Management of Osteoarthritis in Older Adults

Introduction:

Osteoarthritis is a chronic degenerative disease commonly seen in older people. Aging causes musculoskeletal changes in the body, which can be a reason for developing arthritis (joint inflammation). Other reasons can be joint injury, genetics, obesity, anatomical factors, and constant age-related wear and tear. Despite 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 that occurs due to the 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, pain, swelling, and joint movement limitation in the patient are also caused. 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:

• Bone.

• Tendons.

• Ligaments.

• Cartilage.

• Synovium.

• 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 various factors that may increase the risk of osteoarthritis:

• Aging is the most common cause.

• Joint injury or surgery in the past.

• Obesity.

• Repeated stress due to overuse of the joint.

• Improperly formed joints or bone deformity.

• Family or genetic history of osteoarthritis.

• Metabolic diseases, such as hemochromatosis (a condition that causes too much iron in the body) and diabetes (high blood sugar).

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 Is Osteoarthritis Diagnosed?

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 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.

What Is the Treatment of Osteoarthritis in Older Patients?

There is no complete cure for osteoarthritis. However, 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.

• A doctor may also recommend supportive devices like orthotics, braces, shoe inserts, and walkers.

• A doctor also prescribes supportive medications for osteoarthritis, such as vitamins and other supplements. 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 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.

What Are the Complications Associated With Osteoarthritis?

Osteoarthritis is a chronic degenerative disease that can become worse with time and causes chronic pain and stiffness in the joints. This can affect one’s daily life activities and often leads to sleep disturbance and depression due to disability caused by the condition.

How Can Osteoarthritis Be Prevented?

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 proper stretching exercises should be done 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. However, 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 despite having osteoarthritis.