Osteoarthritis (OA) is the most common cause of joint pain. It is characterized by bony spur formation inside of the joint spaces and a loss of cartilage. In a normal, healthy spine there is cartilage in place to prevent neighboring bones from making contact. Osteoarthritis pain occurs when the cartilage is lost and bone spur formations are allowed to touch adjacent bones, causing significant inflammation and pain.
It is known that osteoarthritis is not just a result of aging, but also results from a combination of other factors including genetics, joint degeneration and other mechanical processes, although the cause of osteoarthritis is not clear.
Some of the symptoms that are often seen in patients with osteoarthritis include: limited range of motion, joint stiffness or swelling when not in use. Osteoarthritis pain is often felt within minutes of activity and can last for hours.
The joints that are most often affected by osteoarthritis include the hip, knee, thumb, distal interphalangeal joints (closest to fingertips) and in the neck and lower back (lumbosacral) regions. Getting older is the most common risk factor when it comes to osteoarthritis, but there are other factors to consider including joint instability, obesity, joint trauma, joint overuse or repetitive use.
Before a diagnosis is made, a doctor will thoroughly review a patient’s history and conduct a physical exam, paying close attention to range of motion, joint tenderness, deformity, joint enlargement, swelling and crepitus (cracking joints). Usually a diagnosis will not be made until radiological imaging can be studied to confirm the symptoms of osteoarthritis.
Pain relief can be achieved through a number of techniques depending on the patient’s progression of the disease and the severity of pain. Control of the pain and reduce to a minimum the disability is the main goal in treating osteoarthritis. Medications most commonly used in treating osteoarthritis are over the counter analgesics (pain relievers) and anti-inflammatory medication. In more advanced cases, opioids and a more selective anti-inflammatory medication can be prescribed.
Certain joints respond well to the injection of steroids and hyaluronic acid, alleviating pain for a short period of time. If osteoarthritis is allowed to progress, eventually surgery becomes the only treatment option. Some common surgeries for patients with osteoarthritis include: arthroscopy, joint replacement, or an osteotomy, which is bone being removed from the joint. There are always risks involved with surgery and it is wise to discuss options with a pain specialist. Ultimately the best treatment for osteoarthritis is to prevent it from progressing by making lifestyle changes, including diet and exercise.