What is Osteoarthritis?

Degenerative arthritis, or osteoarthritis (OA), is the most common type of arthritis. While it is the most common type of arthritis among adults over 65 years old, anyone at any age can develop the disease.  Degenerative arthritis and degenerative joint disease are medical terms used by patients and doctors to address the medical condition, osteoarthritis. What is osteoarthritis? It’s degenerative arthritis, degenerative joint disease, wear and tear joint disease and non-auto-immune arthritis.

Degenerative arthritis is a chronic inflammation of the joints which can lead to disability and severe pain if not treated correctly. This is the most common type of arthritis, frequently occurring in men over 45 and women over 55, and it also emerges in the wake of injuries to the bones and joints.

what is osteoarthritis

It is not uncommon for degenerative arthritis to develop years after an injury.

The joints typically affected by degenerative arthritis include the knees, hips, big toes, fingers, and spine. The protective cartilage, which covers the bones in an affected joint, deteriorates or degenerates.

When that occurs, the body starts to form new bone (e.g. osteophytes) in a reparation effort.

The loss of cartilage and the development of osteophytes (spurs) contribute to pain which is the primary characteristic associated with degenerative arthritis.

Osteoarthritis (OA) is a degenerative joint condition that affects as many as 27 million Americans, according to the Centers for Disease Control and Prevention (CDC). The condition is an inflammation that occurs when the cartilage that cushions the joints wears away.

Cartilage

Cartilage is a buffer of sorts that lets your joints move smoothly. When cartilage begins to break down, your bones end up rubbing together when you move. The friction causes inflammation, pain, stiffness, and other uncomfortable symptoms. The only real “fix” to buffer joints is to increase cartilage or increase the muscle mass around the affected joints (more to come on both of these topics).

The condition usually starts with low-grade pain and some mild heat around the joints. Further, it can progress to severe stiffness and pain. Levels of pain associated with this condition can vary depending on the weather due to barometric pressure and even the time of day, due to weight-loading on joints. Other weather factors may come into play which is why so many people want to retire to Arizona or Florida! Many patients, for example, experience more pain and stiffness in cold, moist climates.

Degenerative arthritis of the spine involves the chronic breakdown of cartilage in the joints leading to painful joint inflammation. In the spine, facet joint osteoarthritis, sometimes called degenerative spinal arthritis or spinal arthritis, causes a breakdown of cartilage between the facet joints in the back of the spine.
When the joints articulate or come together, the lack of cartilage causes pain and limits the range of motion. This condition is more common in adults over age 60.

Diagnosis is made by symptoms of pain and stiffness, and in cases where the arthritis is “inflammatory OA,” swelling and redness occur as well. X-rays are positive for loss of cartilage (narrowing of the joint spaces) and spurring.

How common is this?

Overall, in the United States, OA affects 13.9% of adults aged 25 years and older and 33.6% (12.4 million) of those 65+. In 2005, an estimated 26.9 million US adults were “clocked in” with the diagnosis- up from 21 million in 1990 (believed to be a conservative estimate). Average annual prevalence of OA in the ambulatory health care system in the United States, from 2001–2005, was estimated to be 3.5% which amounts to 7.7 million people with OA. Note this is diagnosed OA and not the full picture, but here at the stats for you stat-lovers:

 Hand arthritis (OA):

Age ≥ 26 years old = 6.8% (9.2% female; 3.8%male)

Age ≥ 60 years= 8.0% overall (I doubt this particular statistic from the American College of Rheumatology as I have observed this to be much higher.)

 Hip arthritis (OA):

what is arthritis

Age ≥45 years = 28.0% (29.5% female; 25.4% male)

Symptomatic with X-ray positive evidence:prevalence per 100 people is age ≥45 years = 8.7% (9.3% female; 9.2% male)

Knee arthritis (OA): Studied the most

In one large study: age ≥60 years= 37.4% (42.1 female%; 31.2% male)

In another study not broken down by sex at age ≥60 years, the incidence was reported at 47.8%

In yet another, age ≥45 years= 19.2% (19.3% female; 18.6% male)

And in another age ≥45 years= 37.4% (42.1% female; 31.2% male)

Now the above were symptoms of arthritis reported via medical visits, not necessarily accompanied by X-rays

Symptoms + positive X-rays for knee arthritis (OA):

what is degenerative arthritis

Age ≥60 years= 12.1% (10.0% female; 13.6% male)-per 100 people
Age ≥45 years= 6.7% (7.2% female; 5.9% male)-per 100 people in one study
Age ≥45 years= 16.7% (18.7% female; 13.5% male)-per 100 people in another study

Why such a discrepancy? Likely due to X-ray criteria. In my book, symptoms are symptoms!

