Osteoarthritis and Obesity

Obesity is a known risk factor for osteoarthritis of the knee and hips. An increase in bodyweight increases the load on the knee joints exponentially. Excessive weight on these joints wears away the protective cartilage and accelerates disease progression. Complications that arise from obesity also hamper treatment procedures and limit the options available with doctors. Surgery to treat the condition takes longer. Joint replacement success rate is lower than that for people with normal weight. There is also evidence that an increase in BMI increases the risk of osteoarthritis of the hand.

Weight loss helps reduce pain from the condition in existing patients and lowers the risk in susceptible prospects. Patients can develop a weight loss program in association with their therapists. Given that weight loss is a significant modifiable factor in the treatment for osteoarthritis of the hip and knee, it is important that obese individuals make a concerted effort to lose weight.

Bariatric surgery is useful in helping obese patients reduce their dependence on pain-killers and steroids. Patients are able to cut down on the dose and frequency or both.

What is osteoarthritis?

Osteoarthritis is a condition that leads to structural and functional failure of the joints in the body. It can affect the entire joint which means the adjacent muscle, joint lining, and joint cover. Osteoarthritis is a degenerative condition that worsens over time. It can occur due to several reasons. Progressive loss of cartilage exposes the bone to damage. Joint movement becomes restricted, the subject experiences pain, and ligaments lose their elasticity.

Osteoarthritis is distinguished from other forms of arthritis such as rheumatoid arthritis by the fact that it does not progress to other organs of the body. It remains localized and is a disease of the joints.

Joints commonly afflicted by the condition

Causes

Osteoarthritis is classified as into primary or secondary condition depending upon the detection of an underlying cause. With age, the cartilage begins to degenerate and retain water. The cushioning effect of the cartilage reduces and the joints are exposed to wear. Friction between the cartilage and joint can lead to swelling and pain in the joints. Joint movement becomes restricted. Sometimes, osteoarthritis is characterized by growth of bony spurs around the afflicted joints. There is evidence to suggest that primary osteoarthritis is often genetic and hereditary.

Secondary osteoarthritis occurs as a result of previously existing conditions such as diabetes, Lyme disease, gout, and rheumatoid arthritis. Obesity is a major risk factor as it increases mechanical stress on the joints.

Signs and symptoms

Pain during movement and swelling of the joints are common symptoms. Long periods of inactivity such as during sleep can cause stiffness. If the cartilage cover is totally worn out then the pain is present even when at rest. The symptoms vary with the patient; some patients may report little pain or discomfort even with very obvious degeneration of the joints. The signs and symptoms can appear sporadically. Afflicted patients can experience prolonged periods of pain-free existence. Symptoms will also vary with the joint being afflicted. Advanced osteoarthritis of the knee can result in a "bow legs" and a limp. Osteoarthritis of the hand causes bone spurs in the small joint of the fingers. This is a classic symptom. The bony enlargement is called Heberden's node. Bunions are formed at the base of the big toe when the condition afflicts the feet.

Diagnosis

X-rays are a reliable diagnostic test for the condition. Abnormalities that show up include loss of cartilage covering the joint and bone spurs. Blood tests are performed to check for diseases that can cause secondary osteoarthritis. X-rays are also helpful in excluding other probable causes and determining the best treatment option. MRI and CT-Scan are other imaging techniques used.

A procedure called arthocentesis is used to exclude gout and infection as causes of the condition. It involves removal of joint fluid via a sterile needle and analyzing the fluid.

Arthroscopy is used to view the joint spaces using a tube inserted there. It enables the medical practioner to check for damaged cartilage and lax ligaments.

Physical examination, the presence of Heberden's nodes and bunions on the feet, questioning on the nature and duration of symptoms can help doctors in diagnosing osteoarthritis.

Osteoarthritis treatment

Apart from weight reduction and surgery there are no specific treatment methodologies to halt the breakdown of cartilage. Treatment should focus on reduction of joint pain and improved mobility. If weight loss, oral and topical medicines, and lifestyle changes do not bring relief then the patient may try mechanical support devices. Or surgery may be considered. Because even a small loss in weight can help relieve pain in the weight-bearing joints, it is important to alter lifestyle, incorporate a healthy diet, lose calories, and knock off as many extra pounds as you can. Take note of activities that cause maximum stress to the joints and try to reduce their frequency and intensity.

Exercise is important because it strengthens the muscles surrounding the joints, ensures muscle suppleness and joint flexibility. Consider exercises such as swimming that reduce stress on the joints and at the same time offer a good workout. Stationary cycling and light weight training are also good exercises.

A firm mattress can bring relief in cases of spinal osteoarthritis. Soaking hands in warm water and wearing cotton gloves ease pain in the hands. A doctor may prescribe non-steroidal anti-inflammatory drugs but these can have side effects such as irritation of the gastrointestinal tract, particularly for elderly citizens. Other over-the-counter analgesics can work just as well.

Food supplements containing glucosamine and chondroitin have demonstrated capabilities in relieving osteoarthritis pain. However, chondroitin is also a blood thinner and increases the risk of bleeding in hemophilia patients.

Surgery is considered when conservative treatment methods fail. Bone-removal or osteotomy can help reduce stress in deformed joints. Arthroscopy is carried out to treat torn cartilage. In some cases total joint replacement may have to be carried out.