Artrhrosis

Symptoms

The most common manifestation is pain that improves with rest, stiffness when initiating movement, deformities, and difficulty moving the affected joints. There can be a certain degree of inflammation, which will cause swelling due to the excessive accumulation of liquid in the joint.

However, it must be differentiated from arthritis, which is a rheumatic inflammatory disease rooted in joint inflammation that can cause pain which does not improve with rest. Arthrosis is often also called osteoarthritis, which can create some confusion.

Prevalence

This disease is very prevalent and has a high social and health impact. The EPISER2016 study, by the Spanish Society of Rheumatology, showed that the prevalence in the population over 40 years of age is 29%.

Causes

Age is the main risk factor. It is more frequent in women. A deterioration of the cartilage is clearly associated with obesity and a lack of regular physical exercise. A misaligned joint or poor posture can also be predisposing factors. Sometimes the cause is a traumatic injury or previous disorder of the affected joint. It has a genetic component (especially arthrosis of the hands).

Diagnosis

A diagnosis is obtained by looking at the symptoms, physical examination, and the imaging tests.

Treatment

Treatment for this disease is aimed at improving symptoms and quality of life for patients while slowing down its clinical evolution. A treatment plan must be individually prepared for each patient and type of joint.

Non-pharmaceutical treatment is essential. We recommend:

• Educating patients on healthcare and how to acquire new self-care habits.
• Following a balanced diet and maintaining a correct weight.
• Regularly doing physical exercise. We recommend activities that do not require overloading the joints, such as walking (on normal surfaces), swimming, cycling, tai chi, etc. It is important to do exercises to strengthen the muscles and improve one's posture.
• A cane or other physical support may be necessary, especially when a patient has arthrosis of the knee or hip.  There are also braces, for example for the hands, that improve functionality.
• Applying heat and cold locally using different methods (electric pillows, paraffin baths with hot water for the hands, ultrasound, etc.) can help.
• Using proper footwear will reduce pain and increase mobility.

Pharmacological treatment normally consists of conventional pain relievers such as paracetamol, which is the analgesic treatment of choice. There are slow-acting treatments, such as chondroitin sulphate (taken orally) or hyaluronic acid (given as an injection), which can improve pain, especially in arthrosis of the knees.  Surgery (joint replacement) is reserved for cases in which the joint is destroyed and other measures have failed.