Osteoarthritis Classification and external resources
ICD-10	M15.-M19., M47.
ICD-9	715
OMIM	165720
DiseasesDB	9313
MedlinePlus	000423
eMedicine	med/1682  orthoped/427 pmr/93 radio/492
MeSH	D010003

Osteoarthritis (OA, also known as degenerative arthritis, degenerative joint disease), is a condition in which low-grade inflammation results in pain in the joints, caused by abnormal wearing of the cartilage that covers and acts as a cushion inside joints and destruction or decrease of synovial fluid that lubricates those joints. As the bone surfaces become less well protected by cartilage, the patient experiences pain upon weight bearing, including walking and standing. Due to decreased movement because of the pain, regional muscles may atrophy, and ligaments may become more lax. OA is the most common form of arthritis. Image File history File linksMetadata Size of this preview: 652 × 600 pixelsFull resolution (948 × 872 pixel, file size: 114 KB, MIME type: image/jpeg) Bildbeschreibung: Gonarthrose, medialer Aufbrauch des Knorpels Quelle: eigene Aufnahme Datum: Autor: User:Scuba-limp File history Legend: (cur) = this is the current file, (del) = delete this... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... Cartilage is a type of dense connective tissue. ... Synovial fluid is a thin, stringy fluid found in the cavities of synovial joints. ... Atrophy is the partial or complete wasting away of a part of the body. ... In anatomy, the term ligament is used to denote three different types of structures:[1] Fibrous tissue that connects bones to other bones. ... Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ...

"Osteoarthritis" is derived from the Greek word "osteo", meaning "of the bone", "arthro", meaning "joint", and "itis", meaning inflammation, although many sufferers have little or no inflammation. A common misconception is that OA is due solely to wear and tear, due to the fact that OA typically is not present in younger people. However, while age is correlated with OA incidence, this merely illustrates that OA is a process that takes time to develop. There is usually an underlying cause for OA, in which case it is described as secondary OA. If no underlying cause can be identified it is described as primary OA. "Degenerative arthritis", often used as a synonym for OA, but the latter involves both degenerative and regenerative changes. An abscess on the skin, showing the redness and swelling characteristic of inflammation. ...

OA affects nearly 21 million people in the United States, accounting for 25% of visits to primary care physicians, and half of all NSAID (Non-Steroidal Anti-Inflammatory Drugs) prescriptions. It is estimated that 80% of the population will have radiographic evidence of OA by age 65, although only 60% of those will be symptomatic.^[1] A primary care physician, or PCP, is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... A medical prescription ) is an order (often in written form) by a qualified health care professional to a pharmacist or other therapist for a treatment to be provided to their patient. ... Radiography is the creation of radiographs, photographs made by exposing a photographic film or other image receptor to X-rays. ... In medicine, a disease is symptomatic when it is at a stage when the patient is experiencing symptoms. ...

Signs and symptoms

The main symptom is chronic pain, causing loss of mobility and often stiffness. "Pain" is generally described as a sharp ache, or a burning sensation in the associated muscles and tendons. OA can cause a crackling noise (called "crepitus") when the affected joint is moved or touched, and patients may experience muscle spasm and contractions in the tendons. Occasionally, the joints may also be filled with fluid. Humid weather increases the pain in many patients.^[2] Chronic pain was originally defined as pain that has lasted 6 months or longer. ... Mobility is the ability and willingness to move or change; this can depend on motor skills; mobility aids may be needed such as a walking stick, walker, mobile standing frame, power operated vehicle/scooter, wheelchair or white cane for visual impairment. ... For other uses of Muscles, see Muscles (disambiguation). ... For other uses, see Tendon (disambiguation). ... This article is about the medical term. ... A spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. ...

