Osteoarthritis — guide.

What is osteoarthritis

Osteoarthritis is the most common joint disease and consists of the progressive degradation of the cartilage that covers the ends of the bones in a joint. As the cartilage thins, the bones rub directly against each other, and osteophytes (bone spurs), local inflammation and pain appear. Unlike rheumatoid arthritis, osteoarthritis is a wear-and-tear disease, not an autoimmune one, and it typically affects the load-bearing joints: knee (gonarthrosis), hip (coxarthrosis), spine and hands. It is a major cause of chronic pain and disability in the elderly, but weight loss, appropriate physical exercise and correct treatment can maintain a good quality of life.

Risk factors

Age, obesity, joint trauma, repetitive activities (occupational or sports-related), anatomical abnormalities, genetic predisposition and female sex.

Symptoms

Mechanical-type pain (appears on exertion and improves with rest), short morning stiffness (under 30 minutes), crepitus (cracking sounds) on movement, progressive limitation of mobility and, over time, joint deformities.

Treatment

Non-pharmacological — fundamental:

• Weight loss of 5-10% — reduces pain by 50% in knee osteoarthritis.
• Aerobic exercise (swimming, cycling), muscle strengthening.
• Physical therapy.
• Orthoses, canes.
• Thermotherapy, cryotherapy.

Pharmacological:

• Paracetamol — first line for pain.
• Topical NSAIDs (diclofenac gel) — safe.
• Oral NSAIDs — for greater pain, short term.
• Weak opioids (tramadol) — severe cases.
• Injections with hyaluronic acid, corticosteroid, PRP.
• Duloxetine — for the chronic component.

Surgical: arthroplasty (prosthesis) in severe forms.

Supplements with evidence

• Glucosamine sulfate 1500 mg + chondroitin 1200 mg — modest benefit.
• Hydrolyzed type II collagen 2-10 g/day.
• MSM 1500 mg x 2/day.
• Curcumin with piperine — anti-inflammatory.
• Omega-3 2-3g EPA+DHA/day.
• SAMe, boswellia, topical capsaicin.

Medical disclaimer: the information in this guide is for informational purposes and does not replace the advice of a doctor or pharmacist. For diagnosis and treatment, consult a healthcare professional.