Osteoarthritis Facts - What is Osteoarthritis?

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Osteoarthritis Facts - What is Osteoarthritis?

22 Jul 2005

What is Osteoarthritis?

Osteoarthritis is a chronic condition in which tissue known as

cartilage breaks down. When this tissue deteriorates, it leaves the

bones to rub against each other, causing pain and stiffness. If you

have osteoarthritis, you've probably heard something like this

definition from your doctor. The disease may also be referred to as

osteoarthritis, degenerative joint disease or degenerative arthritis.

Normal Joint Osteoarthritis

In general terms, osteoarthritis is considered to be a chronic

condition. It is important to make the distinction between chronic and

acute conditions. Illnesses such as a cold or the flu are acute

conditions, because they have a clear beginning and end as well as a

specific cause, such as a virus. These illnesses can be diagnosed with

special tests, and many of the most common ones can be treated with

drugs or medical procedures. Chronic conditions like osteoarthritis, on

the other hand, often last for several years or even a lifetime. All of

the causes of osteoarthritis aren't yet known, so there may be no

single, simple treatment. In fact, treatment for osteoarthritis may

require a variety of medications and other measures, and these may

change over time. Because this disease is long-lasting and can affect

your day-to-day life for years, it is crucial that you take an active

role in managing it. You can make a difference in how you feel by

monitoring your symptoms, following your treatment plan, and dealing

with the daily challenges the condition brings.

What Causes Osteoarthritis?

Like other chronic conditions, osteoarthritis has no single, specific

cause. Instead, there are several factors involved in the disease,

including heredity and lifestyle. It may take a combination of these

factors to eventually result in osteoarthritis.

Heredity - Scientists believe that in osteoarthritis, as in many other

diseases and conditions, heredity may play a role in the disease.

Researchers are studying several genes that may be connected to

osteoarthritis. The outcomes of these studies may help predict who is

most likely to get the disease.

Obesity - You probably already know that being overweight puts you at

risk for heart disease and certain types of cancer, but it can also

have a profound effect on your joints. The reason is that your major

joints, such as knees and hips, already bear the brunt of your body's

weight as you move through normal daily activities. Being overweight

puts even more pressure on these joints. Injury and overuse of joints -

Sometimes repetitious movements or serious injuries to joints can lead

to osteoarthritis years later. Some full-time athletes, for example,

may injure the same joints over and over again, causing damage to the

joints, tendons and ligaments that speeds up cartilage breakdown.

What are the Different Types of Arthritis?

There are more than 100 different types of arthritis and related

diseases. It is important to know which type of arthritis you have so

you can treat it properly. If you don't know which type you have, call

your doctor or ask during your next visit.

Osteoarthritis - The most common type of arthritis is osteoarthritis,

or OA. OA affects about 21 million Americans. OA is sometimes called

degenerative arthritis because it is caused by the breakdown of

cartilage and bones, causing pain and stiffness. OA usually affects the

fingers and weight-bearing joints, including the knees, hips, back and

neck. It affects both men and women and usually occurs after age 45.

Rheumatoid Arthritis

In rheumatoid arthritis, or RA, an abnormality in the body's immune

system causes inflammation of the joints. Inflammation begins in the

joint lining, or the synovium, and over time leads to damage of both

cartilage and bone. Rheumatoid arthritis often affects the same joints

on both sides of the body. RA affects about 2.1 million Americans and

is more common in women than in men. Fibromyalgia - Fibromyalgia is a

disease that causes widespread pain and distinct tender points, which

are places on the body that are highly sensitive to touch and produce

pain. People with fibromyalgia usually have fatigue, disturbed sleep

and stiffness. Fibromyalgia is a common condition that usually affects

women and it does not cause muscle or joint damage.

Lupus

Lupus is a disease that affects the skin and joints. In some people,

lupus also affects the internal organs such as the kidneys, lungs or

heart. Lupus affects women about eight to 10 times more often than men.

Symptoms often first appear in women between ages 18 and 45. Some of

the more common symptoms include a rash over the cheeks and across the

bridge of the nose; scaly, disc-shaped sores on the face, neck and/or

chest; abnormal sun sensitivity; kidney problems; and forms of

arthritis.

Bursitis and Tendinitis

Bursitis and tendinitis are caused by irritation from injuring or

overusing a joint. Bursitis affects a small sac called the bursa that

helps to cushion the muscles and tendons surrounding the joint.

Tendinitis affects the tendons that attach muscle to bone.