OA commonly affects the hands, feet, spine, and the large weight-bearing joints, such as the hips and knees, although in theory, any joint in the body can be affected. As OA progresses, the affected joints appear larger, are stiff and painful, and usually feel worse, the more they are used throughout the day, thus distinguishing it from rheumatoid arthritis. Alternate meanings: Hand (disambiguation) A human left hand The hand (med. ... For other uses, see Foot (disambiguation). ... The vertebral column seen from the side Different regions (curvatures) of the vertebral column The vertebral column (backbone or spine) is a column of vertebrae situated in the dorsal aspect of the abdomen. ... Bones of the Hip In anatomy, the hip is the bony projection of the femur, known as the greater trochanter, and the overlying muscle and fat. ... For other uses, see Knee (disambiguation). ... Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ...

In smaller joints, such as at the fingers, hard bony enlargements, called Heberden's nodes (on the distal interphalangeal joints) and/or Bouchard's nodes (on the proximal interphalangeal joints), may form, and though they are not necessarily painful, they do limit the movement of the fingers significantly. OA at the toes leads to the formation of bunions, rendering them red or swollen. Heberdens nodes are seen in the distal interphalangeal joints. ... Bouchards nodes are seen in the proximal interphalangeal joints. ... A bunion (hallux valgus) is a sometimes painful structural deformity of the bones and the joint between the foot and big toe. ...

OA is the most common cause of water on the knee, an accumulation of excess fluid in or around the knee joint. ^[3] Water on the knee is a generic term used to describe knee swelling which occurs when excess fluid accumulates in or around the knee joint. ...

Causes

Although it commonly arises from trauma, osteoarthritis often affects multiple members of the same family, suggesting that there is hereditary susceptibility to this condition. A number of studies have shown that there is a greater prevalence of the disease between siblings and especially identical twins, indicating a hereditary basis^{[citation needed]}. Up to 60% of OA cases are thought to result from genetic factors. Researchers are also investigating the possibility of allergies, infections, or fungi as a cause. There is some evidence that allergies, whether fungal, infectious or systemically induced, may be a significant contributing factor to the appearance of osteoarthritis in a synovial sac. For the scientific journal Heredity see Heredity (journal) Heredity (the adjective is hereditary) is the transfer of characters from parent to offspring, either through their genes or through the social institution called inheritance (for example, a title of nobility is passed from individual to individual according to relevant customs and... Brother and Sister redirect here. ... For other uses, see Twin (disambiguation). ... Allergy is an abnormal reaction to a substance foreign to the body that is acquired, predictable and rapid. ... An infection is the detrimental colonization of a host organism by a foreign species. ... The Term mycosis (plural: mycoses) refers to conditions in which fungi pass the resistance barriers of the human or animal body and establish infections. ...

Two types

OA affects nearly 21 million people in the United States, accounting for 25% of visits to primary care physicians, and half of all NSAID (Non-Steroidal Anti-Inflammatory Drugs) prescriptions. It is estimated that 80% of the population will have radiographic evidence of OA by age 65, although only 60% of those will be symptomatic.^[4] Treatment is with NSAIDs, local injections of glucocorticoid or hyaluronan, and in severe cases, with joint replacement surgery. There has been no cure for OA, as cartilage has not been induced to regenerate. However, if OA is caused by cartilage damage (for example as a result of an injury) Autologous Chondrocyte Implantation may be a possible treatment.^[5] Clinical trials employing tissue-engineering methods have demonstrated regeneration of cartilage in damaged knees, including those that had progressed to osteoarthritis.^[6] Further, in January 2007, Johns Hopkins University was offering to license a technology of this kind, ^[7] listing several clinical competitors in its market analysis. A primary care physician, or PCP, is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... A medical prescription ) is an order (often in written form) by a qualified health care professional to a pharmacist or other therapist for a treatment to be provided to their patient. ... Radiography is the creation of radiographs, photographs made by exposing a photographic film or other image receptor to X-rays. ... In medicine, a disease is symptomatic when it is at a stage when the patient is experiencing symptoms. ... Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... The repeating disaccharide unit of hyaluronan Hyaluronan (also called hyaluronic acid or hyaluronate) is a non-sulfated glycosaminoglycan distributed widely throughout connective, epithelial, and neural tissues. ... ... Tissue engineering is the use of a combination of cells, engineering and materials methods, and suitable biochemical and physio-chemical factors to improve or replace biological functions. ...

