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According to the definition, osteoarthritis is a disease of wear and tear of the joints: The ancient Greek word "arthron" means "joint" and the ending "ose" refers to degenerative changes in medicine. The joint wear and tear, in which the cartilage layer of a joint gradually disappears, is accompanied by painful inflammation. Usually the knee, hip and finger joints are affected. In the late stage, the mobility of the joints is limited.
Osteoarthritis stages
Osteoarthritis develops over years and is initially harmless. If
patients are in pain, they are usually at an advanced stage. Depending on
how far the joint wear has progressed, doctors divide osteoarthritis into
different stages:
- Early
stage: osteoarthritis
begins with a small, superficial cartilage damage. The cartilage is
thickened and the synovial membrane is sometimes irritated. The
patients usually do not have pain here, but changes have already occurred
in the joint.
- Intermediate
stage: The
cartilage damage has increased, the cartilage surface is fraying. The
bone changes, making the joint space appear smaller. The affected
person feels the first movement restrictions. How long this
intermediate stage lasts varies from person to person. It usually takes
years for osteoarthritis to reach the late stage.
- Late
stage: the
cartilage layer is broken down. Now bone rubs on bone in the joint,
which is very painful for the person concerned and can be clearly
seen in the X-ray image . The joint can
stiffen and appear thicker because the body forms bony extensions.
Osteoarthritis forms
Depending on which joint is affected, doctors differentiate between different types of
osteoarthritis. Arthrosis in the knee is called gonarthrosis in technical jargon , while coxarthrosis is hip arthrosis. Patients often
have osteoarthritis in the joints of the hand, usually the fingers and
thumbs. Wrist arthrosis, i.e. joint wear and tear between the carpal bones
and the forearm, is abbreviated to STT arthrosis - the abbreviation stands for
"Scapho-Trapezo-Trapezoidal Arthrosis".
Ultimately,
joint wear and tear can occur wherever two or more bones are connected:
there is osteoarthritis in the ankle, shoulder and foot as well as in the big
toe. Osteoarthritis can even affect the spine, for example on the SI
joint, the sacroiliac joint that connects the pelvis and spine.
Osteoarthritis or
arthritis?
Even if many think so: osteoarthritis and arthritis are not the
same thing. Although both diseases affect the joints and have similar
symptoms, the cause is not the same:
- Arthrosis: The disease describes
the - often age-related - joint wear and tear that occurs after years of
excessive or incorrect loading. Those affected mainly experience pain
when moving.
- Arthritis: This is an inflammation
of the joint caused by pathogens or an autoimmune disease such as rheumatism . Young people
can also have arthritis. The pain occurs at rest and increases with
movement.
How to recognize
symptoms of joint inflammation and how doctors treat your arthritis.
Osteoarthritis:
symptoms
The signs of osteoarthritis are clearer the further the wear and tear of
the joint has progressed. At first, those affected have no symptoms, but
over time the typical pain sets in -
especially when the joint is moved. Movement often causes noticeable and
audible noises in the joint. In the late stage, pain on exercise is
accompanied by persistent pain at rest. In addition to the joint pain that the
disease causes, those affected report a certain joint stiffness.
Over time, the affected joints change; they get thicker or change
position. When overloaded, they can become inflamed, swollen and warm to
the touch.
Arthrosis: An X-ray
shows the extent of the joint changes in the fingers. This cannot always
be transferred one-to-one to the complaints - sometimes patients do not feel
any pain despite high wear and tear
Osteoarthritis:
causes
In the case of osteoarthritis , the cartilage layer
that protects the ends of the bones in the area of the joints wears
off. If a joint is stressed too much or incorrectly over a long period of
time, this accelerates the natural, age-related wear of the cartilage
surface. The body cannot repair or rebuild cartilage. Cartilage
damage, once present, is irreversible.
The most common risk factors for cartilage loss in osteoarthritis are:
- increasing
age
- orthopedic
misalignments such as knock knees or bow legs
- Obesity
- Physical
work overload
- Overload
from competitive sport
- previous
injuries such as torn ligaments or broken bones
- Conditions
like gout
Osteoarthritis:
treatment
There is no remedy for osteoarthritis that combats the causes of the
disease. Doctors cannot cure joint wear and tear because new cartilage
cannot form. However, it is possible to alleviate symptoms and slow the progression of the
disease . Depending on how pronounced the damage in the joint is,
there are different treatment options. Doctors differentiate between
conservative and surgical measures.
These conservative treatment methods relieve
pain, dampen inflammation and prevent incorrect stress:
- Exercise
(swimming, hiking, Nordic walking, cycling)
- Weight
reduction (until a normal body weight is achieved)
- Physiotherapy
(to compensate for misalignments)
- Warmth
(baths, infrared light, mud, mud packs)
- Medicines
(pain gel or ointment, anti-inflammatory and pain relievers in the form of
tablets or syringes)
- Aids
(orthotics, insoles, bandages, walking aids)
At a late stage, when conservative treatment methods no longer
help, surgery can relieve the symptoms of
osteoarthritis. For example, to treat osteoarthritis of the knee, it is
possible to rinse the joint on the operating table and smooth the
cartilage. Doctors call this lavage and debridement. In the case of
misalignments, it is possible to correct the joint position surgically and thus
to shift the load.
There are also ideas to stimulate the remaining cartilage cells to grow
or to bring new cells into the joint. However, these methods are still
being tested in the research laboratory.
If none of this helps, the only option left for
those affected in the late stage is joint replacement in
the operating room. Doctors replace the destroyed joint with a so-called
endoprosthesis, an artificial joint. In 2016, 137,295 people in Germany
received a “new hip” and 107,892 a “new knee”. This means that hip
operations in joint replacement make up the largest proportion of interventions
at 56 percent.
In a global comparison of the implantation of artificial hip joints,
Germany ranks second behind Switzerland - with almost 300 hip joint operations
per 100,000 inhabitants per year.
Medicines for
osteoarthritis
Osteoarthritis is still not curable today. Treatment consists of
relieving symptoms and slowing the progression of joint wear as much as
possible. Various medications, such as ointments or tablets and capsules
with pain relievers , help to combat pain and keep
inflammation at bay . Doctors recommend paracetamol,
ibuprofen or acetylsalicylic acid as suitable active ingredients.
Injections with cortisone, administered directly into the joint, dampen
the inflammatory reaction; those with hyaluronic acid are supposed to restore
mobility. However, there is no clear evidence that the latter work.
Alternative medicine
for osteoarthritis
In addition to conventional medical treatment, many patients rely on
alternative medicine, such as globules from
homeopathy, in the treatment of osteoarthritis . Their
effectiveness has not been adequately proven, but most alternative approaches
also have no side effects, so that they can be used safely. For example,
certain Schüßler salts from alternative medicine are
considered useful in osteoarthritis, even if they are not part of the
conventional medical guidelines.
Home remedies for
osteoarthritis
Where medicine has no medication, no home remedies help - at least not
to cure osteoarthritis. However, patients with osteoarthritis can use home
remedies to alleviate the symptoms: cooling quark compresses or warm heating
pads are beneficial for acute complaints. It has not been scientifically
proven that certain spices such as turmeric help against osteoarthritis.
Few studies suggest that rose hips could help relieve symptoms of
osteoarthritis. Rose hip powder has anti-inflammatory and
cartilage-protecting (antioxidant) effects similar to synthetic
anti-inflammatory agents. Overall, previous studies have not conclusively
proven that rose hip powder has an effect against osteoarthritis and can
relieve pain (further studies with more participants are necessary for this),
which is why experts classify it as "moderately effective" against
osteoarthritis.