I. What is osteoarthritis?
Osteoarthritis used to be called osteophytes, degenerative osteoarthropathy and osteoarthrosis. The disease is characterized by the loss of joint cartilage destruction and subchondral osteophytes, with clinical manifestations of joint pain, stiffness, enlargement and restricted movement, and is one of the most common joint diseases in middle-aged and elderly people.
Second, what is the cause of osteoarthritis?
It is still unclear. It may be due to a combination of systemic or local factors in the joints. Family history, obesity, women, history of joint trauma are prone to this disease, as well as occupations that overuse certain joints, such as farmers and athletes.
The prevalence and location of osteoarthritis?
Osteoarthritis occurs after the age of 40 and is more common in women than men, with a prevalence of 68% in women over 65. Osteoarthritis can affect multiple joints, with the most common sites being the knee, small finger joints, hip joints, cervical spine and lumbar spine. Most of the commonly referred to “cervical spondylosis” and “lumbar spondylosis” are also due to osteoarthritis.
4. What are the clinical manifestations of osteoarthritis?
Osteoarthritis often presents with a variety of clinical manifestations depending on the area of the joint involved. Common clinical manifestations include pain and pressure in the affected joints, characterized by pain that is aggravated by activity and relieved by rest, short morning stiffness, joint swelling, numbness and weakness of the limbs, dizziness, sciatica, etc. if nerves and blood vessels are compressed. The affected joints may have local bony enlargement such as Heberden’s node and Bouchard’s node, etc. There may be bone rubbing sound or bone rubbing sensation when the joint is moved, and in severe cases, joint movement may be limited and deformed.
V. What are Heberden’s nodes and Bouchard’s nodes?
Bony hyperplasia nodules in the distal interphalangeal joints of the fingers are called Heberden’s nodules, and similar nodules in the proximal interphalangeal joints of the fingers are called Bouchard’s nodules. Both are typical manifestations of osteoarthritis of the hand and are commonly seen in female patients.
What are the complications of osteoarthritis of the cervical and lumbar spine?
Osteoarthritis of the cervical and lumbar spine can lead to the formation of large bony bulges, disc prolapse or vertebral dislocation. Various manifestations can occur when the nerves, blood vessels and spinal cord are compressed. Cervical spine hyperplasia can compress nerves and cause pain in the head, neck and shoulders, numbness in the fingers, etc. Compression of the spinal cord can cause hemiplegia or even paraplegia, compression of the vertebral artery can cause vertigo, tinnitus, blurred vision and ataxia, and compression of the trachea and esophagus can cause difficulty in breathing or swallowing. Compression of nerves by lumbar spinal hyperplasia can lead to sciatica and cauda equina syndrome.
7. How is osteoarthritis treated?
Treatment of osteoarthritis includes non-pharmacological treatment, pharmacological treatment and surgical treatment. Non-pharmacological treatment is applicable to all people, including weight reduction, aerobic exercise, muscle strength exercise, physical therapy, use of walking aids such as crutches, etc. Care should be taken to avoid factors that aggravate joint pain, such as excessive exercise, dancing, wearing high heels, climbing mountains, etc.
VIII. What medications are available for osteoarthritis?
Medications for osteoarthritis are divided into two categories. The first category is to improve the symptoms of drugs, both drugs to reduce pain, mild pain can be used topical drugs or oral acetaminophen, medium and severe pain can be oral non-steroidal anti-inflammatory drugs, such as diclofenac. Those with severe pain can take central analgesics, such as tramadol hydrochloride. The second category is condition improving drugs and chondroprotective agents. Currently, they include diphenhydramine, glucosamine, chondroitin sulfate, etc. These drugs can slow down the progress of the disease and improve the patient’s symptoms to some extent. Glucocorticoid injections can be given locally to those with significant local inflammatory reaction in the joint and joint effusion, but not more than 3-4 times in a year. When the knee joint pain is obvious and there is no obvious effusion, the joint cavity can be injected with drugs such as hyaluronic acid or sodium vitrate.
9. When do patients with osteoarthritis need surgical treatment?
Surgery is required when there are free bodies in the joint cavity, severe deformity and dysfunction of the joint, persistent joint pain that has not been treated with medical therapy, and severe neurovascular compression.
X. What are the surgical treatments for osteoarthritis?
Surgical treatment for osteoarthritis includes free-body removal, osteotomy, joint debridement, joint replacement and joint fusion. The appropriate surgical method should be selected according to the patient’s age, the location of the affected joint and the degree of the lesion, physical condition and expectations, etc. The treatment is mainly through arthroscopy and open surgery.
XI. How should osteoarthritis patients exercise?
In general, exercise is not recommended during the acute phase of osteoarthritis, and the affected joints should be given adequate rest. When the acute symptoms of the joint disappear, appropriate exercise should be done. Obese patients need to reduce weight, exercise methods can vary from person to person, swimming is a relatively good exercise, such as those who do not have conditions should mainly carry out non-load exercise of the joint and enhance muscle strength and endurance exercise. Exercise should be carried out gradually and appropriately, and the intensity of exercise should be adjusted if the symptoms worsen after exercise.