Primary

This type of OA is a chronic degenerative disorder related to but not caused by aging, as there are people well into their nineties who have no clinical or functional signs of the disease. As a person ages, the water content of the cartilage decreases due to a reduced proteoglycan content, thus causing the cartilage to be less resilient. Without the protective effects of the proteoglycans, the collagen fibers of the cartilage can become susceptible to degradation and thus exacerbate the degeneration. Inflammation of the surrounding joint capsule can also occur, though often mild (compared to that which occurs in rheumatoid arthritis). This can happen as breakdown products from the cartilage are released into the synovial space, and the cells lining the joint attempt to remove them. New bone outgrowths, called "spurs" or osteophytes, can form on the margins of the joints, possibly in an attempt to improve the congruence of the articular cartilage surfaces. These bone changes, together with the inflammation, can be both painful and debilitating. Ageing or aging is the process of getting older. ... Cartilage is a type of dense connective tissue. ... Proteoglycans represent a special class of glycoprotein that are heavily glycosylated. ... Proteoglycans represent a special class of glycoprotein that are heavily glycosylated. ... Tropocollagen triple helix. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... The joint capsules or articular capsules form complete envelopes for the freely movable bone joints. ... Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... This article is about the skeletal organs. ...

Secondary

This type of OA is caused by other factors or diseases but the resulting pathology is the same as for primary OA:

• Congenital disorders, such as:
  • Congenital hip luxation
  • People with abnormally-formed joints (e.g. hip dysplasia (human)) are more vulnerable to OA, as added stress is specifically placed on the joints whenever they move. [However, recent studies have shown that double-jointedness may actually protect the fingers and hand from osteoarthritis.]
• Cracking joints—the evidence is weak at best that this has any connection to arthritis.
• Diabetes.
• Inflammatory diseases (such as Perthes' disease), (Lyme disease), and all chronic forms of arthritis (e.g. costochondritis, gout, and rheumatoid arthritis). In gout, uric acid crystals cause the cartilage to degenerate at a faster pace.
• Injury to joints, as a result of an accident.
• A joint infection, e.g. from an injury.
• Hormonal disorders.
• Ligamentous deterioration or instability may be a factor.
• Obesity. Obesity puts added weight on the joints, especially the knees.
• Sports injuries, or similar injuries from exercise or work. Certain sports, such as running or football, put undue pressure on the knee joints. Injuries resulting in broken ligaments can lead to instability of the joint and over time to wear on the cartilage and eventually osteoarthritis.
• Pregnancy
• Alkaptonuria
• Hemochromatosis and Wilson's disease

A congenital disorder is a medical condition or defect that is present at or before birth (for example, congenital heart disease). ... This article is about the medical term. ... Cracking joints is the practice of manipulating ones joints such that they produce a sharp sound, likened to cracking (also likened to popping, etc. ... This article is about the disease that features high blood sugar. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Perthes disease is the idiopathic avascular osteonecrosis of the capital femoral epiphysis of the femoral head, also known as Legg-Perthes Disease and Legg-Calve-Perthes disease (LCPD). ... Lyme disease, or borreliosis, is an emerging infectious disease caused by bacteria from the genus Borrelia. ... A disease invented by matt jadrnak to get out of school and use as a FAKE excuse. ... Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... Uric acid (or urate) is an organic compound of carbon, nitrogen, oxygen and hydrogen with the formula C5H4N4O3. ... Injury is damage or harm caused to the structure or function of the body caused by an outside agent or force, which may be physical or chemical. ... A railing accidentally collapses at a college football game, spilling fans onto the sidelines An accident is something going wrong unexpectedly. ... An infection is the detrimental colonization of a host organism by a foreign species. ... For other uses, see Hormone (disambiguation). ... Tackles like this one in Womens Australian rules football can cause injuries. ... For other uses, see Running (disambiguation). ... Look up Football in Wiktionary, the free dictionary. ... This article is about human pregnancy in biological females. ... Alkaptonuria (black urine disease, alcaptonuria or ochronosis) is a rare inherited genetic disorder of tyrosine metabolism. ... Haemochromatosis, also spelled hemochromatosis, is a hereditary disease characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. ... Wilsons disease or hepatolenticular degeneration is an autosomal recessive hereditary disease, with an incidence of about 1 in 30,000 in most parts of the world and a male preponderance. ...

