Why Choose Cedars-Sinai Marina del Rey Hospital for Osteoarthritis Treatment?
Our highly experienced orthopedic specialists and surgeons provide individualized treatment for osteoarthritis, carefully taking into consideration the needs of each patient. We are well aware that no two cases are the same and therefore use every diagnostic tool available to identify the particularities of your condition. After a thorough examination, we will present you the safest and most effective treatment options for your specific case, all of which are carried out by employing the latest medical technology. Whether your osteoarthritis requires treatment with medication or surgery, the orthopedic experts at Cedars-Sinai Marina del Rey Hospital will ensure you receive high-quality care in a warm, compassionate environment.
Also known as degenerative joint disease and degenerative arthritis, osteoarthritis is the most prevalent chronic joint condition, usually affecting the knees, the lower back, the hips, as well as the spine. However, the disease can also occur in the joints of the fingers and toes. Osteoarthritis ensues when the cartilage – a rubbery substance which covers the end of each bone, promoting smooth movement – deteriorates. As a consequence, the patient experiences symptoms such as pain and swelling.
Over time, as osteoarthritis worsens, bones may also break down and spurs will subsequently develop. Inflammation will also take place in the body with the disease, which causes additional damage to cartilage. When osteoarthritis reaches the most severe stage, cartilage disappears almost completely and the two bones between which it was located will rub against each other, leading to increased discomfort. At the moment, roughly 27 million people in the U.S. struggle with osteoarthritis, the majority over the age of 60. The disease is one of the primary causes of disability throughout the country.
Although the damage produced by osteoarthritis to cartilage is irreversible, there are numerous medications and therapies which can alleviate your symptoms and improve your quality of life. Surgery is also available for osteoarthritis accompanied by unbearable pain, as well as for patients whose disease is unresponsive to non-invasive treatments. Depending on the severity of your condition, your doctor will recommend you one or a combination of the treatments below.
The following drugs have been found effective for the long-term management of osteoarthritis:
- nonsteroidal anti-inflammatory drugs – over-the-counter nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen sodium can greatly relieve mild joint pain, whereas for severe pain, stronger ones are available by prescription
- analgesics – this category of medication includes acetaminophen and opioids
- antidepressants – duloxetine, sold under the name of Cymbalta, has shown significant efficiency in alleviating chronic pain
Corticosteroids or hyaluronic acid injections may be recommended to patients whose discomfort cannot be managed by using only conventional treatments such as medication. After numbing the area, the doctor will inject the substance in your joint. It is worthy of note that a person cannot receive more than 3 or 4 cortisone injections per year, as this medication may actually worsen osteoarthritis in large doses. As for hyaluronic acid injections, they work by providing some cushioning and lubrication in the affected joint and thereby temporarily relieving pain.
There are multiple therapies people suffering from osteoarthritis are highly encouraged to undergo for pain relief, such as:
- Physical therapy. By following a personalized exercise program under the guidance of a physical therapist, your range of motions will expand, the muscles around the affected joint will strengthen, and the pain you experience will reduce in intensity. Furthermore, light exercise you can do by yourself, such as walking and swimming, has also been found to be effective in this regard.
- Occupational therapy. The purpose of occupational therapy is to help you discover alternative ways of performing your job or everyday tasks so that no additional stress will be put on your joints.
- Yoga and tai chi. Medical studies revealed that these movement therapies, which involve light exercise and deep breathing techniques, can also help reduce pain and improve flexibility in osteoarthritis patients.
Because people diagnosed with osteoarthritis often struggle with performing even the simplest daily tasks, the use of assistive devices might be necessary. They can ease their difficulties and enhance the quality of their life to a great extent. Some of the assistive devices available for osteoarthritis patients are:
Joint replacement surgery is usually recommended for severe osteoarthritis cases in which the cartilage has almost completely worn out. It is also known as arthroplasty and is most often performed on the hips and knees. The aim of this surgical procedure is to restore the function of the joint, either by resurfacing the bones or by replacing it with a prosthesis (artificial joint). Joint replacement surgery can be carried out by using both localized and general anesthesia. Nonetheless, over time, artificial joints may also deteriorate and therefore require replacement.
In the case of secondary osteoarthritis, losing the excess weight can improve your condition significantly, as it will relieve the stress on your joints. For osteoarthritis which occurs in the knee, osteotomy might prove to be a great way to alleviate pain. This is a surgical procedure during which a cut will be made across the bone – either above or below the knee – and a wedge of bone will subsequently be removed or added to shift your weight from the damaged portion of your knee.
