Osteoarthritis (Degenerative, Hypertrophic Arthritis)
Osteoarthritis usually develops gradually in the latter half of life. It is a part of the aging process of the people afflicted with it. Impaired circulation is possibly a causative factor; and improvement of the circulation in general, as well as in the joints, is one aim in treatment. The condition shows a hereditary tendency; but injuries, excessive body weight, and overexertion that brings increased pressure on the joint cartilages also have a causative influence. The joints of the spine, hips, knees, and fingers are most commonly affected.
Osteoarthritis is a thinning or degeneration of cartilage and degeneration of bone in some parts of the joint, but an overproduction of bony tissue in other parts. It is this overproduction, a prominent feature of the disease, that gave origin to the name "hypertrophic arthritis." It takes the form of "spurring" or "lipping" around the joint margins. It may reduce the range of joint motion, or in time prevent motion entirely; but usually the bones do not actually grow together, even when the vertebrae are involved. The joint may be irregularly enlarged, but it is rarely inflamed. Many severe cases may go on for years without any symptoms except limitation of motion. Attacks of pain are usually brought on by sudden strain, injury, or a direct blow.
The X ray easily shows the abnormal bony growth in Osteoarthritis; and when this disease affects the spine, it is often discovered by chance while an X ray of the chest or abdomen is being taken. A surprising degree of Osteoarthritis, even in the spine, may exist without causing distress; but bony overgrowths along the posterior margins of the vertebrae may press on nerve trunks - one of the causes of sciatica in elderly people. Much can be done through physical therapy and/or orthopedic surgery to relieve distress and restore activity for the osteoarthritic individual, but there is no real cure.
Osteoarthritis (Degenerative, Hypertrophic Arthritis) Treatment And Prevention
- Attention should be given to the patient's mental attitudes. Though still young, he may fear he has passed the prime of life. He thinks his symptoms mean he is approaching old age. He resents this and disregards the symptoms as much as he can, trying to keep up his usual pace of activities. He needs help in becoming willing to establish a new pattern of life consistent with his reduced capacities. Following such a pattern will enable him to prolong his period of productive usefulness, even to the normal lifespan.
- If the joints are painful, apply dry heat in any form for half an hour or more at least three times a day.
- Avoid injury to the involved joints, and avoid bending them far enough to cause pain; but correct faulty posture as far as possible. Give massage and passive exercise with caution, taking care not to cause pain. In some cases splints or casts may be needed to prevent pain-producing motion.
- Avoid fatigue and overexertion, especially in activities that involve the affected joints.
- If overweight, reduce the weight to normal.
- If the joints of the lower spine and hips are involved, lying down for more hours of the day than usual may help bring relief by taking pressure off the affected joint surfaces.
- Pay attention .to all habits that influence the general health, including such correction of posture as will improve body mechanics, also such exercise as will increase muscle power.
- The use of appropriate drugs helps to relieve symptoms but does not alter the course of the disease. The most commonly used drug, the least hazardous, and the cheapest is aspirin. It should not be used indiscriminately, however. It is most effective in doses (for an adult) of 0.6 to 0.9 grams (10 to 15 grains) taken four times a day: after each meal and with milk at bedtime. Taking the medicine after meals or with milk reduces aspirin's irritating effect on the mucosal lining of the stomach. The doctor should check periodically for possible side effects of aspirin use. Some physicians prefer to prescribe more potent drugs, but these carry greater risk of side effects and must be more carefully supervised.