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Apa saja penyebab osteoarthritis? Obat atau terapi apa saja yang bisa diberikan kepada penderita osteoarthritis? Bagaimana cara kerja obat yang mengandung diclofenac? Apa yang dimaksud dengan anti-inflamasi non-steroid? Apa yang dimaksud dengan akupungtur? Apa perbedaan osteoarthritis dan osteoporosis?
http://www.arthritis.org/who-gets-osteoarthritis.php http://www.medscape.com/ http://www.medicinenet.com/diclofenac/article.htm
http://www.medicinenet.com/osteoarthritis/page1.htm tanggal : 17 September 2012 Osteoarthritis facts
Osteoarthritis is a joint inflammation that results from cartilage degeneration. Osteoarthritis can be caused by aging, heredity, and injury from trauma or disease. The most common symptom of osteoarthritis is pain in the affected joint(s) after repetitive use. There is no blood test for the diagnosis of osteoarthritis. The goal of treatment in osteoarthritis is to reduce joint pain and inflammation while improving and maintaining joint function.
What is osteoarthritis?
Osteoarthritis is a form of arthritis that features the breakdown and eventual loss of the cartilage of one or more joints. Cartilage is a protein substance that serves as a "cushion" between the bones of the joints. Among the over 100 different types of arthritis conditions, osteoarthritis is the most common, affecting over 25 million people in the United States. Osteoarthritis occurs more frequently as we age. Before age 45, osteoarthritis occurs more frequently in males. After 55 years of age, it occurs more frequently in females. In the United States, all races appear equally affected. A higher incidence of osteoarthritis exists in the Japanese population, while South-African blacks, East Indians, and Southern Chinese have lower rates. Osteoarthritis is abbreviated as OA or referred to as degenerative arthritis or degenerative joint disease (DJD).
repeated trauma or surgery to the joint structures. What causes osteoarthritis? Primary osteoarthritis. In fact. feet. bones. the condition is referred to as secondary osteoarthritis. causing joint pain and swelling. diabetes. also referred to as osteophytes) to form around the joints. and large weight-bearing joints. gout. In advanced osteoarthritis. osteoarthritis not resulting from injury or disease. such as the hips and knees. Osteoarthritis occasionally can develop in multiple members of the same family. With aging. spine. Secondary osteoarthritis is a form of osteoarthritis that is caused by another disease or condition. Repeated trauma to joint tissues (ligaments. implying a hereditary (genetic) basis for this condition. Osteoarthritis usually has no known cause and is referred to as primary osteoarthritis. abnormal joints at birth (congenital abnormalities). is mostly a result of natural aging of the joint. there is a total loss of the cartilage cushion between the bones of the joints. The early development of osteoarthritis of the knees among weight lifters is believed to be in part due to their high body weight. and other hormone disorders. Repetitive use of the worn joints over the years can irritate and inflame the cartilage. Eventually. obesity is the most significant risk factor for osteoarthritis of the knees. Conditions that can lead to secondary osteoarthritis include obesity. next to aging. and the protein makeup of cartilage degenerates. Obesity causes osteoarthritis by increasing the mechanical stress on the joint and therefore on the cartilage.Osteoarthritis commonly affects the hands. and cartilage) . Inflammation of the cartilage can also stimulate new bone outgrowths (spurs. the water content of the cartilage increases. Loss of the cartilage cushion causes friction between the bones. cartilage begins to degenerate by flaking or forming tiny crevasses. When the cause of the osteoarthritis is known. leading to pain and limitation of joint mobility.
studies have not found an increased risk of osteoarthritis in long-distance runners. complete loss of the cartilage cushion causes friction between bones. with obesity. or a history of repeated injury and/or joint surgery. Crystal deposits in the cartilage can cause cartilage degeneration and osteoarthritis. Uric acid crystals cause arthritis in gout.is believed to lead to early osteoarthritis of the knees in soccer players and army military personnel. Hormone disturbances. osteoarthritis does not affect other organs of the body. The limping can worsen as more cartilage degenerates. The most common symptom of osteoarthritis is pain in the affected joint(s) after repetitive use. limping." People with osteoarthritis of the weight-bearing joints (such as the knees) can develop a limp. In severe osteoarthritis. and creaking of the affected joints. are also associated with early cartilage wear and secondary osteoarthritis. Osteoarthritis of the hip joints is commonly related to structural abnormalities of these joints that had been present since birth. Joint pain of osteoarthritis is usually worse later in the day. Therefore. the pain. others may have remarkably few symptoms in spite of dramatic degeneration of the joints apparent on X-rays. Some patients can be debilitated by their symptoms. On the other hand. causing pain even at rest or pain with limited motion. causing early degeneration and loss of joint cartilage. which is referred to as being "bowlegged. MD on 11/18/2011 What are osteoarthritis symptoms and signs? Osteoarthritis is a disease of the joints. Symptoms of osteoarthritis vary greatly from patient to patient. while calcium pyrophosphate crystals cause arthritis in pseudogout. such as diabetes and growth hormone disorders. There can be swelling. warmth. and joint dysfunction may not respond to medications or other conservative measures. Osteoarthritis of the knees is often associated with excess upper body weight. It is not unusual for patients with osteoarthritis of the finger joints of the hands and knees to have years of pain-free intervals between symptoms. Interestingly. sitting in a theater). such as rheumatoid arthritis and systemic lupus. Reviewed by Melissa Conrad Stöppler. Progressive cartilage degeneration of the knee joints can lead to deformity and outward curvature of the knees. Unlike many other forms of arthritis that are systemic illnesses (conditions that affect multiple areas of the body or the entire body). . Pain and stiffness of the joints can also occur after long periods of inactivity (for example. In some patients. Symptoms also can be intermittent. severe osteoarthritis of the knees is one of the most common reasons for total knee replacement surgical procedures in the United States. Some people are born with abnormally formed joints (congenital abnormalities) that are vulnerable to mechanical wear.
