From the Wellness Center
by Diane Manzi, RN
Osteoarthritis is the kind of arthritis that everybody gets. It is a practically universal problem, increasing with age, and one that, because of its relationship to the aging process, is not as responsive to medical treatment as we might like. However, there are many things you can do for yourself to alleviate this condition. Fortunately, osteoarthritis usually is a relatively mild condition. Osteoarthritis is a much less severe form of the disorder than rheumatoid arthritis. In other words, the changes in the skeleton that occur with age are inevitable, but they cause symptoms in a minority of people and severe symptoms in very few.
Osteoarthritis used to be thought of as the inevitable result of wear and tear. In fact, most activities with a lot of wear donít seem to cause much tear, and authorities now recognize the need for exercise to strengthen the joints, both before and after signs of arthritis have developed.
The tissue involved in osteoarthritis is the cartilage. This is the gristle material that faces the ends of the bones and forms the surface of the joint on both sides. Gristle is tough, somewhat elastic, and very durable. The cartilage or gristle does not have a blood supply, so it gets its oxygen and nutrition from the surrounding joint fluid. It is aided in this by being elastic and by being able to absorb fluid. When we use a joint, the pressure squeezes fluid and waste products out of the cartilage, and when the pressure is relieved, the fluid seeps back, together with oxygen and nutrients. Hence, the health of the cartilage depends on use of the joint. Over many years, the cartilage may become frayed and may even wear away entirely. When this happens, the bone surface on one side of the joint grates against the bone of the other side of the joint, providing a much less elastic joint surface. With time, the opposing bony surfaces may become polished, a process called eburnation. As this happens, the joint may again move more smoothly and cause less discomfort. This is one of the reasons it is important to continue to use painful joints.
There are three common types of osteoarthritis. The first and mildest causes knobby enlargement of the finger joints. The end joints of the fingers become bony and the hands begin to assume the appearance we associate with old age. The other joints of the fingers may also be involved. This kind of arthritis usually causes little difficulty beyond the cosmetic. There may be some stiffness.
The second form of osteoarthritis involves the spine and is sometimes called degenerative joint disease. Bony growths (spurs) appear on the spine in the neck region or in the low back. Usually the bony growths are associated with some narrowing of the space between the vertebrae. This time the disc rather than cartilage is the material that becomes frayed. Changes in the spine begin early in life in almost all of us, but seldom cause symptoms.
This third form of osteoarthritis involves the weight-bearing joints, almost always the hips and knees. These problems can be quite severe. It is possible to have all three kinds of osteoarthritis or any two of them, but often a person will have only one.
Individuals who have had fractures near a joint or have a congenital malformation at a joint seem to develop osteoarthritis in those joints at an earlier age. But, as noted, the usual description of this arthritis as wear and tear is not accurate. While excessive wear and tear on the joint can theoretically result in damage, activity helps the joint remain supple and lubricated, and this tends to cancel out the bad effects.