Diagnosis

Diagnosis is normally done through x-rays. This is possible because loss of cartilage, subchondral ("below cartilage") sclerosis, subchondral cysts, narrowing of the joint space between the articulating bones, and bone spur formation (osteophytes) show up clearly on x-rays. Plain films, however, often do not correlate well with the findings of physical examination of the affected joints. In general, diagnosis (plural diagnoses) has two distinct dictionary definitions. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... Multiple sclerosis (MS) is a demyelinating disease, a non-contagious chronic autoimmune disorder of the central nervous system which can present with a variety of neurological symptoms occurring in attacks or slowly progressing over time. ... A cyst (soft c, rhymes with list) is a cloed sac having a distinct membrane and division on the nearby tissue. ... Bone spurs, also known as osteophytes, are bony projections that form along joints. ...

With or without other techniques, such as MRI (magnetic resonance imaging), arthrocentesis and arthroscopy, diagnosis can be made by a careful study of the duration, location, the character of the joint symptoms, and the appearance of the joints themselves. As yet, there are no methods available to detect OA in its early and potentially treatable stages. MRI redirects here. ... Arthrocentesis is the clinical procedure of using a syringe to collect synovial fluid from a joint capsule. ... Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision. ...

In 1990, the College of Rheumatology, using data from a multi-center study, developed a set of criteria for the diagnosis of hand osteoarthritis based on hard tissue enlargement and swelling of certain joints. These criteria were found to be 92% sensitive and 98% specific for hand osteoarthritis versus other entities such as rheumatoid arthritis and spondyloarthropities ^[8]. The sensitivity of a binary classification test or algorithm, such as a blood test to determine if a person has a certain disease, or an automated system to detect faulty products in a factory, is a parameter that expresses something about the tests performance. ... The specificity is a statistical measure of how well a binary classification test correctly identifies the negative cases, or those cases that do not meet the condition under study. ... Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... Spondyloarthropathies are a group of related inflammatory joint disease associated with the MHC class I molecule HLA-B27. ...

Related pathologies whose names may be confused with osteoarthritis include pseudo-arthrosis. This is derived from the Greek words pseudo, meaning "false", and arthrosis, meaning "joint." Radiographic diagnosis results in diagnosis of a fracture within a joint, which is not to be confused with osteoarthritis which is a degenerative pathology affecting a high incidence of distal phalangeal joints of female patients.

Treatment

Generally speaking, the process of clinically detectable osteoarthritis is irreversible, and typical treatment consists of medication or other interventions that can reduce the pain of OA and thereby improve the function of the joint.

Conservative care

No matter the severity or location of OA, conservative measures such as weight control, appropriate rest and exercise, and the use of mechanical support devices are usually beneficial. In OA of the knees, knee braces, a cane, or a walker can be helpful for walking and support. Regular exercise, if possible, in the form of walking or swimming, is encouraged. Applying local heat before, and cold packs after exercise, can help relieve pain and inflammation, as can relaxation techniques. Heat — often moist heat — eases inflammation and swelling, and may improve circulation, which has a healing effect on the local area. Weight loss can relieve joint stress and may delay progression^{[citation needed]}. Proper advice and guidance by a health care provider is important in OA management, enabling people with this condition to improve their quality of life. To meet Wikipedias quality standards, this article or section may require cleanup. ... Rest may refer to: rest (fitness), a period of relative inactivity to allow recovery and growth. ... The term Exercise can refer to: Physical exercise such as running or strength training Exercise (options), the financial term for enacting and terminating a contract Category: ... // Look up walker in Wiktionary, the free dictionary. ... For other uses, see Walking (disambiguation). ... Swimmer redirects here. ... Relaxation techniques are used by people who wish to relax, for a wide variety of reasons. ... The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ...

