Osteoarthritis is a rheumatic disease very frequent. Specifically, experts estimate that its prevalence is around 29.35% in those over 40 years of age. This means that about 7 million Spaniards suffer from this pathology.
Osteoarthritis is caused by an injury to the articular cartilage. This injury may be due to different factors, as explained by specialists from the Spanish Society of Rheumatology (SER).
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Genetic factors, previous trauma, infections, congenital malformations are some of the causes of osteoarthritis.
In addition, the incidence of so-called environmental factors must be taken into account, such as age, gender (women suffer it more), obesity, performing certain jobs and excessive physical exercise.
And the joint groups most affected are the hands, cervical spine, hips and knees.
Pain and loss of mobility
If there is something that characterizes osteoarthritis, it is pain. A pain that worsens when the patient over exerts himself, and that increases as the hours of the day go by.
Another of the most common symptoms is stiffness. That is, the patient feels difficulties when starting to move the joint after resting for a while. In addition, the joint creaks, can be deformed or swollen.
As a consequence of all these symptoms, the patient can gradually reduce their mobility, which can lead to muscle atrophy, muscle contractures, pain radiating to other parts of the body and even pinching of the nerves.
A disease that worsens the quality of life
The doctor Cristóbal Orellana Garrido rheumatologist at the Hospital Universitari Parc Taulí de Sabadel (Barcelona) explains that “the physical impact of osteoarthritis is derived from the functional limitation associated with joint involvement and pain, which is the main symptom of the disease.”
An impact that is variable since it depends on the joint or joints involved, their degree of involvement, the activity (for example, work) of the patient or comorbidities that affect the disease (for example, obesity) or treatment (contraindication for depending on which drugs).
“In any case, and in general terms, we can say that for most patients it has a significant impact, especially in those in advanced stages or without response to existing treatments,” explains the rheumatologist, for whom the emotional impact is also important. , «Derived, in part, from experiencing pain and functional limitation, but also in relation to the impact on daily life, be it at work or leisure, as well as the expectations of generating negatives that the population already has previously, as it is a chronic, progressive and degenerative disease “.
It will be all these symptoms that we have seen, together with the physical examination of the patient, which will clearly determine the diagnosis from the specialist in rheumatology.
If deemed convenient, some additional tests may be performed, such as X-rays or analysis of the fluid accumulated in the joints.
Treatment of osteoarthritis
For the specialists of the SER, the objective when dealing with osteoarthritis is clear: “to improve pain, delay the evolution of the disease and improve quality of life.”
And how? Well, rheumatologists have three types of ‘weapons’ to deal with osteoarthritis: physical measures, drugs and surgery.
Among the physical measures that can improve the quality of life of patients are:
Avoid obesity. This pathology not only increases the risk of having knee and hip osteoarthritis, but also favors its progression. So following a healthy and balanced diet, in addition to physical exercise are essential for the treatment.Practice physical exercise on a regular basis. Better if it is aerobic (walking, swimming, cycling). This will facilitate the control of the disease, prevent muscle atrophy and, of course, control excess weight.Apply local heat to the affected area.Use of splints, cane or insoles. These aids make it easier for the sore joint to rest.
In the pharmacological section, the most used drugs are paracetamol and anti-inflammatory drugs. Sometimes intra-articular corticosteroids are also used.
The SER specialists also include in the treatment with slow-acting drugs, also called SYSADOA (Symptomatic Slow Action Drugs for Osteoarthritis).
This type of medication, “in addition to controlling pain, helps preserve cartilage and slow down the progression of the disease,” explain the rheumatologists.
The last therapeutic option is surgery, used when the rest of the treatments fail to control the disease and the patient’s quality of life is severely affected.
The intervention may consist of a cleaning of the joint, or in its total or partial replacement. This last surgery, called arthroplasty, is usually performed on the knees and hips.
Neither take cartilage, nor live in hot climates
Rheumatologists also want to dismantle some myths about this pathology. In the first place, the experts from the Society of Rheumatology emphasize that “there are no special diets that improve osteoarthritis.”
There is also no scientific evidence that the consumption of cartilage derivatives improves or stops osteoarthritis.
Finally, there is the widespread belief that the best for a patient with osteoarthritis is living in hot climates. Well, experts point out that this type of climate “does not influence the disease in the long term, although it can temporarily improve symptoms.”
A disease with a great economic impact
«Due to the high prevalence in the population the economic impact of osteoarthritis is enormous, but this impact is not so much due to healthcare expenditure on drugs or even surgery in the case of prosthetic surgery, as in indirect expenses in terms of consumption of other resources (days off or hours not worked, temporary or permanent disabilities, health resources for dependency, etc.) “, says Dr. Cristóbal Orellana Garrido.
Likewise, the rheumatologist at the Hospital Universitari Parc Taulí de Sabadel (Barcelona) insists that “osteoarthritis is a disease whose prevalence increases with ageTherefore, the resources allocated to this pathology will only increase, given that we are in a society in which, on the one hand, life expectancy is greater and also with expectations of a life as complete in old age.
Present and future of osteoarthritis
As we have already seen, the basis of the treatment of osteoarthritis rests very especially in the modification of habits and lifestyle.
«It is of great importance that the population is aware of the general benefit of maintain a physical activity regular, and appropriate to the circumstances of each if you already have osteoarthritis in any location. Also very especially in the modification of known risk factors, both for the appearance and especially of the progression, as is the very remarkable case of obesity ”, points out Dr. Orellana.
For this expert, furthermore, it is essential to continue researching in order to obtain “more effective and at the same time well-tolerated treatments that, ideally, not only improve symptoms, but also prevent or modify the course of the disease.”
The doctor Francisco Castro Dominguez, of the Rheumatology Service of the Hospital Universitari Sagrat Cor de Barcelona insists that “osteoarthritis is the most frequent joint disease, and despite the great efforts of the national and international scientific community, it continues to be a disease that still has no cure or highly effective treatment with which a sustained remission or effective repair of joint damage caused by the disease can be achieved.