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Osteoartharitis


Osteoarthritis is a form of arthritis caused by the inflammation, breakdown, and eventual loss of cartilage in the joints. The cartilage wears down over time.

It affects around 10 percent of men and 13 percent of women aged over 60 years.

OA is a progressive disease. Symptoms worsen over time.


There is no cure, but treatment can help the individual control pain and swelling, and stay mobile and active.


Fast facts on osteoarthritis


Here are some key points about osteoarthritis.

· Osteoarthritis (OA) is a common cause of joint damage, especially in the hands, hips, knees, lower back, and hands.

· Symptoms normally begin after the age of 40 years, but they can affect younger people after a traumatic injury.

· OA is more likely to affect women than men after the age of 50 years.

· Symptoms progress slowly and contribute to workplace disability and reduced quality of life.


Physical therapy


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.


Medications

· Medication cannot reverse 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 does 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 chillies. 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 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.

Problems with the lower limbs

People whose hips, knees or feet are affected may benefit from special footwear, or shoe-insoles.

Some shock-absorbing soles can reduce the pressure on the joints. Special insoles may help distribute bodyweight more evenly.

Wearing leg braces, or holding a stick or cane on the opposite side of the body to the affected leg, may help.

A splint can help the patient rest a painful joint. A splint is a piece of rigid material that provides joint or bone support.

Surgery

Surgery is not usually necessary, but it may help if OA affects the hips, knees, joints, and the base of the thumbs.

It is only usually recommended if other therapies have been ineffective, or if one of the joints is severely damaged. But I would suggest not to go for surgery .

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