How to Mend Your Osteoarthritis

Primary Osteoarthritis usually indicates that the cause of OA is unknown, but is also directly related to aging, or the gradual degeneration of cartilage due to stress placed on the joints.

Secondary Osteoarthritis usually has an identifiable cause that is related to a pre-disposed condition, disease, or injury. Some conditions attributing to secondary osteoarthritis include, but are not limited to, another form of arthritis, congenital disorders, inflammatory diseases, joint infection, Wilson's disease, hormonal disorders, Hemochromatosis, Acromegaly, Hemophilia, Ochronosis, Paget's disease, and sickle cell disease.

If you have a form of OA you will most likely experience pain, stiffness, swelling in and around your joints, loss of mobility, and deformed joints. You may also have a symptom referred to as "Water on the Knee", which is the accumulation of excess fluid in or around the joint (this may result in swelling). Some individuals also encounter a crackling, crunching or creaking sound when you move (this is also referred to as "Crepitus"). Humid weather or noticeable changes in temperature often agitate these symptoms.

It is important that you receive a proper diagnosis from a physician in order to determine the severity of your OA. There are 4 grades that denote the severity of a case of osteoarthritis and determining the grade of your condition will allow for a more tailored treatment program.

Grade One, also referred to as Condromalacia, involves the early onset of OA where the cartilage in the joint begins to soften thus stressing the joint and filling the joint cavity with fluid. Although you may not have any surface damage to the bones in your joint at this stage, your knee will become swollen and inflamed.

Grade Two, also referred to as Fissuring, is the minute tearing or cracking of joint cartilage - this damage often goes unnoticed.

Grade Three, also referred to as Fibrillation, indicates a later onset of OA with noticeable tearing of the cartilage. At this point your injured cartilage will break into small pieces, and these pieces will release enzymes that will act to further damage your joint.

It is important to note that those individuals suffering from Grade One, Two or Three cases of OA are able to explore alternative treatment methods that are non-invasive in nature. Those suffering from Grade One, Two or Three conditions may act to reduce pain from their OA and encourage their injury to heal through Cold Compression Therapy, Blood Flow Stimulation Therapy and Therapeutic Ultrasound treatments.

Grade Four involves the exposure and damage of underlying bone in the joint. At this phase the injury will most likely need surgery to heal.

There is no known cure or preventative methods for OA, however there are treatments available that can provide relief from pain and other symptoms associated with OA. Pain, swelling and inflammation of any kind can be reduced through Cold Compression Therapy (R.I.C.E.), Blood Flow Stimulation Therapy and Therapeutic Ultrasound.

Cold Compression Therapy - The R.I.C.E. Method

Cold Compression Therapy is ideal when you are experiencing pain, swelling or "Water on the Knee". In order to reduce swelling and rest your injured area you may choose to administer the R.I.C.E. method.

Begin R.I.C.E. treatments by resting your injury as much as possible and restrict any of movement that may aggravate your OA. Ice the swollen area at least 3 times a day for approximately 15 to 20 minutes (allow for 45 minute periods between treatments). Do not apply ice directly onto your injury as this may cause cryoburn (freezer burn to the skin) - use a piece of cloth, towel or compression wrap to protect your injury. Compress the area if possible by adding light pressure to minimize swelling. Finally, elevate your injury to relieve swelling and allow fluid to properly drain.

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Blood Flow Stimulation Therapy

If your injury is still inflamed and the area is no longer swollen you may want to explore the use of Blood Flow Stimulation Therapy (BFST). BFST decreases inflammation and increases blood circulation. Blood is the transport mechanism for oxygen, nutrients, water and antibodies, thus proper blood flow is essential when treating pain from OA. BFST is provided through the use of heat therapy which can be found in heating wrap products.

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Therapeutic Ultrasound

Therapeutic ultrasound is a method of stimulating tissue beneath the skin's surface using sound waves. It is like a high frequency massage that can penetrate up to 4" below the surface of the skin. The heating and massaging effects of therapeutic ultrasound can reduce swelling. Essentially, the nutrient absorption rate and blood flow within the injury will be greatly enhanced through the use of an ultrasound device. Portable ultrasound therapy is recommended and administered by many doctors and physical therapists.

When applied directly to the skin, the transducer head of an ultrasound unit cannot effectively transfer sound waves into the body. A conductive medium (ultrasound gel) is required to facilitate therapeutic ultrasound.

Ultrasound can also be used to administer therapeutic medicines into the body which provides the added benefit of delivering soothing medicated gel to the site of the pain. This is a process known as Phonophoresis.

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Surgery is often reserved for extreme cases of OA where individuals are experiencing debilitating pain and severe dysfunction of joints. Some surgical procedures that may be performed include: arthroscopy, joint replacement (arthroplasty), fusing of bones (arthrodesis). There are also a variety of alternative procedures that are conducted for specific joints, as well as new experimental procedures.

Arthroscopy

Arthroscopy may be performed in order to surgically remove cartilage or bone fragments from the OA injury. This procedure involves inserting a fiber optic camera through a small incision on the outside of the injury. At this point the surgeon can view inside of the joint in order to view the amount of damage around your joint. The surgeon will remove damaged cartilage and fragments. This particular procedure may slightly reduce pain from OA, but there has also been some debate as to the effectiveness of this surgery in relieving pain.

For more information regarding the effectiveness of this surgery please view the following scholarly articles: "A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee" from the New England Journal of Medicine, and "Factors Affecting the Outcome of Arthroscopy in Medial-Compartment Osteoarthritis of the Knee" from the Journal of Arthroscopic and Related Surgery.

Joint Replacement (Arthroplasty)

This procedure is most common with hip and knee replacements and involves the insertion of artificial prosthetic joint implant. Replacement of joints in the shoulders, elbows, hands and feet are much less common. Individuals who have severe cases of osteoporosis or other medical conditions may not be viable candidates for this procedure. There are also many complications and limitations that may arise due to this surgery, therefore it is wise to discuss these issues with your surgeon before going forward with a joint replacement procedure.

Fusing of Bones (Arthrodesis)

This particular surgery usually involves treating pain in smaller joints in the hands, feet or spine because fusion of these bones will directly affect range of motion (ROM) or movement of the joint. This surgery can diminish or eliminate pain as the surgeon fuses the bones in the joint affected by OA together. Although this procedure will diminish pain from OA, it will be nearly impossible to move the joint in any way.