In 2002, a randomized, blinded assessor trial was published showing a positive effect on hand function with patients who practiced home joint protection exercises (JPE). Grip strength, the primary outcome parameter, increased by 25% in the exercise group versus no improvement in the control group. Global hand function improved by 65% for those undertaking JPE. ^[9]

Medical treatment

Medical treatment includes NSAIDs, local injections of glucocorticoid or hyaluronan, and in severe cases, with joint replacement surgery. There has been no cure for OA, as cartilage has not been induced to regenerate. However, if OA is caused by cartilage damage (for example as a result of an injury) Autologous Chondrocyte Implantation may be a possible treatment.^[10] Clinical trials employing tissue-engineering methods have demonstrated regeneration of cartilage in damaged knees, including those that had progressed to osteoarthritis.^[11] Further, in January 2007, Johns Hopkins University was offering to license a technology of this kind, ^[12] listing several clinical competitors in its market analysis. Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... The repeating disaccharide unit of hyaluronan Hyaluronan (also called hyaluronic acid or hyaluronate) is a non-sulfated glycosaminoglycan distributed widely throughout connective, epithelial, and neural tissues. ... ... Tissue engineering is the use of a combination of cells, engineering and materials methods, and suitable biochemical and physio-chemical factors to improve or replace biological functions. ...

Dietary

Supplements which may be useful for treating OA include:

Glucosamine

A molecule derived from glucosamine is used by the body to make some of the components of cartilage and synovial fluid. Supplemental glucosamine may improve symptoms of OA and delay its progression.^[13] However, a large study suggests that glucosamine is not effective in treating OA of the knee.^[14] A subsequent meta-analysis that includes this trial concluded that glucosamine hydrochloride is not effective and that the effect of glucosamine sulfate is uncertain.^[15] Glucosamine (C6H13NO5) is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. ... A meta-analysis is a statistical practice of combining the results of a number of studies. ...

Chondroitin

Along with glucosamine, chondroitin sulfate has become a widely used dietary supplement for treatment of osteoarthritis. A meta-analysis of randomized controlled trials found no benefit from chondroitin.^[16] Chondroitin sulfate (CS) is a glycosaminoglycan (GAG) found in connective tissue and the nervous system, normally attached to a protein core. ... A dietary supplement is intended to supply nutrients, (vitamins, minerals, fatty acids or amino acids) that are missing or not consumed in sufficient quantity in a persons diet. ... A meta-analysis is a statistical practice of combining the results of a number of studies. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ...

The Osteoarthritis Research Society International is in support of the use of chondroitin sulfate for OA.

Other supplements

• Omega-3 fatty acid,a vitamin supplement comprised of important oils derived from fish.^{[citation needed]}

• Boswellia, an herbal supplement known in Ayurvedic medicine. It is widely available in health food stores and online.^{[citation needed]}

• Antioxidants, including vitamins C and E in both foods and supplements, provide pain relief from OA. ^[17]

• Hydrolyzed collagen (hydrolysate) (a gelatin product) may also prove beneficial in the relief of OA symptoms, as substantiated in a German study by Beuker F. et al. and Seeligmuller et al. In their 6-month placebo-controlled study of 100 elderly patients, the verum group showed significant improvement in joint mobility.^{[citation needed]}

• Ginger (rhizome) extract - has improved knee symptoms moderately.^[18]

• Selenium deficiency has been correlated with a higher risk and severity of OA.^[19]

• vitamins B9 (folate) and B12 (cobalamin) taken in large doses has been thought to reduced OA hand pain in one very small, non-quantitative study of 25 people. The results of which are extremely vague at best.^[20] The risk from large doses would suggest that this is not a safe treatment.

