Osteoarthritis

Also known as degenerative joint disease or wear and tear arthritis, osteoarthritis is the most prevalent type of arthritis. The cartilage (a protein substance present in all joints, this substance serves as a cushion in between the bones) in the joints deteriorates over time thus leading to osteoarthritis. Generally women are more at risk of osteoarthritis when compared to men.

Osteoarthritis can affect any joint in the body but it largely affects the joints of the hips, feet, knees, spine and hands. The weight bearing joints get affected the most due to osteoarthritis. Usually a single joint is affected due to osteoarthritis but if osteoarthritis sets in the finger joints, it can affect more than one joint at the same time.

Causes for osteoarthritis

Protein content of the cartilage drops and water content increases with age. This will degenerate the cartilage thus causing osteoarthritis. Increased mechanical stress on the joints due to obesity can cause osteoarthritis. The knee joint, in particular, unable to take the excess weight will degenerate thus leading to osteoarthritis. People who are born with abnormally shaped joints risk osteoarthritis as their joints are put to undue stress thus causing early deterioration. Any external injury can cause degeneration of the joints thus leading to osteoarthritis. In rare cases heredity can be a cause for osteoporosis.

Symptoms of osteoarthritis

Symptoms for osteoarthritis vary from person to person depending on the severity of the problem. The most commonly prevalent symptoms for osteoarthritis are:

• Tenderness/softness of the joints even when light pressure is applied to the joint.
  
• Creaking/annoying feeling in the joint.
  
• Warmth in the joint.
  
• Fluid retention in few cases.
  
• Pain in the joint while using the joint, after use of the joint or after a prolonged period of rest of the joint.
  
• Bone spurs in the form of lumps occur in the joint.
  
• Reduced flexibility of the joint.
  
• Swelling of the affected joint.
  
• Stiffness of the joint, particularly in the mornings while you get out of the bed and after a prolonged period of rest.
  

Diagnosis of osteoarthritis

An x-ray can reveal the extent to which the joint is affected, be it bone spurs and narrowing of the joints. Arthroscopy and Arthrocentesis may be done. Fluid from the joint is drawn using a long sterile needle. This fluid is analyzed for determining the cause for the pain.

Treatment for osteoarthritis

Rest can help the joints recover to a great extent. Reducing weight can help relieve the strain on the joints thus reducing pain. Applying heat and cold packs alternately on the affected joint can relieve pain to a certain extent. Physical therapy can strengthen the muscles around the joints thus reducing the pain. Physical therapy also improves the mobility of the joint. Exercises can help relieve pain; but ensure that you are under supervision by a trained person. Support device like splints, braces, walkers, canes etc can offer extra support for the affected joint. For patients suffering from acute osteoarthritis, surgery is the final respite. Surgery is particularly helpful for patients who have not responded to any of the above mentioned treatments.

Adhesive capsulitis

Adhesive capsulitis is a condition associated with the shoulder. It is also known as frozen shoulder. The indications for the onset of adhesive capsulitis include difficulty in performing day to day activities involving the shoulder. The articulations associated with the shoulder are complex comprising three joints and four groups of muscles which facilitate the movement of the shoulder in various directions. The range of motion of the shoulder is taken into consideration to identify the underlying cause for the onset of adhesive capsulitis. Adhesive capsulitis is also defined as the idiopathic painful restriction of the shoulder. This condition results in the global restriction of the muscles associated with glenohumeral joint. Adhesive capsulitis predominantly occurs in people belonging to the age group of 40-60. Women are prone to adhesive capsulitis than men. Adhesive capsulitis usually lasts for a period of two years and gradually subsides.

Clinical manifestations of Adhesive capsulitis

Adhesive capsulitis occurs in three stages. The first stage is called as the freezing stage where the patient experiences mild pain and discomfort with movements of the shoulder. Increased pain during sleep and muscle spasms are more predominant in this stage. The freezing stage usually occurs for a period of three to four months.

The second stage is called the adhesive or the frozen stage, in which the pain is reduced but movement of the shoulder is restricted to a greater extent leading to stiffness. The second stage is the most difficult stage which can last up to nine months and it involves the restriction of shoulder movements in many angles causing discomfort.

The third stage is the recovery stage or the thawing stage in which the movement is restored only to a certain degree but the patient continues to experience mild pain and movement restriction in certain angles of rotation.

Diagnosis of Frozen Shoulder

The predominant risk groups who are susceptible to adhesive capsulitis are patients who have underlying conditions such as diabetes, Parkinson's disease, hypothyroidism and cardiac conditions. Women are more prone to adhesive capsulitis than men. Patients who have a history associated with injuries or trauma pertaining to the shoulder may experience adhesive capsulitis.

Adhesive capsulitis diagnosis is more symptom-associated than radiological determination. X-rays and MRI do not play a significant role in identifying this condition as it is associated with muscle groups of the shoulder. The common symptoms through which the diagnosis of this condition is done is through the movements pertaining to the shoulder such as ability to reach and touch the back of the shoulder, reaching to the back pocket and also to reach behind the head. The exact cause for the occurrence of adhesive capsulitis is not known. In some cases young people experience this condition without any associated risk factors.

Treatment of Frozen Shoulder

Adhesive capsulitis can be treated upon early discovery of the condition. Patients suffering from frozen shoulder are usually treated by physical therapy for a few months followed by anti-inflammatory medication to relieve pain and restore motion. The primary objective during the physiotherapy is to strengthen the muscle groups of the shoulder to enable movement in various angles. Surgical intervention is done in case of intense pain and loss of movement.

Shoulder arthroscopy is done followed by physiotherapy to restore the motion of the shoulder. In the surgical procedure, the movement of shoulder is rectified by removing the scar tissue under anaesthesia. The range of motion associated with the shoulder is analyzed as a post-operative measure to ensure the accuracy of the procedure. Physiotherapy increases the shoulder movements by strengthening the internal muscles of the shoulder. Patients are also advised to follow few shoulder stretches and exercise patterns to prevent relapse of the respective condition.