Degenerative Arthritis

Degenerative arthritis or degenerative joint disease or Osteoarthritis or osteoarthrosis makes up about half of all kinds of arthritis. Essentially a joint failure, by the age of 65 years, 80 percent of people show X-ray evidence of the disease. Men and women are both affected, but it is more severe and more generalised in older women. It may affect any joint in your body. Initially it tends to strike only one joint. But if your fingers are affected, multiple hand joints may become arthritic.

With osteoarthritis, the problem lies in the cartilage that cushions the ends of bones in your joints. Over time, the cartilage deteriorates and its smooth surface roughens. Eventually, if the cartilage wears down com¬pletely, you may be left with bone rubbing on bone and the ends of your bones become damaged. This is generally painful.

Some scientists believe the cartilage damage may be due to an imbal¬ance of enzymes released from the cartilage cells or from the lining of the joint. When balanced, these enzymes allow for the natural breakdown and regeneration of cartilage. But too much of the enzymes can cause the joint cartilage to break down faster than it's rebuilt. The exact cause of this enzyme imbalance is unclear.

Your body goes to work repairing the damage, but the repairs may be inadequate, resulting instead in growth of new bone along the sides of tl1e existing bone, which produces prominent lumps, most often on hands and feet. Each of the steps in this repair process produces pain. The pain and tenderness over the bony lumps may be most marked early in the course of the disease and less evident later on.

If you're fortunate enough to live a long life, you'll almost surely experience one or more painful joints, because osteoarthritis affects almost everyone as they age. Osteoarthritis most often develops after age 45. In young people, in the absence of a joint injury, osteoarthritis is relatively rare. Affected individuals often have a family history of osteoartl1ritis.

Although an active lifestyle may slow the process, almost all people older tl1an 60 have mild symptoms in the neck or spine. Many older adults have osteoarthritis but don't know it until their physicians see it on a routine X-ray.

If you have osteoarthritis, you may experience the following symptoms:

• Pain in a joint during or after use
• Discomfort in a joint before or during a change in the weather
• Swelling and stiffness in a joint, particularly after using it
• Bony lumps on the middle or end joints of your fingers or the base of your thumb
• Loss of flexibility of a joint

Osteoarthritis commonly occurs in the neck or back. Disks between vertebrae are made of cartilage. Like cartilage, the disks can wear out. When tl1is happens, the spaces between the bones narrow. Bony out¬ growths called spurs (osteophytes) frequently form. When bone surfaces rub together, the joint and areas around the cartilage become inflamed and painful. Gradually your spine stiffens and loses flexibility. If several disks are involved, you may lose height.

Hips and knees are also frequently affected because they bear most of your weight. You can have chronic pain or varying amounts of dis¬comfort when you stand and walk. Swelling also may occur, especially in your knees.

Although it generally isn't a seriously disabling condition, osteoarthritis won't go away either. The acute pain of early osteoarthri¬tis often tends to fade with.in a year of its appearance, but it may return if you overuse the affected joint. Still, unless multiple joints are involved, the effects of osteoarthritis are unlikely to be disabling physically. And keeping fit helps prevent disability.

If a complete breakdown of cartilage occurs, the ends of the bones rub together and eventually become polished in a process Called "eburnation." At this advanced stage, it will be difficult to use the joint.

If you think you may have osteoarthritis, schedule an appointment with your physician. Pain in either one or a few joints is a key to the diagnosis of osteoarthritis. Bone spurs and wearing down of cartilage may be evident in an X-ray of the affected joint, indicating the presence of osteoarthritis. The fact that osteoarthritis is so common is another clue that could explain your joint pain.

Changes of osteoarthritis occur in the cartilage before they are evident on an X-ray. Consequently, X-ray findings may be normal early on.

There is no blood test for osteoarthritis, but some blood tests and the appearance of the X-ray can help exclude rheumatoid and other forms of arthritis. The nature of the joint pain and the specific joints affected also help to distinguish these forms of arthritis.

Remember, the presence of osteoarthritis does not, in itself, indicate a problem. Many people have no symptoms or disability from their arthritis. Many are unaware they have osteoarthritis, having no appar¬ent discomfort.