• Vitamin D deficiency has been reported in patients with OA, and supplementation with Vitamin D3 is recommended for pain relief.^[21]

• Bone Morphogenetic Protein 6 (BMP-6) has recently been shown to have a functional role in the maintenance of joint integrity and is now being produced in an orally ingested form. ^[22]

Other nutritional changes shown to aid in the treatment of OA include decreasing saturated fat intake^[23] and using a low energy diet to decrease body fat.^[24] Lifestyle change may be needed for effective symptomatic relief, especially for knee OA.^[25] For an explanation of n and numerical nomenclature (such as n−3 or 18:3), see Nomenclature of fatty acids. ... Species Boswellia sacra (aka or )Boswellia frereana Boswellia papyrifera Boswellia serrata Boswellia is a genus of trees known for their fragrant resin which has many pharmacological uses particularly as anti-inflamatories. ... Ayurveda (आयुर्वेद Sanskrit: ayu—life; veda—knowledge of) or ayurvedic medicine is a more than 2,000 year old comprehensive system of medicine based on a holistic approach rooted in Vedic culture. ... Space-filling model of the antioxidant metabolite glutathione. ... This article is about the nutrient. ... Tocopherol, or Vitamin E, is a fat-soluble vitamin in eight forms that is an important antioxidant. ... The current version of the article or section reads like an advertisement. ... For other uses, see Ginger (disambiguation). ... For other uses, see Rhizome (disambiguation). ... For other uses, see Selenium (disambiguation). ... This article needs to be cleaned up to conform to a higher standard of quality. ... Folic acid (the anion form is called folate) is a B-complex vitamin (once called vitamin M) that is important in preventing neural tube defects (NTDs) in the developing human fetus. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... In mathematics, a deficient number or defective number is a number n for which σ(n) < 2n. ... Chemical structure of cholecalciferol Cholecalciferol is a form of Vitamin D. Vitamin D3 is also a steroid much like testosterone, cholesterol and cortisol. ... Bone morphogenetic proteins (BMPs) are growth factors belonging to the TGF-β (Transforming Growth Factor-beta) super family with a strong ability to induce new bone and/or cartilage formation. ... Saturated fat is fat that consists of triglycerides containing only saturated fatty acids. ... In biochemistry, fat is a generic term for a class of lipids. ...

Complications

Dealing with chronic pain can be difficult and result in depression. Communicating with other patients and caregivers can be helpful, as can maintaining a positive attitude. People who take control of their treatment, communicate with their health care provider, and actively manage their arthritis experience can reduce pain and improve function.^{[citation needed]} On the Threshold of Eternity. ... Half full or half empty? Wikiquote has a collection of quotations related to: Optimism Optimism, the opposite of pessimism, exemplifies a lifeview where one looks upon the world as a positive place. ...

Specific medications

Paracetamol

A mild pain reliever may be sufficiently efficacious. Paracetamol (tylenol/acetaminophen), is commonly used to treat the pain from OA, although unlike NSAIDs, acetaminophen does not treat the inflammation.^{[citation needed]} A randomized controlled trial comparing paracetamol with ibuprofen in x-ray-proven mild to moderate osteoarthritis of the hip or knee found equal benefit.^[26] However, acetaminophen at a dose of 4 grams per day can increase liver function tests.^[27] For other uses of painkiller, see painkiller (disambiguation) An analgesic (colloquially known as painkiller) is any member of the diverse group of drugs used to relieve pain. ... Paracetamol (INN) (IPA: ) or acetaminophen (USAN), is the active metabolite of phenacetin, a so-called coal tar analgesic. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicines or medical procedures. ... Paracetamol (INN) (IPA: ) or acetaminophen (USAN), is the active metabolite of phenacetin, a so-called coal tar analgesic. ... Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks, including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Burana (Finland), Ipren or Ibumetin (Denmark and Sweden), Ibuprom... Acetaminophen (USAN) or paracetamol (INN), is a popular analgesic and antipyretic drug that is used for the relief of fever, headaches, and other minor aches and pains. ... Liver function tests (LFTs or LFs), are groups of clinical biochemistry laboratory blood assays designed to give a doctor or other health professional information about the state of a patients liver. ...

