Degenerative Arthritis – Treatment, Causes, Symptoms, Types

What is Degenerative Arthritis?

Degenerative arthritis is a medical condition involving the wearing or degeneration of the cartilage in the joints, leading to contact between two bones. Degenerative arthritis is also termed as osteoarthritis. The cartilage in the joints is responsible for the motion of the joint as well as limiting the friction and tension between bones in the joints. In degenerative arthritis, the cartilage is damaged, leading to increased friction between the bones. Degenerative arthritis is most commonly seen in weight-bearing joints in the body such as the neck, knees and hips, but it can also occur in other joints. The damage in the joint also causes certain changes in the joint capsule as a result of inflammatory response and healing.

The initial response of the joints is to damage the formation of osteophytes in the cartilage. Because of this, there is further narrowing in the joint space. The osteophytes result in the growth of subchondral cysts in the cartilage.

Symptoms of Degenerative Arthritis

Symptoms of degenerative arthritis include:

• Joint pain

The constant friction in the joint causes inflammatory response in the area causing pain. Pain is characterized as burning and sharp on the joint area, including the muscles. Cold temperatures usually aggravate the pain. The pain is relieved by gentle motions but becomes severe with high impact use.

• Stiffness of joints

The other structures such as the muscles, ligaments and tendons in the area are also affected, leading to limited motions of the joint. The cartilage that normally allows for smooth motion of the joints is damaged and causes stiffness in the area.

• Swelling of the joint

The joint also appears swollen because of underlying inflammatory processes in the area.

• Crepitus

When moving the joint, a characteristic crackling sound is heard because of contact between the bones in the joint.

• Heberden’s nodes

Heberden’s nodes are bony enlargements on the distal interphalangeal joint. These appear because of the growth of subchondral cysts in the joints. These are often not painful.

• Bouchard’s nodes

These are similar to Bouchard’s nodes in that they occur on the proximal interphalangeal joints.

• Joint effusion

The joints may also develop collection of water or fluid as a result of accumulation of synovial fluid in the area.

Degenerative Arthritis at various places

Degenerative arthritis is most commonly located at weight-bearing joints, but it can also occur in all joints of the body. The most common locations include:

Degenerative Arthritis of the Spine

The spine is a common site of degeneration because it bears the weight of the back and the head. The spine can also be affected by trauma and various inflammatory conditions such as ankylosing spondylitis, leading to degenerative arthritis.

Degenerative Arthritis of the Knee

The knee is also a common location especially among obese patients because of increased tension in the area as the knees bear the weight of the body.

Degenerative Arthritis of the Neck

The neck or cervical spine carries the weight of the cranium and its contents. It also has several ranges of motion, which increases the stress in cervical joints.

Types of Degenerative Arthritis

Primary

Primary degenerative arthritis is a type of joint disorder caused by the actual  destruction of the joint due to genetic factors. Primary osteoarthritis causes the water content of the cartilage to decrease. The loss of fluid is associated with aging. The absence of protective fluid or proteoglycan causes the cartilage to become susceptible to damage. Primary osteoarthritis is classified as nodal osteoarthritis and erosive osteoarthritis. Nodal osteoarthritis involves the formation of nodes in the joints, while the erosive type involves the progressive destruction of the joint. The erosive form tends to be more severe but less common than nodal osteoarthritis.

Secondary Osteoarthritis

Secondary osteoarthritis is a type of arthritis that results from the degeneration of joints as a result of underlying conditions.

Causes of Degenerative Arthritis

Degenerative arthritis is caused by certain factors. Primary and secondary osteoarthritis have different causative factors. The main cause of primary osteoarthritis is genetics. Aging is an aggravating factor because of the normal degeneration of the joint. Secondary osteoarthritis is caused by various factors such as:

• Obesity

Obesity is one of the most common causes of secondary arthritis because of increased tension on the cartilage on weight-bearing joints.

• Congenital disorders

Congenital disorders of the joints involve the presence of defects in the area since birth, leading to an increased risk for developing degenerative arthritis.

• Inflammatory disorders

Inflammatory disorders such as Lyme disease and Perthe’s disease increase the tendency to develop similar inflammatory condition in the joint.

• Metabolic disorders

Disease such as diabetes and Wilson’s disease also lead to increased degradation of the joints.

• Trauma

Trauma to the joints or ligaments also leads to tearing and injury to the area.

Treatment of Degenerative Arthritis

Various treatments for degenerative arthritis include:

Weight Loss

Losing weight is an important management for osteoarthritis to prevent further stress and tension in the joints.

Exercise

Exercise is also essential for patients with osteoarthritis. Stretching exercises are more beneficial because they strengthen the muscles and structures around the joints, thereby providing more support.

Anti-inflammatory medications

Medications such as ibuprofen and naproxen relieve inflammation and pain. Aspirin may also be used, but it can cause adverse reactions such as gastric irritation and bleeding in the joints. Newer medications such as celecoxib can prevent these effects. Cymbalta, an antidepressant drug, is also effective in reducing inflammation and pain.

Warm compress

Warm compresses may be placed on they areas for 15 minutes, three times a day to relax the muscles and relieve pain.

Alternative medications

Chondroitin and glucosamine can also be given to patients as food supplements. These substances are a natural component of the synovial fluid. Taking these drugs may help in the synthesis of collagen in the cartilage, thereby increasing the integrity of joints.

Surgery

Surgery becomes the last treatment for degenerative arthritis. This may involve osteomy, the removal of the subchondral cysts, and chondroplasty,  the repair of the cartilage. Severe cases may require joint replacement by artificial prostheses.