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Osteoarthritis

Osteoarthritis (OA) is a type of joint disease that results from breakdown of joint cartilage and underlying bone. The most common symptoms are joint pain and stiffness. Initially, symptoms may occur only following exercise, but over time may become constant. Other symptoms may include joint swelling, decreased range of motion, and, when the back is affected, weakness or numbness of the arms and legs. The most commonly involved joints are those near the ends of the fingers, at the base of the thumb, neck, lower back, knee, and hips. Joints on one side of the body are often more affected than those on the other. Usually the symptoms come on over years. It can affect work and normal daily activities. Unlike other types of arthritis, only the joints are typically affected.

Causes include previous joint injury, abnormal joint or limb development, and inherited factors. Risk is greater in those who are overweight, have one leg of a different length, and have jobs that result in high levels of joint stress. Osteoarthritis is believed to be caused by mechanical stress on the joint and low grade inflammatory processes. It develops as cartilage is lost and the underlying bone becomes affected. As pain may make it difficult to exercise, muscle loss may occur. Diagnosis is typically based on signs and symptoms, with medical imaging and other tests occasionally used to either support or rule out other problems. In contrast to rheumatoid arthritis, which is primarily an inflammatory condition, in osteoarthritis, the joints do not typically become hot or red.

Treatment includes exercise, efforts to decrease joint stress, support groups, and pain medications. Efforts to decrease joint stress include resting and the use of a cane. Weight loss may help in those who are overweight. Pain medications may include paracetamol (acetaminophen) as well as NSAIDs such as naproxen or ibuprofen. Long-term opioid use is generally discouraged due to lack of information on benefits as well as risks of addiction and other side effects. If pain interferes with normal life despite other treatments, joint replacement surgery may help. An artificial joint typically lasts 10 to 15 years.

Osteoarthritis is the most common form of arthritis, affecting about 237 million (3.3% of the population). Among those over 60 years old, about 10% of males and 18% of females are affected. It is the cause of about 2% of years lived with disability. In Australia, about 1.9 million people are affected, and in the United States, 30 to 53 million people are affected. It becomes more common in both sexes as people become older.

  • The efficacy of Brazilian black mud treatment in chronic experimental arthritis.

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    Abstract Title:

    The efficacy of Brazilian black mud treatment in chronic experimental arthritis.

    Abstract Source:

    Rheumatol Int. 2007 Nov;28(1):39-45. Epub 2007 Jun 12. PMID: 17562044

    Abstract Author(s):

    Zélia Maria Nogueira Britschka, Walcy Rosolia Teodoro, Ana Paula Pereira Velosa, Suzana Beatriz Veríssimo de Mello

    Article Affiliation:

    Department of Internal Medicine, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, São Paulo 0124-6903, SP, Brazil.

    Abstract:

    Studies have demonstrated the beneficial effects of fangotherapy on relieve of pain improving function of rheumatic patients. Herein, we investigated the effect of Brazilian black mud in protect articular damage in chronic arthritis induced in rats. Mud was daily applied (40 degrees C/30 min) during the course of arthritis and was compared with warm water and no treated groups. At 21th day after arthritis induction synovial fluid and membrane were analyzed regarding cellular influx, hyperplasia and vascular proliferation. Cartilage structure, cell count, proteoglycan and collagen amount were also analyzed by three pathologists blinded to the treatment. Mud treatment diminished leukocyte migration into the synovial membrane and articular cavity when compared with both control groups. Regarding cartilage, an increase in collagen, number of chondrocytes and more conserved tissue structure was observed in mud-treated animals. These results demonstrate a protective effect of Brazilian mud on this model of arthritis, suggesting that this therapy may be useful as a complementary approach to treat articular diseases.

  • Treatment of Osteoarthritis With Low-level Laser Therapy, Acupuncture, and Herbal Therapy: A Case Report. 📎

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    Abstract Title:

    Treatment of Osteoarthritis With Low-level Laser Therapy, Acupuncture, and Herbal Therapy: A Case Report.

    Abstract Source:

    Integr Med (Encinitas). 2018 Apr ;17(2):48-53. PMID: 30962785

    Abstract Author(s):

    Adam Dombrowski, Krista Imre, Michelle Yan, Paul Kalnins, Laura Gouge, Daniel Silver, Heather Zwickey

    Article Affiliation:

    Adam Dombrowski

    Abstract:

    Osteoarthritis is a challenging diagnosis to navigate and treat. Management options range from nonpharmacological agents to surgical repair. No specific combination of therapies has yet been identified for optimal management although a variety of therapeutic options have been studied. This case report details the use of low-level laser therapy, acupuncture, and herbal medicine in a 64-y-old female with radiographically confirmed osteoarthritis. Near-complete resolution of her symptoms was associated with the multiple therapies outlined in this case report.

  • Upper cervical manipulation combined with mobilization for the treatment of atlantoaxial osteoarthritis: a report of 10 cases.

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    Abstract Title:

    Upper cervical manipulation combined with mobilization for the treatment of atlantoaxial osteoarthritis: a report of 10 cases.

    Abstract Source:

    J Manipulative Physiol Ther. 2011 Feb ;34(2):131-7. PMID: 21334546

    Abstract Author(s):

    Hong Yu, Shuxun Hou, Wenwen Wu, Xiaohua He

    Article Affiliation:

    Department of Orthopedics, The 1st Affiliated Hospital of the General Military Hospital, Beijing, China.

    Abstract:

    OBJECTIVE:This study presents the outcomes of patients with idiopathic degenerative and posttraumatic atlantoaxial osteoarthritis who were treated with upper cervical manipulation in combination with mobilization device therapy.

    CLINICAL FEATURES:A retrospective case review of 10 patients who were diagnosed with either degenerative or posttraumatic atlantoaxial arthritis based on histories, clinical symptoms, physical examination, and radiographic presentations was conducted at a multidisciplinary integrated clinic that used both chiropractic and orthopedic services. All 10 patients selected for this series were treated with a combination of upper cervical manipulation and mechanical mobilization device therapy. Outcome measures were collected at baseline and at the end of the treatment period. Assessments were measured using patients' self-report of pain using a numeric pain scale (NPS), physical examination, and radiologic changes. Average premanipulative NPS was 8.6 (range, 7-10), which was improved to a mean NPS of 2.6 (range, 0-7) at posttreatment follow-up. Mean rotation of C1-C2 at the end of treatment was improved from 28° (±3.1) to 52° (±4.5). Restoration of joint space was observed in 6 patients. Overall clinical improvement was described as "good" or "excellent" in about 80% of patients. Clinical improvements in pain and range of motion were seen in 80% and 90% of patients, respectively.

    CONCLUSION:Chiropractic management of atlantoaxial osteoarthritis yielded favorable outcomes for these 10 patients.