Non-steroidal anti-inflammatory drugs

In more severe cases, non-steroidal anti-inflammatory drugs (NSAID) may reduce both the pain and inflammation. These include medications such as diclofenac, ibuprofen and naproxen. High doses are often required. All NSAIDs act by inhibiting the formation of prostaglandins, which play a central role in inflammation and pain. However, these drugs are rather taxing on the gastrointestinal tract, and may cause stomach upset, cramping, diarrhea, and peptic ulcer. Diclofenac has also been found to cause damage to the articular cartilage. Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... my sister died form overdose!!! Diclofenac (marketed as Voltaren, Voltarol, Diclon, Dicloflex Difen, Difene, Cataflam, Pennsaid, Rhumalgan, Modifenac, Abitren and Zolterol) is a non-steroidal anti-inflammatory drug (NSAID) taken to reduce inflammation and an analgesic reducing pain in conditions such as in arthritis or acute injury. ... Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks, including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Burana (Finland), Ipren or Ibumetin (Denmark and Sweden), Ibuprom... Naproxen (INN) (IPA: ) is a non-steroidal anti-inflammatory drug (NSAID) commonly used for the reduction of mild to moderate pain, fever, inflammation and stiffness caused by conditions such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis, injury (like fractures), menstrual cramps, tendonitis, bursitis, and the treatment of primary... E1 - Alprostadil I2 - Prostacyclin A prostaglandin is any member of a group of lipid compounds that are derived enzymatically from fatty acids and have important functions in the animal body. ... Gut redirects here. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... This article is about muscular pain. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... A benign gastric ulcer (from the antrum) of a gastrectomy specimen. ...

COX-2 selective inhibitors

Another type of NSAID, COX-2 selective inhibitors (such as celecoxib, and the withdrawn rofecoxib and valdecoxib) reduce this risk substantially. These latter NSAIDs carry an elevated risk for cardiovascular disease, and some have now been withdrawn from the market. This article needs cleanup. ... Celecoxib (INN) (pronounced ) is a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, acute pain, painful menstruation and menstrual symptoms, and to reduce numbers of colon and rectum polyps in patients with familial adenomatous polyposis. ... Rofecoxib (IPA: ) is a nonsteroidal anti-inflammatory drug (NSAID) developed by Merck & Co. ... Valdecoxib is a prescription drug used in the treatment of osteoarthritis, rheumatoid arthritis, and painful menstruation and menstrual symptoms. ... Cardiovascular disease refers to the class of diseases that involve the heart or blood vessels (arteries and veins). ...

Corticosteroids

Most doctors nowadays avoid the use of steroids in the treatment of OA as their effect is modest and the adverse effects may outweigh the benefits. This article is about the chemical family of steroids. ...

Narcotics

For moderate to severe pain, narcotic pain relievers such as tramadol, and eventually opioids (hydrocodone, oxycodone or morphine) may be necessary. 19th century Heroin bottle This article is about the drug classification. ... Tramadol (INN) (IPA: ) is an atypical opioid which is a centrally acting analgesic, used for treating moderate to severe pain. ... An opioid is a chemical substance that has a morphine-like action in the body. ... Hydrocodone or dihydrocodeinone is a semi-synthetic opioid derived from two of the naturally occurring opiates, codeine and thebaine. ... Not to be confused with oxytocin. ... This article is about the drug. ...

Topical

"Topical treatments" are treatments designed for local application and action. Some NSAIDs are available for topical use (e.g. ibuprofen and diclofenac) and may improve symptoms without having systemic side-effects. Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks, including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Burana (Finland), Ipren or Ibumetin (Denmark and Sweden), Ibuprom... my sister died form overdose!!! Diclofenac (marketed as Voltaren, Voltarol, Diclon, Dicloflex Difen, Difene, Cataflam, Pennsaid, Rhumalgan, Modifenac, Abitren and Zolterol) is a non-steroidal anti-inflammatory drug (NSAID) taken to reduce inflammation and an analgesic reducing pain in conditions such as in arthritis or acute injury. ...

