Osteoarthritis is the most common form of arthritis, affects approximately 40 million Americans. It is also the leading cause of disability.
While more than half of patients older than 65 years osteoarthritis changes in her knee on x-ray, have arthritis, is not considered a normal part of aging.
increase in individual activities and occupations, the likelihood of osteoarthritis. For instance, baseball players have an increased incidence of osteoarthritis in the elbow and shoulder. Football players have an increased incidence of osteoarthritis in the hips and knees. Backhoe and digging have an increased incidence of arthritis in the wrists.
Obesity is a risk factor for developing osteoarthritis in the knees.
Osteoarthritis is a disease characterized by biochemical changes in cartilage, the results include a decline in glycosoaminoglycans, an important part of the collage, an increase of water content and an increase in the content of the destructive enzymes such as matrix metalloproteinases.
These changes lead to structural weakening of cartilage. Develop small cracks that occur then larger cracks and irregularities. Ulceration of the cartilage and a further deterioration. The end result is premature wear of the cartilage with exposure of underlying bone. Along with this erosion of the cartilage is an increase in inflammation of the lining of the joint, the synovial fluid.
The joints that are most affected by osteoarthritis of the polluted areas such as the neck, lower back, hips and knees.
Stiffness and pain the most common symptoms are moist.
On physical examination there are signs that point to the diagnosis, including bony swellings and distribution of common problems.
Laboratory tests will usually normal. X-rays can show changes.
Treatment for osteoarthritis is focused on five priority goals. You are alleviating pain, maintaining function, prevention of disabilities, the control of co-morbid conditions and avoidance of side effects of medication.
Non-drug therapies are patient education, physical therapy, thermal modalities, weight loss if indicated, and exercise.
Drug therapies are non-steroidal anti-inflammatory drugs, injections of glucocorticoids or supplements visco (lubricants) and disease modifying drugs.
Alternative therapies such as acupuncture, balneotherapy (BSG), glucosamine / chondroitin, massage, chiropractic, etc. all have their proponents.
One area that has received much attention is the use of mechanical switching devices that unload certain joints. For example, get osteoarthritis of the knee, a common problem that has a lot of scrutiny lately.
A recent study showed that the use of shoes, go barefoot can help because there is more pressure on the center of the knee when the people around shoes when they walk barefoot imitating placed against wear.
The use of a simple device such as a floor reduces the load on the knee.
(Kemp G, et al Arthritis Care and Research 2008, 59: 609-614).
Other studies have found that the lateral wedge orthotics can be worn to reduce the load on the medial side of the joint.
Until the day comes that new cartilage can be grown. . . and may that day closer than we think, especially with a focus on stem cell research, the above-mentioned procedures have to do.

Nathan Wei, MD FACP FACR is a rheumatologist. For more information: Arthritis Treatment = or Arthritis and Osteoporosis Center of Maryland