Management of Osteoarthritis in Older Adults

Introduction:

Osteoarthritis is described as a chronic degenerative disease, and it is very commonly seen in the older age group. Aging causes musculoskeletal changes in the body, which can be a reason for developing arthritis. Some of the other reasons can be joint injury, genetics, obesity, anatomical factors, and constant age-related wear and tear. In spite of its high prevalence among older adults, not every old person develops osteoarthritis. There are many steps that the patient can take to prevent it and also reduce its severity.

What Happens in Osteoarthritis?

Osteoarthritis is a type of arthritis where there is a breakdown of the joint tissues. This happens due to many reasons, and the most common is aging. As the soft tissues of the joint are damaged, this causes pain, swelling, and joint movement limitation in the patient. Older patients with osteoarthritis are very inactive due to joint pain and this, in turn, leads to further degeneration of the joint. Eventually, the joint might lose its original shape, and small bony growths called “bone spurs'' may develop around the bone. Since the bone weakens in this disorder, pieces of bone and cartilage may break off and move to the joint space, worsening the condition. The tissues affected by osteoarthritis are:

1. Bone.

2. Tendons.

3. Ligaments.

4. Cartilage.

5. Synovium.

6. The meniscus in the knee.

What Are the Causes of Osteoarthritis in Older Adults?

In osteoarthritis, there is wear and tear to the joint tissues and surrounding tissues. As age increases the chance of developing osteoarthritis also increases. It is suspected to be a combination of factors of the environment and the body. This might occur due to various reasons mentioned below:

• Aging is the most common cause.

• Joint injury or surgery in the past.

• Obesity.

• Overuse of the joint.

• Improperly formed joints.

• Family history of osteoarthritis.

What Are the Symptoms of Osteoarthritis in Older Adults?

The symptoms of osteoarthritis include

• Pain while using the joint. This pain may improve when the individual rests the joint.

• Increased joint stiffness in the morning or after a resting period.

• Changes in the shape of the joint.

• Limited joint movement and activity.

• Swelling and redness around the joint.

• Feeling that the joint is loose and unstable.

• Bony spurs develop around the joints.

• Shape changes and enlargement of fingers.

• A grinding noise can be heard while walking.

• Pain and stiffness in the hip joint.

• Pain in the neck and lower back region due to stiffness in the spine.

• Unable to perform daily activities.

• Pain might lead to feelings of fatigue and depression.

How Can We Prevent Osteoarthritis?

Doctors do the following tests to confirm osteoarthritis:

• Physical examination of the area with pain and swelling.

• Complete family and medical history of any such disorder.

• Laboratory tests of different body fluids (blood, urine, joint fluid) to determine the type of arthritis.

• Magnetic resonance imaging (MRI) of the affected joint.

• X-rays of lower levels are used to check for any bony spurs, cartilage and bone damage, and arthritic joint changes.

• Computerized tomography (CT), in which X-rays are taken from many different angles and cross-sections to see the changes in the bone and the soft tissues of the joint.

• Ultrasound of the affected area. This uses high-frequency sound waves to visualize soft tissues, cartilage, and joint fluids.

• Arthroscopy is done by the doctor, if required, to visualize the affected joint.

How to Treat Osteoarthritis in Older Patients?

There is no complete cure for osteoarthritis. But the symptoms can be treated, and the severity of the disease can be reduced.

• Increase physical activity. Consult a physiotherapist to start with joint and muscle strengthening exercises.

• One must lose weight if overweight. This can prevent excess load on the joints.

• Have a proper diet plan and treat underlying chronic diseases like cholesterol and diabetes.

• Intra-articular steroid injections can be given to relieve severe pain.

• Supportive devices are prescribed, like orthotics, braces, shoe inserts, and walkers.

• Supportive medications like vitamins and other supplements are given.

• Non-steroidal anti-inflammatory drugs (NSAIDs) are most commonly prescribed to relieve pain along with other steroidal drugs. Consult the doctor before starting any medications.

• Topical analgesics in the form of creams, patches, rubs, and sprays are applied over the affected area to relieve pain.

• Intermittent hot and cold pack treatment can temporarily relieve pain and stiffness.

• If medications and other treatment options are not working, surgery can be done. Surgery is done in severe cases of osteoarthritis where the patient is unable to do basic daily activities. Joint replacement surgeries have proven to be very helpful in restoring back function and relieving pain in the affected area.

• Alternative medicine therapy is also useful in improving this condition. They are natural, homeopathic, and nutritional supplements. They are easily available without a prescription at health stores and pharmacies. Some examples are vitamin supplements and fish oil which have anti-inflammatory properties.

How Can We Prevent Osteoarthritis?

By making these lifestyle changes, we can prevent osteoarthritis:

• Obesity is one of the risk factors for developing osteoarthritis. One must reduce weight if overweight and keep it under control. Excess weight can put excess pressure on the joints.

• Get enough sleep every night and give rest to the injured joint. Exercise is good for health, but over-exertion of the joints can lead to osteoarthritis.

• Regular exercise will strengthen the muscles and joints but do proper stretching exercises before starting the muscles and joints.

• Occupational hazards like constant walking, kneeling, lifting, and twisting can be dangerous for the joints. Try to keep these activities under control.

• Keep the blood sugar levels under control.

Conclusion:

Since osteoarthritis is a progressive degenerative condition where the joints and surrounding tissues are affected, there is no cure for this disorder. But with proper treatment, the symptoms and pain can be reduced to a great extent. Treatment helps to improve the quality of living of an individual. This disorder is commonly seen in older adults, but it is not considered a part of the normal aging process. Nowadays, many pharmacological and non-pharmacological treatment options are available for older patients to live happy and active lives in spite of having osteoarthritis.