Living With Wear-and-Tear Arthritis

By Ghufran Alghafli, PharmD Candidate Class of 2021
The University of Kansas School of Pharmacy

March 15, 2021

Osteoarthritis 2021

Did you know Osteoarthritis (OA) is the most common form of arthritis? Osteoarthritis can be broken down into two groups: primary OA, which has no known cause, and secondary OA, which is caused by conditions such as joint injury and obesity.

Osteoarthritis, also known as wear-and-tear arthritis, occurs when the protective cartilage, a type of connective tissue, breaks down and as a result, the bones within the joints rub together. Patients diagnosed with OA may experience a variety of symptoms but most common is pain, swelling, loss of flexibility, and stiffness.

Who is at Risk for Osteoarthritis?

Osteoarthritis affects over 32.5 million US adults. So, what factors put you at greater risk for developing OA? Age is the biggest risk factor and here is why. It affects older people because as we age, we become more fragile and with advancing age, there is a decline in muscle mass and bone reformation which puts you at greater risk for developing OA, women are another big risk factor (women more likely to be diagnosed with OA), occupation plays a factor especially if it involves high usage of joints, family history (genetics), joint injury, diabetes, and obesity. Why is weight a risk factor? Being obese adds more weight to your knees which can result in osteoarthritis pain.

How Can You Manage OA?

You have probably heard OA does not have a cure and that is correct, but treatment often helps relieve your symptoms. It is a degenerative disease that worsens over time, so treatment is usually focused on the patient’s signs and symptoms and reducing pain. Some non-drug treatments include lifestyle changes such as weight management and exercises. Losing weight will reduce the pressure off your joints reducing pain. Other examples include foot orthoses, physical therapy, crutches, occupational therapy, and educational workshops to help improve adherence. Educating yourself on this disease state is very important as it allows you to set goals for yourself, for example setting an exercise schedule, and understanding the disease state allows you to limit activities that reduces OA pain.

Pharmacologic Therapy of OA

Medications can also be used in patients who have failed non-drug treatment and should only be used when symptoms are present. It is best to target OA by location of joint and number of joints involved. Acetaminophen is the first line drug treatment for OA.

Topical NSAIDs (diclofenac gel) have similar efficacy as oral NSAIDs when there are one or few joints (knee/hand) involved. The lowest effective dose of oral NSAIDs should be used when treating multiple joints, knee, or hip pain. Ibuprofen and Naproxen have been widely used in OA patients. Duloxetine can also be used to help reduce OA pain.

Osteoarthritis is a disease that worsens over time which is why understanding this disease state is important. This allows you to set goals for yourself and slow down the progression. Going to doctor’s appointments on time and following a healthy lifestyle can make daily tasks easier and improve your quality of life.

References:

Abramoff B, Caldera FE. Osteoarthritis: Pathology, Diagnosis, and Treatment Options. Med Clin North Am. 2020 Mar;104(2):293-311. doi: 10.1016/j.mcna.2019.10.007. Epub 2019 Dec 18. PMID: 32035570

“Osteoarthritis (OA).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 27 July 2020, www.cdc.gov/arthritis/basics/osteoarthritis.htm

O'Brien MS, McDougall JJ. Age and frailty as risk factors for the development of osteoarthritis. Mech Ageing Dev. 2019 Jun;180:21-28. doi: 10.1016/j.mad.2019.03.003. Epub 2019 Mar 18. PMID: 30898635

 

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