Osteoarthritis Update: 2015

Osteoarthritis (OA) is one of most common causes of chronic pain and a major cause of reduced activity in middle aged and older patients. It is estimated to affect between 20 and 30 million Americans, but these numbers may be deceiving.

Up to 85% of people older than 65 years of age have radiographic evidence of OA, and autopsy studies indicate evidence of OA in weight-bearing joints in almost all persons by the age of 45 years.Based on these statistics, it is no wonder that it feels as if every patient being treated for chronic pain has OA as a primary or contributing factor. Osteoarthritis (OA) is a common cause of pain and disability in adults. Approximately 27 million Americans have clinical OA, which translates to nearly 14% of those over age 25 and 33% of those over 65 years of age. OA is a disease of the entire joint involving the cartilage, joint lining, ligaments, and underlying bone. The breakdown of these tissues eventually leads to pain and joint stiffness. The joints most commonly affected are the knees, hips, and those in the hands.

There is a highly heritable component associated with OA. In fact, there is a genetic contribution to OA for 60% of women. Among the genes that have been linked to OA are several that are involved in the development and maintenance of joint shape, including members of the Wingless and bone morphogenetic protein families. Important genetic markers for the development and progression of the disease are under research.

OA impacts quality of life and increases health-related expenditures. For example, OA of the knee is one of the 5 leading causes of disability among non-institutionalized adults. About 80% of patients with OA have some degree of movement limitation and 25% cannot perform major activities of daily living; 11% of adults with knee OA need help with personal care and 14% require help with routine needs. About 40% of adults with knee OA report their health as “poor” or “fair.”

According to the Centers for Disease Control and Prevention, OA costs $3.4 to $13 billion per year.9 The average direct cost of OA per patient is $2,600 per year,and the total annual cost is $5,700 per person. Treatment for OA focuses on relieving symptoms and improving function, and can include a combination of patient education, physical therapy, weight control, medications, and, perhaps eventually, total joint replacement. Hospital expenditures for total knee and hip joint replacements in 2009 were estimated to be $28.5 billion and $13.7 billion, respectively.

Read the full article here: http://www.practicalpainmanagement.com/pain/myofascial/osteoarthritis/practical-overview-osteoarthritis

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