Therefore. and other causes of arthritis. Removal of joint fluid and injection of corticosteroids into the joints during arthrocentesis can help relieve pain. Heberden's and Bouchard's nodes may not be painful. patients can recover from the arthroscopic surgery much more quickly than from open joint surgery. Osteoarthritis causes the formation of hard.Osteoarthritis of the cervical spine or lumbar spine causes pain in the neck or low back. a sterile needle is used to remove joint fluid for analysis. During arthrocentesis. Bouchard was a famous French doctor who also studied arthritis patients in the late 1800s. The bony deformity is a result of the bone spurs from the osteoarthritis in that joint. bony enlargements of the small joints of the fingers. Bony enlargement of the joints from spur formations is characteristic of osteoarthritis. and character of the joint symptoms and the appearance of the joints helps the doctor in diagnosing osteoarthritis. causing severe pain that can radiate from the spine as well as numbness and tingling of the affected parts of the body. . How is osteoarthritis diagnosed? There is no blood test for the diagnosis of osteoarthritis. Osteoarthritis of the joint at the base of the big toe of the foot leads to the formation of a bunion. Dr. named after a famous British doctor. Joint fluid analysis is useful in excluding gout. Simple X-ray testing can also be very helpful to exclude other causes of pain in a particular joint as well as assisting the decision-making as to when surgical intervention might be considered. and bone spur formation. The common X-ray findings of osteoarthritis include loss of joint cartilage. Classic bony enlargement of the small joint at the end of the fingers is called a Heberden's node. Arthrocentesis is a procedure to remove joint fluid that is often performed in the doctor's office. X-rays of the affected joints can be used to diagnose osteoarthritis. duration. Finally. called osteophytes. Another common bony knob (node) occurs at the middle joint of the fingers in many patients with osteoarthritis and is called a Bouchard's node. Blood tests are performed to exclude diseases that can cause secondary osteoarthritis. Osteoarthritis of the fingers and the toes may have a genetic basis and can be found in numerous female members of some families. If successful. as well as to exclude other arthritis conditions that can mimic osteoarthritis. narrowing of the joint space between adjacent bones. a careful analysis of the location. Abnormalities of and damage to the cartilage and ligaments can be detected and sometimes repaired through the arthroscope. infection. the presence of Heberden's nodes. but they are often associated with limitation of motion of the joint. and inflammation. and bunions of the feet can indicate to the doctor a diagnosis of osteoarthritis. that form along the arthritic spine can irritate spinal nerves. The characteristic appearances of these finger nodes can be helpful in diagnosing osteoarthritis. swelling. Bony spurs. Arthroscopy is a surgical technique whereby a doctor inserts a viewing tube into the joint space. Bouchard's nodes.
