What are "biologic" processes in osteoarthritis?
Cartilage undergoes a normal cycle of breakdown and repair, but in the condition of osteoarthritis, the cartilage is not replaced effectively, and ultimately the joint lining wears thin. The fundamental problem of osteoarthritis is thought to be the imbalance between fresh cartilage production, and natural degradation.
As the joint surface wears away, the body attempts to correct the problem. Your body will initiate an inflammatory response to the joint, causing swelling. New bone in the form of bone spurs are created to increase the joint surface area. Unfortunately, your body cannot compensate for the cartilage that is lost, and the painful condition of osteoarthritis is the result.
How does this understanding of osteoarthritis impact treatment?
Treatments for osteoarthritis are directed at controlling the inflammatory response and maximizing your body's ability to compensate for the damaged joint.
Some of the treatments aimed at controlling this inflammation from osteoarthritis are:
- Anti-Inflammatory Medications
Anti-inflammatory medications, also called NSAIDs, are oral medications that help control the cycle of inflammation. These medications are sold under the trade names Motrin, Naprosyn, Celebrex, and others. These medications help decrease the inflammatory process and also help reduce pain.
- Cortisone Injections
Cortisone injections also help to control inflammation. Cortisone is a substance that is naturally produced in your body by the adrenal gland. An injection of synthetic cortisone can be helpful at providing a very high does of anti-inflammatory medication directly to the affected joint.
Absolutely! There are several treatments that many patients find very helpful and can help to control the symptoms of osteoarthritis without having to consider surgery:
- Physical Therapy
Physical therapy is used to strengthen the muscles around the joint affected by osteoarthritis. By doing so, the muscles can support more of the forces around the joint, placing less of a burden on the cartilage and bone.
- Weight Loss
Weight loss if often very difficult, but it can be the most effective step in controlling the pain associated with arthritis. Weight loss decreases the burden the joint must carry, especially with the hips, knees, and feet. Patients with osteoarthritis of the lower extremity who are able to lose weight almost always have symptoms relief.
- Activity Modification
Limiting certain activities may be necessary, and learning new exercise methods may be helpful. Aquatic exercise is an excellent option for patients who have difficulty exercising.
The effect of changing diet is not well understood, but it is known that obesity is a risk factor for developing osteoarthritis, and when people with osteoarthritis loose weight they experience significant improvement of clinical symptoms.
Specific diets have been studied, but little has been proven. In small studies, antioxidants have been shown to decrease the progression of osteoarthritis, but they have not been proven in longer studies, and they have not been shown to change the overall incidence of osteoarthritis. Vitamin D has also been shown to decrease progression of osteoarthritis. These data suggest that diet may be important in preventing progression of the disease, but other factors may be more important in primary prevention.
Read on for more information about research into new treatments for osteoarthritis...