“It puts my work on hold. Everything talaga, until the pain is bearable again. Then I can continue working around the house,” says Teresa, who has been diagnosed with osteoarthritis on her left hand. “Delikado, especially because I’m the lone homemaker in the house. Sometimes when I’m moving furniture or washing dishes, I’d feel a sharp pain. I’ve broken a few plates, but so far I’ve done my best not to drop my apo when my osteoarthritis attacks.”
Teresa, 57, is just one of the many people afflicted with osteoarthritis (OA), the most common of several types of arthritis. Millions of people are suffering from this immobilizing disease worldwide. A significant number of Filipinos battles OA day in and day out.
Osteoarthritis is a degenerative joint disease that is highly debilitating and painful. Known as the “wear and tear” arthritis, it concerns the cartilage—the tough, elastic connective tissue that cushions the bones in our joints. Cartilage allows smooth movement and absorbs shock during high-impact activities. When it breaks down or wears away, bare bones rub against each other, causing extreme pain and bone spur formation. Some attacks can be so excruciating that people, like Teresa, are forced to put work, family and friends on hold—preventing them from enjoying life to the fullest.
Creaking and cringing
Stiff joints? Bones that creak with movement? Swelling and sharp pain? Whether it’s in the knees, hand, hip or even neck, the culprit could be OA. Many types of arthritis share common symptoms, though, so how do you know for sure? A clue would be the onset of symptoms. Unlike others types, symptoms of OA usually develop after repetitive use. While rheumatoid arthritis, for example, is painful upon waking in the morning, joint pain from OA becomes intolerable in the late afternoon or evening.
Prolonged inactivity can result in stiffness as well. Severe cases of OA with almost total loss of the cartilage cushion leave patients with severely limited range of motion and pain even at rest.
It is important to note that the presentation and severity of OA differ among patients. Symptoms can be intermittent, with years of pain-free intervals. Some diagnosed with the condition may feel nothing unusual, but their x-rays reveal dramatic damage to the joints.
Nature, nurture or culture?
There are many factors that determine the occurrence of osteoarthritis: the uncontrollable, like age and genetics; and the avoidable, like obesity, injuries and overuse.
OA is a disease of middle age. Before the age of 45, OA occurs frequently in men. After 55, it is more prevalent in women. One can be diagnosed as early as 25 years old, but symptoms may appear 15 to 20 years later.
Genetics also plays a big factor as OA tends to run in families. Having a parent or a sibling with this medical condition increases your risk of inheriting that limp or stoop.
Being overweight is another important determinant—and one that is preventable. Weight-bearing joints, such as the hips and knees, support a good bulk of our bodies. Additional pounds that weigh them down can wear down cartilage.
Accidents that cause injuries to our joints can also fast-track the development of OA. A study concluded that a number of active sports contributes to developing OA, such as soccer, rugby, racket sports, track-and-field and long-distance running.
Screen to win
Although OA is a progressive disease without a cure, there are ways to battle and survive it. The first armament is early detection. There are a number of screening tools, but no single one can diagnose it definitively. They will, however, give just cause for your trip to the doctor’s clinic for proper evaluation.
• Bone density exams and x-rays help reveal signs of OA: cartilage loss, joint space narrowing and abnormalities like bone spurs and erosions. However, a negative x-ray result does not rule out OA automatically; if you continue to experience persisting symptoms, go through a second round of tests, especially the ones below.
• Arthrocentesis is done by using a sterile needle to extract joint fluid for lab testing. This is an invasive procedure and is only warranted if the diagnosis is uncertain. It can help determine other causes of pain in the joint, such as gout and infection.
• Arthroscopy, also an invasive procedure, is done by inserting a viewing tube into the joint space. Damages and abnormalities in the cartilage are checked and sometimes mended through the arthroscope.
Knowledge is one of the most important defenses against the disease and its effect on your life. Doctors will often suggest joint-replacement surgery as a last resort because of the risks and cost, but for some, the relief and improvement in function is worth it. Conservative interventions are worth considering first.