as fractures, dislocations, or ligament tears, can lead to osteoarthritis later in life.
• Repetitive use: Chronic overuse of the joints, such as in certain sports or occupations, can lead to osteoarthritis.

Signs and Symptoms of Osteoarthritis

Osteoarthritis symptoms can vary depending on the severity of the disease and the affected joints. The most common symptoms include:

• Pain: The affected joints may be painful, especially during or after movement.
• Stiffness: The joints may feel stiff, especially in the morning or after sitting for a long time.
• Swelling: The affected joints may be swollen, especially after extended periods of use.
• Reduced range of motion: The affected joints may be less flexible than normal, making movement difficult.
• Cracking or popping sounds: The affected joints may make cracking or popping sounds when moved.

Diagnosis of Osteoarthritis

Diagnosing osteoarthritis typically involves a thorough  medical history, physical exam and may include imaging tests. The doctor or clinician will ask about the patient’s symptoms, past medical history, and family history of arthritis.

During the physical examination, a doctor will look for signs of joint damage, such as swelling, tenderness, or limited range of motion, and muscle loss. Often muscles around the arthritic joint are weaker than the healthy opposite side.

Imaging tests, such as X-rays, can help confirm the diagnosis and determine the extent of joint damage. MRIs or CT scans are generally not needed to diagnose osteoarthritis. In some cases blood tests may also be ordered to rule out other conditions, such as rheumatoid arthritis or gout..

Xrays are used to assess how advanced the OA is in the affected joint: Grade 0 is normal; Grade 1 is mild OA, Grade 2 is moderate, Grade 3 is moderate to severe and Grade 4 is severe. While very helpful for planning the best treatment, the grade of osteoarthritis on xray may not match how little or how much impact and pain a person’s osteoarthritis can cause.

Osteoarthritis Treatment

There are many ways to manage OA, including lifestyle changes, medication, neuromuscular exercises, physical therapy, bracing and surgery. The goal of treatment is to reduce pain, improve joint function, and prevent further damage. Here are some common treatments for osteoarthritis:

Lifestyle Changes/ Self Management Strategies

• Exercise: Regular physical activity will help improve joint flexibility, strength, and mobility. Low-impact exercises, such as walking, swimming, or cycling, are recommended for people with painful osteoarthritis. People who are very active may want to reduce the volume, intensity or frequency of impact exercise, if pain levels during or after these activities are not manageable.
• Weight loss: Losing weight can reduce the strain on the joints, especially the knees and hips.
• Nutrition: Eating a healthy diet, rich in fruits, vegetables, whole grains, and lean protein, can help reduce inflammation and improve joint health. Eating more plant based protein sources may also be helpful.
• Applying ice packs to sore joints can temporarily reduce pain and swelling related to activity.
• Supplements are commonly advertised and may help some people but there are many individuals who do not find them helpful. Chat with your medical team to discuss supplementation.

Medication

Oral Medication:

Over-the-counter pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), can help reduce pain and inflammation in the affected joints.

Topical Creams and Medication:

Topical creams, such as capsaicin or lidocaine, can provide temporary relief from pain and stiffness. Diclofenac acid or other NSAIDs can be mixed into a gel or cream and is helpful for many superficial joints eg knees. All topical products are most helpful when used three to four times daily.

Injections: 

Corticosteroids are potent anti-inflammatories and can be given by injection directly into the affected joint to reduce inflammation and pain.

Other Injections:

There are other injections that not only help with pain but may slow down how fast osteoarthritis progresses, though research is still ongoing.

A. Hyaluronic acid

Hyaluronic acid is normally present in healthy joints and other body tissues. In joints affected by OA, there is less HA and it is abnormal. There are a variety of hyaluronic acid products available that replace this when injected into the joint with OA. The HA increases joint fluid viscosity, cartilage hydration acting like a temporary joint lubricant. It can reduce pain. These injections can last up to 6 months and can safely be repeated for many years. Many extended health benefit plans will cover the cost of this treatment.