and light weight training. Physical therapists can provide support devices. physical therapy and/or occupational therapy. or a firm mattress. Others may benefit from conservative measures such as rest. These measures are particularly important when large. Some patients with osteoarthritis have minimal or no pain and may not need treatment. especially among elderly people. mild pain relievers such as aspirin and acetaminophen (Tylenol) may be sufficient treatment. there is no specific treatment to halt cartilage degeneration or to repair damaged cartilage in osteoarthritis. These devices can be helpful in reducing stress on the joints. Medication may be used topically. depending on what areas are involved. walkers. Occupational therapists can assess the demands of daily activities and suggest additional devices that may help people at work or home. In many patients with osteoarthritis.What is the treatment for osteoarthritis? Aside from weight reduction and avoiding activities that exert excessive stress on the joint cartilage. and braces. Medications are used to complement the physical measures described above. Paraffin wax dips. such as splints. exercise. Exercise is helpful for relief of symptoms of osteoarthritis in several ways. such as knee braces. Medicine to relax muscles in spasm might also be given temporarily. When conservative measures fail to control pain and improve joint function. Resting sore joints decreases stress on the joints and relieves pain and swelling. Finger splints can support individual joints of the fingers. Patients are asked to simply decrease the intensity and/or frequency of the activities that consistently cause joint pain. or injected into the joints to decrease joint inflammation and pain. surgery can be considered. Finally. It also prevents the joints from "freezing up" and improves and maintains joint mobility. and nighttime cotton gloves can help ease hand symptoms. Studies have shown that acetaminophen given in adequate doses can often be equally as effective as prescription anti-inflammatory medications in relieving pain in osteoarthritis of the knees. and mechanical support devices. stationary cycling. it helps with weight reduction and promotes endurance. including strengthening the muscular support around the joints. warm water soaks. Other popular exercises include walking. lumbar corset. diet control with weight reduction. Exercise usually does not aggravate osteoarthritis when performed at levels that do not cause joint pain. even modest weight reduction can help to decrease symptoms of osteoarthritis of the large joints. such as the knees and hips. canes. weight-bearing joints are involved. In fact. The goal of treatment in osteoarthritis is to reduce joint pain and inflammation while improving and maintaining joint function. Spine symptoms can improve with a neck collar. Applying local heat before and cold packs after exercise can help relieve pain and inflammation. Since acetaminophen has fewer gastrointestinal side effects than NSAIDS (see below). Swimming is particularly well suited for patients with osteoarthritis because it allows patients to exercise with minimal impact stress to the joints. such as the hips or knees. Pain-relieving creams applied to the skin over the joints can provide relief of minor . acetaminophen is generally the preferred initial drug given to patients with osteoarthritis. taken orally.
will clarify many issues regarding dosing. and increasing the dietary fish intake and/or taking fish-oil capsules (omega-3 capsules) can sometimes reduce the inflammation of arthritis. and effectiveness of different formulations of glucosamine for osteoarthritis. ibuprofen (Motrin). such as stomach upset. Hyalgan. Because osteoarthritis symptoms vary and can be intermittent. these medicines might be given only when joint pains occur or prior to activities that have traditionally brought on symptoms. Icy Hot). thereby decreasing the risk of side effects. Some studies. and in most patients. Newer NSAIDs called COX-2 inhibitors have been designed that have less toxicity to the stomach and bowels. Orthovisc. The most common side effects of NSAIDs involve gastrointestinal distress.S. The risk of these and other side effects increases in the elderly. Fish-oil supplements have been shown to have some anti-inflammatory properties. New topical treatments include an anti-inflammatory lotion. which are used for the relief of the pain of osteoarthritis. Zostrix). or medications. there was no benefit greater than that from placebo pills. It is sometimes possible to use NSAIDs temporarily and then discontinue them for periods of time without recurrent symptoms. cramping diarrhea. although there is no certainty about the purity of the products or the dose of the active ingredients because they are not monitored by the U. Their initial research demonstrated only a minor benefit in relieving pain for those with the most severe osteoarthritis. For persisting pain of severe osteoarthritis of the knee that does not respond to weight reduction. diclofenac (Voltaren Gel) and diclofenac patch (Flector Patch). salycin (Aspercreme). a series of injections of hyaluronic acid (Synvisc. methyl salicylate (Ben-Gay. Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that are used to reduce pain and inflammation in the joints. Examples include capsaicin (ArthriCare.arthritis pain. and even bleeding. exercise. it is hoped. and menthol (Flexall). Further studies. they are reserved for patients with more pronounced symptoms. have suggested that alternative treatment with the food supplements glucosamine and chondroitin can relieve symptoms of pain and stiffness for some people with osteoarthritis. While oral cortisone is generally not used in treating osteoarthritis. FDA. and naproxen (Naprosyn). Examples of NSAIDs include aspirin (Ecotrin). when injected directly into the inflamed joints. The National Institutes of Health studied glucosamine in the treatment of the pain of osteoarthritis. but not all. ulcers. . These supplements are available in pharmacies and health-food stores without a prescription. it can rapidly decrease pain and restore function. Since repetitive cortisone injections can be harmful to the tissues and bones. nabumetone (Relafen). Patients taking blood thinners should be careful when taking chondroitin as it can increase the blood thinning and cause excessive bleeding. safety.
especially if surgery is not being considered. These can bring dramatic pain relief and improved function. usually those with certain forms of knee disease. and perhaps by directly affecting pain receptors. can be helpful when cartilage tears are suspected. In some cases. allowing better joint lubrication and impact capability. These products seem to work by temporarily restoring the thickness of the joint fluid. severely degenerated joints are best treated by fusion (arthrodesis) or replacement with an artificial joint (arthroplasty). Euflexa) into the joint can sometimes be helpful.Supartz. Arthroscopy. Total hip and total knee replacements are now commonly performed in community hospitals throughout the United States. discussed above. Osteotomy is a bone-removal procedure that can help realign some of the deformity in selected patients. Surgery is generally reserved for those patients with osteoarthritis that is particularly severe and unresponsive to the conservative treatments. .