Creams and lotions, containing capsaicin, are effective in treating pain associated with OA if they are applied with sufficient frequency. Emollients soften skin (and moisturisers add moisture). ... A lotion is a low- to medium-viscosity medicated or non-medicated topical preparation intended for application to unbroken skin. ... Capsaicin (8-methyl-N-vanillyl-6-nonenamide) is the active component of chilli peppers, which are plants belonging to the genus Capsicum. ...

Severe pain in specific joints can be treated with local lidocaine injections or similar local anaesthetics, and glucocorticoids (such as hydrocortisone). Corticosteroids (cortisone and similar agents) may temporarily reduce the pain. Lidocaine (INN) (IPA: ) or lignocaine (former BAN) (IPA: ) is a common local anesthetic and antiarrhythmic drug. ... An injection is a method of putting liquid into the body with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body. ... Anesthesia (AE), also anaesthesia (BE), is the process of blocking the perception of pain and other sensations. ... Hydrocortisone is a synthetic corticosteroid drug which may be given by injection or by topical application. ...

Surgery

If the above management is ineffective, joint replacement surgery may be required. Individuals with very painful OA joints may require surgery such as fragment removal, repositioning bones, or fusing bone to increase stability and reduce pain. ... “Surgeon” redirects here. ...

Other approaches

There are various other modalities in use for osteoarthritis:

Acupuncture

A meta-analysis of randomized controlled trials of acupuncture for knee osteoarthritis concluded "clinically relevant benefits, some of which may be due to placebo or expectation effects".^[28] A meta-analysis is a statistical practice of combining the results of a number of studies. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ... Acupuncture chart from Hua Shou (fl. ... For other uses, see Placebo (disambiguation). ...

Low level laser therapy

Low level laser therapy is a light wave based treatment that may reduce pain. The treatment is painless, inexpensive and without risks or side effects. Unfortunately, it may not actually have any real benefits.[1]

Prolotherapy

Prolotherapy (proliferative therapy) is the injection of an irritant substance (such as dextrose) to create an acute inflammatory reaction. It is claimed to strengthen and heal damaged tissues including ligaments, tendons and cartilage as part of this reaction. The injection is painful (like corticosteroids or hyaluronic acid) and may cause an increase in pain for a few days afterwards. The only other significant risk is the rare possibility of infection. It has been suggested that this article or section be merged with Sclerotherapy. ... A space-filling model of glucose Glucose, a simple monosaccharide sugar, is one of the most important carbohydrates and is used as a source of energy in animals and plants. ...

Radiosynoviorthesis

A radioactive isotope (a beta-ray emitter with a brief half-life) is injected into the joint to soften the tissue. Due to the involvement of radioactive material, this is an elaborate and costly procedure, but it has a success rate of around 80%.

Prognosis

The most common course of OA is an intermittent, progressive worsening of symptoms over time, although in some patients the disease stabilizes. Prognosis also varies depending on which joint is involved.

Factors associated with progression of OA:

• Knees: High body mass index, varus or valgus knee deformity.
• Hips: Night pain, presence of femoral osteophytes, and subchondral sclerosis in females.
• Hands: Older age.

Look up body mass index in Wiktionary, the free dictionary. ... Genu varum A deformity marked by medial angulation of the leg in relation to the thigh; an outward bowing of the legs. ... Genu valgum, commonly called knock-knees, is a condition where the knees angle in and touch one another when the legs are straightened. ... A deformity, dysmorphism, or dysmorphic feature is a major difference in the shape of the body a body part, or a body organ (internal or external) compared to the average shape for the part in question. ... The femur or thigh bone is the longest, most voluminous, and strongest bone of the mammalian bodies. ...

References

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 173rd day of the year (174th in leap years) in the Gregorian calendar. ...