Depending on the cause, there are two types of osteoarthritis: primary and secondary. While the former occurs naturally due to the wear and tear of the cartilage which takes place with aging, being also the most common kind, the latter is the result of a condition which leads to cartilage damage, such as:
According to orthopedic specialists, developing primary osteoarthritis is inevitable if we reach old age, as joints are bound to deteriorate over time. This type mostly affects individuals between the ages of 55 and 60, whereas secondary osteoarthritis is usually diagnosed in younger people (45 to 50 years old).
- stiffness, which is generally most bothersome in the morning and after periods of physical inactivity
- pain during or after movement
- tenderness when pressure is applied to the affected joint
- loss of flexibility, which prevents you from performing a full range of motions
- a grating or scraping sensation when you use the joint in question
- spurs – tiny fragments of bone which may grow around the joint
- clicking or cracking sounds when bending the joint
- soreness and inflammation around the joint following inactivity or overuse
- in severe cases, joint instability, which may lead to locking (sudden lack of movement) or buckling (your knee giving out)
- muscle weakness
- joint deformity
In general, the diagnostic process for osteoarthritis entails undergoing a physical examination and one or multiple tests which will allow the orthopedic specialist to determine with certainty whether you suffer from this joint disease. After discussing your health history and symptoms, the doctor will take a careful look at your joints and test their range of motion. They will seek signs of joint damage such as tenderness and swelling.
Nevertheless, a physical exam in and of itself cannot provide enough information to assign you a reliable diagnosis, so the orthopedic specialist will subsequently order one or more of the following tests:
- X-ray. The images obtained will allow your doctor to observe potential signs of joint damage.
- Joint aspiration. During this test, the affected area will be numbed and a sample of fluid will then be collected from the inside of your joint. It will later be examined for the presence of crystals or joint deterioration, which will help the specialist decide whether you have osteoarthritis or another form of arthritis.
- MRI. This is the most accurate diagnostic test when it comes to osteoarthritis, as magnetic resonance imaging provides a complex and detailed perspective of your joints. Nonetheless, it is rarely necessary, as X-rays usually offer sufficient evidence of osteoarthritis.
- Blood tests. While there is currently no blood test which can detect osteoarthritis, your doctor may order some to rule out other causes of joint pain.
For primary osteoarthritis, old age is the main risk factor, as the wear and tear of the cartilage in our joints is unavoidable. The longer we use our joints, the more susceptible we are to developing osteoarthritis later in life. Other risk factors for primary osteoarthritis include:
- age – people over the age of 60 make up the vast majority of osteoarthritis patients
- gender – osteoarthritis is more likely to occur in men before they reach the age of 45 and is more common in women over that age
- occupational factors – performing repetitive actions on the job, such as lifting, walking, climbing stairs, and kneeling or squatting for more than one hour per day has been found to increase osteoarthritis risk
- poor posture
- family history – if you have a parent or sibling who suffers from osteoarthritis, chances are you will develop the disease too
As for secondary osteoarthritis, the disease ensues as a result of another condition which somehow affects the joints. Examples of such conditions can be found above, in the Types of Osteoarthritis section.
A wide range of home remedies and alternative treatments are believed to improve the symptoms of osteoarthritis. However, they should not represent the only form of pain management you use, as their purpose is to complement standard treatment, not to replace it. We advise you to always seek the opinion of your doctor before employing alternative remedies.
Here are several alternative methods of reducing osteoarthritis discomfort:
- gentle exercise such as light weight lifting, swimming, walking, and biking can strengthen the muscles around your joints and thereby alleviate your pain
- knee taping, which consists in strapping tape around the affected knee to improve discomfort, a procedure your doctor needs to show you how to carry out first
- over-the-counter pain creams and gels may also help with pain relief, particularly when it comes to joints which are close to the surface of the skin, as they create a hot or cool sensation after being applied on the area in question
- ice or heat therapy
- natural supplements such as chondroitin and glucosamine
- massage therapy – one hour of massage per week for at least 8 weeks in a row has been discovered to be quite effective in reducing pain and stiffness, as well as improving mobility
- topical capsaicin, a component found in hot chili peppers, might be a good alternative for people who cannot take anti-inflammatory medication
While primary osteoarthritis cannot be prevented, as it is bound to occur with ageing, you can lower your risk of secondary osteoarthritis if you take into consideration the following advice:
- engage in regular exercise
- maintain a healthy weight
- monitor your blood sugar, as diabetes can lead to osteoarthritis
- manage occupational risks if your job entails too much kneeling, twisting, lifting, or walking
- keep yourself hydrated, as drinking enough water has been found to reduce the risk of developing osteoarthritis
- use Epsom salts when taking a bath, as they facilitate the elimination of carbon – a waste product of the body – through the skin