Consequences of OA include pain, reduced function, & restriction in daily activities.
Management is made complex because structural changes can occur without the patient displaying any symptoms.
There are different definition of OA (Osteoarthritis)
“Definition of OA varies, but considered to be a chronic degenerative & progressive condition affecting synovial joint.” – Carol David, 1999
“It is a degenerative, non-inflammatory joint disease characterized by destruction of articular cartilage & formation of new bone at the joint surface & margins.” John Ebnezar, 2003
“OA (Osteoarthritis) refers to a clinical syndrome of joint pain accompanied by varying degrees of functional limitation & reduced quality of life.” – Royal College of Physician, 2008
OA (Osteoarthritis) The most common reasons of disability except traumas.
Disability, initially appears asymptomatically in the 2th and 3rd grades.
Incidence increases by aging. Incidence rate in population is 10% and incidence rate goes up to 50% for population aged 60 and above. Incidence is highly common for population aged 80 and above with 90%
Incidence rate usually onset in the 50s
Mostly occurs at the ends of the fingers, knees, and hips
Women are more commonly affected than men.
Osteoarthritis vs. Rheumatoid Arthritis : Arthritis’ is an umbrella condition that characterizes inflammation of one or more joints in the body.
This condition can be triggered by a number of different causes, including ‘wear-and-tear’ of the joints, obesity, and the body attacking its own immune system (autoimmune diseases).
Out of over 100 different types of arthritis, osteoarthritis and rheumatoid arthritis are two of the most common.
Osteoarthritis is a type of arthritis commonly referred to as ‘wear-and-tear’ arthritis. This disease develops as cartilage breaks down, and the joints start to rub against each other over time. When cartilage (the flexible tissue that connects the joints) breaks down, the joints no longer have the padding they need to move and extend properly. This lack of support causes the synovial membrane (the membrane that surrounds the joint) to inflame.
As cartilage continues to wear down, the bones eventually rub against each other, which can cause severe joint pain, stiffness, and swelling. Although osteoarthritis can affect any joint, it frequently affects joints in the hands, neck, knees, and hips.
Rheumatoid arthritis, another common type of arthritis, is an autoimmune disease that affects the joints in the hands, elbows, knees, ankles, wrists, and feet. This form of arthritis can also damage the organs, as well as the respiratory system and the cardiovascular system, which is why this disease is considered a ‘systemic’ disease.
Rheumatoid arthritis is caused by the immune system attacking the synovial membrane. The immune system mistakes the synovial membrane for a foreign invader, attacking it as if it were an infection or virus. The cause behind this mistaken autoimmune attack is unknown.
There are various types of rheumatoid arthritis, such as seronegative rheumatoid arthritis, as well as other types of common arthritis like psoriasis arthritis.
The difference between osteoarthritis (OA) and rheumatoid arthritis (RA) is in the way these diseases harm the body. While OA is a degenerative disease caused by a physical breakdown of the cartilage, and eventually the bones, RA is an autoimmune disease caused by a reaction in the immune system.
Because RA is a systemic disease, it can attack multiple joints and areas of the body at the same time. A systemic disease is one that affects an entire bodily system at once, as opposed to affecting a single organ or area of the body.
When RA is present, a person’s immune system perceives their joints, the synovial tissues surrounding their joints, and other healthy organs as viruses or foreign invaders that need to be expelled from the body. In response to these invaders, the body’s white blood cells will rush to the site of the joint or organ, and create antibodies to destroy the perceived threat.
OA, on the other hand, is a degenerative disease and typically originates in a single joint. Unlike RA, this degenerative disease is non-inflammatory; it deteriorates (or degenerates) the connective cartilage between the joints, and eventually deteriorates the bones. OA is sometimes called ‘wear-and-tear’ arthritis because it results from natural aging and years of wear on the joints.
RA (a systemic disease) is caused by an autoimmune response, and OA (a degenerative disease) is caused by years of natural wear-and-tear.
Because OA and RA are caused by different factors, they elicit different symptoms.
A person who has rheumatoid arthritis may experience fatigue, malaise, and depression, preceding other symptoms by weeks to months. These are common symptoms of systemic diseases, as critical body systems, like the respiratory and cardiovascular systems, are under attack. These systems have key responsibilities in the body, and any damage to these systems can throw neurological, physiological, and physical functions off track.
Osteoarthritis manifests differently around the body. Because this disease attacks the cartilage between joints, and not the bodily systems (like RA), symptoms are typically felt around the joints. Severe joint pain, stiffness and swelling are common, along with the following symptoms:
The causes, symptoms, and treatment methods differ for OA and RA, so it’s important that we determine the type of arthritis a patient has in order for us to develop an effective treatment plan.
Osteoarthritis is generally diagnosed through a series of tests, along with a physical examination and an assessment of past medical history.
Ultrasound to evaluate the ligaments and tendons around the affected joint
Analysis of synovial fluid to determine whether degeneration is present
Closed synovial biopsy to remove a piece of synovial tissue and assess its condition
Arthroscopy examination of the joints through a small camera
Arthrocentesis examination to remove joint fluid and assess its condition
Rheumatoid arthritis is generally diagnosed through a series of tests, including physical examinations, blood tests, and x-rays.
Anti-cyclic citrullinated peptide (anti-CCP) test to identify auto-antibodies, called anti-CCPs
C-reactive protein (CRP) test to identify c-reactive proteins that are produced in response to inflammation
Rheumatoid factor (RF) test to measure levels of RF, an antibody often present when RA is present
Erythrocyte sedimentation rate (ESR) test to identify elevated levels that are indicative of inflammation
MRI and ultrasound tests to assess the joints
X-rays to identify any damage on the joints
Treatment of OA and RA
Unfortunately, osteoarthritis cannot be reversed or treated. We offer various treatments and pain relievers to help patients with OA manage unpleasant symptoms.
Intra-articular injections: Injections of corticosteroids, hyaluronic acid, BOTOX® or platelet-rich plasma (PRP) in the joints can help to relieve pain in the joints. These injections can provide the missing ‘cushion’ or padding that the cartilage once provided before it degenerated.
Physical therapy: Because OA weakens the joints and muscles, physical therapy can help to strengthen the affected joints. Similarly, pain management classes can help patients to minimize the symptoms of OA.
Pain-relieving medications: Various medications can be taken to relieve the symptoms of OA, dull the pain and discomfort, and reduce swelling. These medications include Tylenol® and NSAIDs (nonsteroidal anti-inflammatory drugs).
There is unfortunately no treatment to reverse rheumatoid arthritis either. We can provide various medications along with therapy to help patients manage the symptoms of RA.
Disease-modifying medications: Various medications, known as DMARDs (disease-modifying anti-rheumatic drugs), can be taken to either slow the progression of RA or stop the progression entirely. These treatments can save the joints from further damage.
Pain-relieving medications: Medications, such as NSAIDs and corticosteroids, can help to reduce swelling and inflammation and relieve the pain caused by RA. These medications can also help to improve physical function.
Physical therapy: Physical therapy sessions can help patients to improve joint and muscle function. These sessions can also introduce patients to new ways of functioning or completing tasks to minimize joint pain.
