By Ryan Acosta, Staff Writer

No dashing young Victorian era gentleman would venture out in the streets without his walking stick. It was one of the essential fashion apparels for men back then, a symbol of elegance and affluence. In contrast, today’s young men would probably scoff at the notion of roaming around with walking sticks.

That’s understandable enough if you consider the it’s-hip-to-be-young trend that’s being perpetually portrayed in the mass media. In the modern youth’s psyche, the walking stick is synonymous to old age, to frailty, and, perhaps, to arthritis. For the vast majority of those strolling the streets equipped with walking sticks these days are old people struggling with arthritis, particularly osteoarthritis.

Osteoarthritis is the most common form of arthritis and occurs in more than 27 million Americans (Helmick, C., Felson, D., Lawrence, R., Gabriel, S., et al, 2008). Because osteoarthritis usually affects the knee and hip, it is the main reason for disability in the US (Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, et al, 1994).

What makes this disease very painful is that it slowly chews the top portion of the cartilage, which is the soft that prevents bones from colliding. In time, the cartilage is entirely broken down and bones rub together. Constant collision between bones causes severe pain and swelling and gradually deforms the affected joint.

Symptoms

According to the Mayo Clinic, majority of patients with osteoarthritis complain of severe pain, especially when moving. Patients may also experience stiffness, tenderness, and a “grating sensation” in the affected joint. It is generally suggested that individuals should see a doctor if the aforementioned symptoms persist for two or more weeks.

Diagnosis

According to the National Institutes of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), there is not one test that can be performed to identify osteoarthritis. Usually, it is diagnosed by X-ray tests, which normally reveals bone and cartilage protrusions in affected joints. However, doctors would only recommend X-ray tests after physical examination of the patient showed joint swelling and tenderness, decreased motion of the joints, or visible damage to the joints. Aside from X-ray tests, synovial fluid analysis, blood tests, and other exams are also performed to diagnose osteoarthritis.

Aging and Osteoarthritis

Age is not the main risk factor for osteoarthritis. Joint injury, obesity, genetic defect in joint cartilage, severe stress on the joints resulting from occupational tasks, and other things may cause osteoarthritis (NIAMS). However, the prevalence of individuals affected with osteoarthritis increases with age. And many elderly people are not aware that they have osteoarthritis until X-ray tests are performed since common signs and symptoms (such as pain, stiffness, and tenderness in the joint area) do not necessarily occur at all times. In fact, it is estimated that about 70% of people above 65 may be diagnosed with osteoarthritis upon X-ray examination (Lane and Thompson, 1997).

As humans grow older, chondrocytes, the cells in the cartilage, are not replaced at a consistent rate. This results in an older chondrocyte population in the cartilage and makes it prone to degeneration (Bulkwalter and Mankin, 1998).

Treatment

Right now, there is no cure for osteoarthritis. Joint replacement surgery is sometimes performed if the pain is very severe and untreatable with normal pain medication. Treatment usually aims to alleviate the pain and other symptoms that cause disability to the patient. Analgesics, like acetaminophen, are the common medications for osteoarthritis (Brandt, 2000). Non-steroidal anti-inflammatory drugs (NSAID) are also used to treat osteoarthritis, which not only minimize pain but also reduces inflammation around the affected joints.

Research

Osteoarthritis is really a debilitating disease. As such, many studies are now being conducted in order to know more about it, particularly on determining its exact causes and developing better treatment. Tissue engineering therapy is perhaps the most promising research that is being conducted to treat osteoarthritis. Studies in this field focus on ways to develop techniques on transplanting healthy cartilage cells (preferably stem cells) to damaged joints.

The possibilities are really promising. The time will really come when people, especially elderly people, with osteoarthritis will not experience debilitating pain and disability.

References:

Brandt, K.D. The role of analgesics in the management of osteoarthritis pain. American Journal of Therapeutics. 7.2 (2000): 75-70.

Buckwalter , J.A. and Mankin, J.H. Articular Cartilage: Degeneration and Osteoarthritis, Repair, Regeneration, and Transplantation. Instructional Course Lectures. 47 (1998): 487-504.

Guccione, A.A., Felson D.T., Anderson J.J., Anthony J.M., Zhang Y., Wilson P.W., et al. The effects of specific medical conditions on functional limitations of elders in the Framingham Study. American Journal of Public Health. 84 (1994): 351-8.

Helmick, C., Felson, D., Lawrence, R., Gabriel, S., et al. Estimates of the Prevalence of Arthritis and Other Rheumatic conditions in the United States. Arthritis & Rheumatism 58.1 (2008): 15-25.

Lane, N.E. and Thompson, J.M. Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment. American Journal of Medicine 103.6 (1997): 25-30.

Mayo Clinic. Osteoarthritis: Symptoms. October 13, 2009. http://www.mayoclinic.com/health/osteoarthritis/ds00019/dsection=symptoms.

NIAMS (National Institute of Arthritis and Musculoskeletal and Skin Diseases). What Is Osteoarthritis? September 2006. http://www.niams.nih.gov/Health_info/Osteoarthritis/osteoarthritis_ff.asp.