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.

Chondrodystrophy

Chondrodystrophy is a genetic disorder that affects the skeletal cartilage resulting in dwarfism. Due to genetic mutation affecting the hyaline cartilage, skeletal dysplasia occurs leading to osteoarthritis. The person suffering from this disorder has a normal sized trunk with shorter limbs. Chondrodystrophy is usually accompanied by metabolic and hormonal disorders. Usually x-rays and bone growth patterns are studied to diagnose Chondrodystrophy.

Indomethacin

Indomethacin is a NSAID prescribed for fever, pain, stiffness and swelling. In particular, Indomethacin is used for relieving symptoms of swelling and pain related to osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. In addition, Indomethacin is used to treat acute shoulder pain and gouty arthritis. Indomethacin is available as an oral suspension, suppositories and in the form of extended-release capsule. It is best to take the capsule with a glass of milk or food, if not it can upset stomach. Indomethacin suppository is not to be used if there is an inflammation of the rectum or anus or in case of a rectal or anal bleeding.

Precaution: Indomethacin (trade name Indocin) as is common with other NSAIDs can increase the risk of internal bleeding, ulcers, or even stomach perforation especially for long term usage. It can also increase the risk for heart attack or Stroke -

• if you already have underlying issues like high Cholesterol, hypertension or diabetes
  
• if you are a smoker
  
• if you are above 64 years of age
  
• if you drink Alcohol heavily
  

Indomethacin can also potentiate the action of other drugs - anticoagulants like Warfarin, Steroids like dexamethasone, methylprednisolone and prednisone.

Dosage: For Pain management in Adults: 25 - 50 mg every 8 hours subject to a maximum of 150 - 200 mg per day depending upon the severity of the pain.