 The incidence of osteoarthritis (OA) – General stats:

Incidence rates of OA increased with age, and level off around age 80.  Women had higher rates than men, especially after age 50. Men have a 45% lower risk of incident knee OA and 36% reduced risk of hip OA than women.

My thoughts on the men vs. women stat: Men have more muscle mass meaning more joint padding, so women just need to “work it” a bit more!

Speaking of joint padding, it really helps with pain. Everyone needs to be on a good weight training program to increase lean body mass. The supplement acetyl l carnitine will assist in the cause.

Mortality – actual deaths attributable to arthritis

OA is associated with excess mortality. Approximately  500 deaths per year are attributed to OA. The numbers have increased during the past decade. The annual average of 0.2 to 0.3 deaths per 100,000 population is due to OA (1979–1988). Finally, OA accounts for approximately 6% of all arthritis-related deaths.

Deaths from all causes, cardiovascular deaths, and dementia deaths among adults with OA are 1.6, 1.7, and 2.0 times higher compared with the general population.

OA deaths are likely highly underestimated. For example, gastrointestinal bleeding due to treatment with NSAIDs is not counted. (IMHO this is a biggie!)

Hospitalizations for arthritis (OA):

OA accounts for 47.4% of all arthritis-related hospitalizations; 3,161,100 hospitalizations for OA as the principal diagnosis were recorded in 2011.
Knee and hip joint replacement procedures (usually for OA) accounted for 35% of total arthritis-related procedures during hospitalization. This is big business folks, and it doesn’t have to be you!

Estimated costs due to hospital expenditures of total knee and hip joint replacements, respectively, $28.5 billion and $13.7 billion in 2009.
Nationally, from 1992 to 2011 the rate (per 100,000) of total knee replacement increased 217% from 203.6 to 645. In addition, the rate (per 100,000) of total hip replacement increased 119% from 139.9 to 306.6.

Now, I’m not going to go on my rant about the costs of medical care in America but let me plant the following thought. We know how to prevent heart disease and cancer. We do. At least we A4M docs do, and we do it all the time. It’s not that difficult. Furthermore, heart disease and cancer are a multi-billion dollar industry as is the joint replacement “industry.” There are many steps to take before resorting to a joint replacement, and you can read it in the potential cures for arthritis article I have written. That mentioned article has information about cartilage regeneration I was discussing earlier.

Ambulatory Care for arthritis (OA)

OA accounted for an annual prevalence of 21.7 million (21.7%) of all arthritis-related ambulatory medical care visits in 2010.  Average direct costs of OA per patient ~$2,600 per year. The total (direct and indirect) annual costs of OA per patient are $5700. Job-related OA costs $3.4 to $13.2 billion per year.

 Impact of arthritis (OA) on Health-Related Quality of Life (HRQOL)

what is DJDAbout 80% of patients with OA have some degree of movement limitation.

OA of the knee is 1 of 5 leading causes of disability among non-institutionalized adults.
In 1999, adults with knee OA reported more than 13 days of lost work due to health problems.
About 40% of adults with knee OA reported their health as “poor” or “fair.”

Additionally, 25% of adults with OA cannot perform major activities of daily living (ADL’s), 11% of adults with knee OA need help with personal care, and 14% require help with routine needs. So, this is no small little illness! In fact, this impacts a lot of people in a lot of ways, and it doesn’t have to be this way!

All-in-one relief:

I have plenty of other articles in progress, discussing traditional therapy (the kind that’s toxic to livers and kidneys), and all sorts of promising natural therapies for arthritis. Here is an article about all the causes of osteoarthritis so you can check to make sure you’re not “being bad.” And here is a big scientific review on all of the natural treatments for degenerative joint disease.

 

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