What is Degenerative Arthritis?

Understanding Cartilage and Joint Function

In your joints, the connective tissue known as cartilage plays a crucial role. Cartilage is both firm and flexible, providing a cushion that absorbs stress during movement.

Overview of Degenerative Arthritis

Degenerative arthritis (DA), commonly referred to as osteoarthritis, primarily occurs due to aging. Over time, repetitive use of the joints leads to damage. As the cartilage deteriorates, it increasingly consists of water rather than protein, resulting in degeneration.

Causes of Degenerative Arthritis

Degenerative arthritis results from the natural wear and tear of cartilage over time. Healthy cartilage is typically smooth and allows for nearly frictionless joint movement. However, in DA, the surface of the cartilage becomes rough. Complete erosion of cartilage can lead to bone-on-bone contact. Factors such as joint infection or injury can exacerbate the condition.

Symptoms of Degenerative Arthritis

Unlike inflammatory arthritis, which can develop suddenly, degenerative arthritis tends to manifest gradually, becoming more prevalent in individuals aged 65 and older. Symptoms may worsen in the morning and include:

– Pain in joints (arthralgia)
– Tenderness of joints
– Swelling in joints
– Stiffness of joints
– Decreased range of joint motion
– Skin redness around joints
– A grating sensation during joint use

Risk Factors of Degenerative Arthritis

Several factors can increase the likelihood of developing degenerative arthritis, including:

– Family history of arthritis
– Being over the age of 65
– Female gender
– Obesity
– Previous joint injuries
– Joint infections
– Congenital bone or cartilage defects
– Occupations that involve repetitive joint stress
– Existing conditions such as gout or rheumatoid arthritis

Diagnosis of Degenerative Arthritis

Diagnosis of degenerative arthritis involves a combination of reported symptoms, physical examinations, and imaging techniques such as X-rays, CT scans, and MRI scans. Early and accurate diagnosis is critical for effective treatment and prevention of permanent joint damage.

Treatment of Degenerative Arthritis

Treatment aims to alleviate pain and prevent further joint damage while enhancing joint function.

Medications

– Analgesics, such as acetaminophen (Tylenol) and topical creams with menthol or capsaicin, can help relieve pain.
– Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Advil) and naproxen sodium (Aleve), reduce pain and inflammation.
– Fulranumab, a new medication currently in clinical trials, is designed to alleviate pain.
– Stem cell therapy is being developed to introduce adult stem cells to damaged cartilage areas.
– For severe cases, opioids (e.g., Vicodin) or medical marijuana may be prescribed.

Non-Medication Treatments

Various supportive treatments include splints, heat/cold packs, braces, shoe inserts, assistive devices (such as canes), and paraffin wax dips.

Surgery and Medical Procedures

Surgical options include repairing damaged tendons in affected joints and joint replacement surgeries for advanced arthritis, particularly in knees and hips. Surgeons often recommend cessation of smoking to promote optimal healing post-surgery. For severe arthritis in fingers or wrists, joint fusion surgery may be performed. Cortisone shots can provide pain relief, while hyaluronic acid injections serve to cushion and alleviate pain in knees. Radiofrequency (RF) ablation reduces pain by using electric currents to heat targeted areas. Prolotherapy, which involves injecting irritating solutions to stimulate healing, and Platelet Rich Plasma (PRP) injections, are also options.

Physical Therapy

Exercises, including aquatic therapy, can strengthen muscles surrounding affected joints, improving range of motion. Stationary biking is particularly beneficial for knee and lumbar spine arthritis. Physical and occupational therapists can offer strategies to minimize joint strain during daily activities. Gentle movement therapies like yoga and tai chi promote flexibility and relaxation.

Diet

While diet typically plays a minor role in arthritis progression, certain supplements such as omega-3 fatty acids, glucosamine, and curcumin may have anti-inflammatory effects. Individuals with arthritis and celiac disease may experience increased joint pain from gluten-containing foods.

Prevention of Degenerative Arthritis

Although many arthritis types have a genetic component and cannot be prevented, joint injuries can be avoided through safety measures in daily activities. Preventing infections that could lead to arthritis is another strategy.

References

Constance R. Chu, Michael B. Millis, Steven A. Olson. “Osteoarthritis: From Palliation to Prevention.” J Bone Joint Surg Am. 2014;96(15):e130.
Yves Henrotin, Ali Mobasheri, Marc Marty. “Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis?” Arthritis Res Ther. 2012;14(1):201. doi: 10.1186/ar3657.
Sanga, N. Katz, E. Polverejan, S. Wang, K.M. Kelly, J. Haeussler, J. Thipphawong. “Efficacy, safety, and tolerability of fulranumab, an anti-nerve growth factor antibody, in the treatment of patients with moderate to severe osteoarthritis pain.” Pain. 2013;154(10):1910-1919. doi: 10.1016/j.pain.2013.05.051.