B. Platelet Rich Plasma

Platelet rich plasma is rich in many biological factors known to promote tissue recovery. The patient’s own blood is used as a source of platelets which are rich in natural healing factors. In patients who respond to PRP injections the benefits can last up to a year or more. At this time the patient pays for the cost of this treatment.

GLA:D Therapy Program

GLA:D therapy program is an evidence-based treatment program designed for people with knee and hip osteoarthritis. It focuses on education, neuromuscular exercises, and pain management. The program includes supervised exercise sessions, individualized home exercises, and regular follow-up appointments. Successful completion results in improved daily function, fewer medications and fewer physician visits due to pain.

Mobility Devices

Mobility devices, such as canes, crutches, or walkers, can help reduce the strain on the affected joints and improve balance and stability. They can also help prevent falls, which can cause further joint damage and disability.

Physiotherapy

Physiotherapy can help improve joint function, reduce pain, and increase mobility. A physiotherapist can develop an exercise program tailored to the individual’s needs, as well as provide hands-on treatment, such as joint mobilization or soft tissue massage.

Bracing

Bracing can help support the affected joint and reduce pain and inflammation. Many braces are designed with OA in mind, to decrease the pressure on the painful part of the joint enabling ongoing participation in chosen activities.

There are many types of braces available, including hip and knee braces, ankle braces, and wrist braces.

Surgery

Surgery may be recommended for people with severe osteoarthritis who have not responded to other treatments. The most common type of surgery for osteoarthritis is joint replacement, where the damaged joint is replaced with an artificial joint.

Conclusion

Osteoarthritis is a common joint disease that can cause pain, stiffness, and swelling. There are many ways to manage the condition, including lifestyle changes, medication, and surgery. GLA:D therapy program, nutrition, mobility devices, physiotherapy, and bracing are all effective treatment options for osteoarthritis and may help delay surgery.

It’s essential to consult with a healthcare provider for proper diagnosis and treatment.

How LiveActive Can Help

LiveActive is an extensive OA program that help you design a treatment plan to slow down the progression of osteoarthritis. Consultations with our sport medicine physicians will help diagnose and organize how to manage osteoarthritis, decrease the risks of of osteoarthritis, relieve symptoms, and you back to the activities you love.

For those suffering from hip and knee osteoarthritis, recommendations may include the GLA:D Therapy program, one on one physiotherapy, sessions with LiveActive’s dietitian, braces or walking aids. For the treatment of knee osteoarthritis, the physicians may recommend an injection to help reduce the pain due to osteoarthritis and increase the likelihood of success.

Physiotherapy is a type of treatment that will help use manual therapy and acupuncture to help relieve pain while providing great exercises to build strength to improve quality of life. Pain relief in weight-bearing joints is so important to be able to consistently treat osteoarthritis.

FAQs

1. Is exercise recommended for people with osteoarthritis? Yes, regular exercise can help improve joint function, reduce pain, and increase mobility. Low-impact exercises, such as walking, swimming, or cycling, are recommended for people with osteoarthritis.
2. What is the GLA:D therapy program? The GLA:D therapy program is an evidence-based treatment program designed for people with knee and hip osteoarthritis. It focuses on education, neuromuscular exercises, and pain management.
3. How long does the GLA:D therapy program last? The GLA:D therapy program typically lasts for 6-8 weeks, with two exercise sessions per week.
4. Is surgery the only option for severe osteoarthritis? No, surgery is not the only option for severe osteoarthritis. There are many other treatments available, including medication, physiotherapy, and bracing.
5. What is the best way to prevent osteoarthritis? Maintaining a healthy weight, staying active, and avoiding repetitive joint movements can help prevent osteoarthritis.
6. Can nutrition play a role in osteoarthritis management? Yes, a healthy diet that is rich in fruits, vegetables, whole grains, lean protein, and healthy fats can help reduce inflammation and promote joint health.

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