About Physiatry

Degenerative Joint Disease

Condition: Degenerative joint disease, which is also referred to as osteoarthritis (OA), is a common “wear and tear” disease that occurs when the cartilage that serves as a cushion in the joints deteriorates. This condition can affect any joint but is most common in knees, hands, hips, and spine.

Background: More than 50% of adults over the age of 65 are affected by degenerative joint disease. This condition is associated with pain, loss of function, and reduced endurance, ultimately leading to weight gain and associated complications. The underlying cause of this condition is typically chronic repetitive motion that results in inflammation and structural joint damage.

Risk Factors: Predisposing factors include repetitive motion, infection, rheumatoid arthritis, muscular dystrophy, osteoporosis, hormone disorders, obesity, sickle cell disease, and bone disorders. OA is equally common in men and women before age 55 but increases in women thereafter. Knee OA is more common in African-American women. Higher rates are observed in the knees in women and in the hips in men.

History and Symptoms: Patients may have pain, stiffness, limited range of motion, loss of flexibility, swelling, weakness deformed joints, and damaged cartilage. As disease progresses, joint pain and discomfort that could be relieved with rest become persistent and can limit activity and reduce quality of life.

Physical Exam: Physical examination will focus on the strength of the associated muscles and joint structure as well as tenderness of the joint. Ability to walk and range of motion will be examined as well. Evaluation of self-care and depression in the face of chronic pain are also necessary.

Diagnostic Process: X-rays, MRI, CT, or bone scans are imaging techniques used to diagnose OA. Fluids removed from the affected joints may be analyzed, and arthroscopy, which involves insertion of a small scope into the joint, can be used to view the damage.

Rehab Management: Pain alleviation via medications including acetaminophen, NSAIDs, narcotics, and injection of corticosteroids and rehabilitation lead to improvement. Weight loss if necessary and low-impact land or aquatic exercise are important features of treatment. Rehabilitation involves muscle strengthening and stretching around the diseased joints. Patients that participate in regular exercise tend to experience greater improvement.

Other Resources for Patients and Families: Patient and family education about weight reduction, exercise, and use of pain medications is beneficial. Several organizations can offer information and support for patients and families.

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