Osteoarthritis

Osteoarthritis (OA) is the most common of many types of joint problems. It's the type that most of us develop as we get older. OA is a result of age, injury, repetitive trauma, and inheritance.

The basic abnormality in OA occurs in the articular cartilage, which caps the ends of all of our long bones where they meet to form joints (e.g., the knee). Normal cartilage is the best shock absorber in the world. It’s smoother than Teflon, very slippery, and fits each joint perfectly.

The sponginess of cartilage comes from its construction of extremely large molecules called proteoglycans. The many arms of these complicated structures are interlocked like the branches of a tightly packed grove of willow trees. The spaces between the arms provide compressibility and are normally filled with water.

Weight-bearing squeezes the water out of the cartilage into the joint space where it picks up nutrients and oxygen. When unloaded the cartilage instantly springs back, re-absorbing water. In this way, very little of the shock is transmitted to the rigid bone beneath.

When cartilage wears away, normal activities begin to break and fracture the unprotected bone, causing it to overgrow in a fruitless attempt to heal. This leads to the hard, swollen, crunchy-sounding joints of OA.

OA can be prevented and its progression can be slowed by joint protection techniques. Medications to increase comfort and decrease pain should be employed to improve the effectiveness of the physical therapy and joint protection techniques, not as ends unto themselves.

Don't ever accept the answer that "nothing can be done" for OA. This is wrong and tragic, when so much can be done so simply.