What are the causes, risk factors, preventive measures, signs, symptoms, and treatment options for Osteoarthritis (Degenerative Joint Disease)?

From the Guidelines

Osteoarthritis is a degenerative joint disease that can be managed through lifestyle changes and medical treatments, with the most recent and highest quality study recommending a comprehensive, multimodal approach to treating patients with hand, hip, and/or knee OA offered in the context of shared decision-making with patients, to choose the safest and most effective treatment possible 1.

Cause and Risk Factors

Osteoarthritis occurs when the protective cartilage in joints breaks down over time, leading to bone-on-bone contact and inflammation. Risk factors include:

• Age (more common in older adults)
• Obesity
• Joint injuries or overuse
• Genetics
• Gender (more common in women)

Preventive Measures

Preventive measures for osteoarthritis include:

1. Maintaining a healthy weight
2. Exercising regularly, focusing on low-impact activities
3. Protecting joints during physical activities
4. Maintaining good posture
5. Staying hydrated

Signs and Symptoms

Signs and symptoms of osteoarthritis include:

• Joint pain and stiffness
• Reduced range of motion
• Swelling
• Grating sensation or cracking sounds in joints
• Bone spurs

Treatment

The most effective treatment approach for osteoarthritis involves a combination of lifestyle modifications, medications, physical therapy, injections, and surgery, with a focus on individualized care and shared decision-making with patients 1. Treatment options include:

1. Lifestyle modifications:
   • Weight loss if overweight
   • Regular exercise (swimming, cycling, walking)
   • Use of assistive devices (canes, braces)
2. Medications:
   • Over-the-counter pain relievers: Acetaminophen (up to 3000 mg/day)
   • NSAIDs: Ibuprofen (up to 2400 mg/day) or naproxen (up to 1000 mg/day)
   • Topical treatments: Diclofenac gel or capsaicin cream
3. Physical therapy: To improve flexibility and strengthen muscles around affected joints
4. Injections:
   • Corticosteroids: For short-term pain relief (limit to 3-4 injections per year)
   • Hyaluronic acid: To improve joint lubrication (series of weekly injections)
5. Surgery (for severe cases):
   • Joint replacement
   • Osteotomy (realignment of bones)

Patients should work closely with their healthcare provider to develop a personalized treatment plan, as the effectiveness of treatments can vary between individuals. Early intervention and consistent management can help slow disease progression and improve quality of life 1.

From the FDA Drug Label

Celecoxib capsules has demonstrated significant reduction in joint pain compared to placebo. Celecoxib capsules was evaluated for treatment of the signs and the symptoms of OA of the knee and hip in placebo- and active-controlled clinical trials of up to 12 weeks duration In patients with OA, treatment with celecoxib capsules 100 mg twice daily or 200 mg once daily resulted in improvement in WOMAC (Western Ontario and McMaster Universities) osteoarthritis index, a composite of pain, stiffness, and functional measures in OA

The causes and risk factors of Osteoarthritis (Degenerative Joint Disease) are not mentioned in the provided drug labels. The preventive measures for Osteoarthritis are not mentioned in the provided drug labels. The signs and symptoms of Osteoarthritis mentioned in the provided drug labels include:

• Joint pain
• Stiffness
• Functional measures in OA The treatment options for Osteoarthritis mentioned in the provided drug labels include:
• Celecoxib capsules 100 mg twice daily or 200 mg once daily
• Naproxen 500 mg twice daily 2

From the Research

Causes and Risk Factors

• Osteoarthritis (OA) is a heterogeneous group of conditions that leads to joint symptoms and signs associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins 3
• The etiology of OA is multifactorial, with inflammatory, metabolic, and mechanical causes 3
• Risk factors include genetics, female sex, past trauma, advancing age, and obesity 4
• Age is the major risk factor for the development of OA, with a prevalence of about 60% in men and 70% in women after the age of 65 years 3

Preventive Measures

• There are no approved effective disease-modifying osteoarthritis drugs (DMOADs) for the prevention of OA 5
• Non-pharmacological strategies, such as physical therapy and lifestyle changes, are crucial for pain relief and functional improvement 6
• Exercise is a useful adjunct to treatment and has been shown to reduce pain and disability 4

Signs and Symptoms

• Clinical manifestation of OA includes joint pain, stiffness, and loss of mobility 7
• Joint pain worsened by movement, which can lead to disability in activities of daily living, is a common symptom of OA 4

Treatment Options

• Pharmacologic treatment should begin with acetaminophen and step up to nonsteroidal anti-inflammatory drugs (NSAIDs) 4
• The supplements glucosamine and chondroitin can be used for moderate to severe osteoarthritis when taken in combination 4
• Corticosteroid injections provide inexpensive, short-term relief of osteoarthritic flare-ups of the knee, whereas hyaluronic acid injections can maintain symptom improvement for longer periods 4
• Total joint replacement of the hip, knee, or shoulder is recommended for patients with chronic pain and disability despite maximal medical therapy 4
• Non-pharmacological interventions, such as patient education, self-management, and exercise, are frequently and widely used in the management of OA patients 3
• Regenerative medicine and personalized treatments may revolutionize OA management in the future 6