Other common forms of arthritis and related conditions include:

• Polymyalgia Rheumatica

• Psoriatic Arthritis

• Ankylosing Spondylitis

• Juvenile Rheumatoid Arthritis

• Gout

• Vasculitis

• Scleroderma

How is Osteoarthritis Different?

In osteoarthritis, the cartilage begins to break down, usually

gradually. As the cartilage wears away, the bones become exposed and

rub against each other, which leads to pain. The deterioration of

cartilage also affects the shape and makeup of the whole joint, so that

it no longer functions smoothly. You may notice a limp when you walk,

or you may have trouble going up and down stairs. This deterioration

puts additional stress on the joint as it moves. Other problems can

occur inside the joint as cartilage breakdown affects the joint

components. Fragments of bone or cartilage may float in the joint

fluid, causing irritation and pain. Bony spurs or osteophytes can

develop on the ends of the bones. Fluid inside the joint may not have

enough of a substance called hyaluronan, which may affect the joint's

ability to absorb shock. And although inflammation is not a main

symptom of osteoarthritis, it can occur in the joint lining in response

to the breakdown of cartilage.

Treatment Plan and New Developments

For some people who suffer from pain associated with arthritis, their

symptoms can be managed with exercise, heat/cold therapy, joint

protection, assistive devices, weight control, or in some severe cases,

surgery. For others, medications are needed to help manage the symptoms

associated with arthritis.

COX-2 inhibitors

COX-2 inhibitors are the newest members of the NSAID class of

medications. Available by prescription only, they became widely used in

recent years to reduce joint pain and swelling. COX-2 inhibitors work

by selectively blocking, or inhibiting, one of the two enzymes

associated with inflammation. Some experts have hypothesized that this

selective inhibition may be the reason for the negative cardiovascular

effects currently associated with COX-2 inhibitors.

Non-selective NSAIDs

Non-selective NSAIDs were developed earlier than COX-2 inhibitors and

have been widely used to relieve arthritis pain and inflammation for

many years. Unlike COX-2 inhibitors, non-selective NSAIDs inhibit both

major enzymes involved in the inflammatory process, COX-1 and COX-2.

The non-selective NSAID category includes a number of different

medications that are available in both prescription and

over-the-counter (OTC) products.

However, recent controversy about the safety of pain medications for

arthritis has left patients and health care professionals alike

uncertain about which medications are safe to use. In fact, a recent

survey by the Boston-based Rippe Lifestyle Institute indicated that

many people with arthritis are suffering unnecessarily because they

have stopped or reduced their use of pain relievers due to confusion

about which drugs are considered safe.

To clarify the confusion around recent news about arthritis

medications, here are some facts:

On April 7, 2005, the FDA announced the following:

• Bextra, a COX-2 inhibitor manufactured by Pfizer, was being

voluntarily withdrawn from the market.

• All prescription NSAIDs must revise their labeling to include a

“black box” warning that highlights the potential increased risk for

cardiovascular (CV) events as well as the potentially life threatening

gastrointestinal (GI) bleeding associated with these drugs. Celebrex,

the only COX-2 inhibitor remaining on the US market, was included in

this directive.

• All OTC NSAIDs (except aspirin) will be required to revise their

labeling to include more specific information about the potential for

GI and CV side effects, a stronger reminder to follow label

instructions, as well as a warning about potential skin reactions.

To further evaluate the potential for increased CV risk, the FDA also

announced that all NSAIDs must conduct and submit to the Agency a

comprehensive review and analysis of pertinent safety data from

clinical trials.

The FDA emphasized that when label directions are followed, OTC pain

relievers such as Aleve (naproxen sodium) provide a safe and effective

way to treat mild to moderate pain of minor arthritis. If patients have

questions, they should consult their health care professional about

which treatment option is most appropriate.

More Information

For more information about osteoarthritis, and living with it, visit

the ALEVE website at http://www.aleve.com. ALEVE is an over-the-counter

(OTC) pain reliever that provides relief for a variety of pain

conditions, including minor pains associated with arthritis.

The above information from What is Osteoarthritis?, What Causes

Osteoarthritis?, What are the Different Types of Arthritis?, and How is

Osteoarthritis Different? has been excerpted from The Arthritis

Foundation's Guide to Good Living with Osteoarthritis, copyright ©2000,

Arthritis Foundation. For more information about this book and other

resources about osteoarthritis, call (800) 283-7800.

http://www.arthritis.org

http://www.medicalnewstoday.com/medicalnews.php?newsid=27871