Osteoarthritis: Causes, Risk Factors, Symptoms, Healing Cycle & Treatment
What is Osteoarthritis?
Osteoarthritis, also known as wear and tear of joints, is a common form of arthritis. It is characterized by the destruction of cartilage that lined the joint surfaces of the bones, degeneration of the underlying bone, and resultant bony overgrowth. As the joint structures deteriorate in osteoarthritis, the joint becomes stiff and painful as well as there is a limited range of movement at the joint. Osteoarthritis of the vertebrae may also irritate the corresponding spinal nerves and cause radiculopathies. The classic presentation of osteoarthritis is pain and loss of function of the involved joint. 
Causes and Risk Factors of Osteoarthritis
The common risk factors for developing osteoarthritis include female gender, old age, obesity, anatomic anomalies of the joint, muscle weakness, and trauma to the joint during athletic and occupational activities. Other conditions that lay down the pathological basis of osteoarthritis include the following. 
- Repetitive joint movement (occupational, sports, and hobbies)
- Trauma or injury to the surrounding structures
- Congenital disorders of the joint
- Inflammation of the joints (inflammatory arthritis)
- Compromised blood supply to the joint i.e. avascular necrosis
- Infection of the joint (infectious arthritis)
- Paget disease (bone remodeling disorder)
- Osteoporosis (absence of bone resorption)
- Osteochondritis dissecans (separation of bone and cartilage)
- Metabolic disorders
Approximately 60% of the population suffering from osteoarthritis present with clinical signs and symptoms. The most common clinical features of osteoarthritis are listed below. 
- Joint pain elicits upon movement
- Joint stiffness in the morning and after rest due to lack of production of synovial fluid and joint lubrication during periods of inactivity
- Limited range of movement at the affected joint
- Joint crepitus or production of sounds during movement at the joint
- Tenderness around the joint
- Swelling at the affected joint
Normal Healing Cycle
Basic knowledge of the normal healing cycle of the body is essential for understanding the treatment of osteoarthritis. Inflammation, proliferation, and maturation are the three main stages of the healing cycle. In chronic inflammatory conditions such as arthritis, the involved site moves back and forth between the inflammation and proliferation stages. The description of each stage of the healing cycle is mentioned below.
During the inflammation stage, various reaction cascades cause the inflammatory cells to release cytokines and recruit the immune cells to eliminate the cause of inflammation. The inflammatory stage removes the harmful pathogens and yields a clean wound site for other healing processes to act on. This stage is characterized by redness, swelling, warmth, pain, and loss of function at the joint.
The proliferation stage refers to the formation of blood vessels, laying down of the collagen fibers, reepithelization, and production of granular tissue, which work together to form scar tissue that conceals the wound defect. This is an auto-regulatory stage in which negative feedback mechanisms prevent further formation of scar tissue and excessive collagen deposition. Abnormalities of this stage manifest as muscle spasm, fascia restriction, and formation of trigger points or muscle knots. Persistent and excessive scar tissue limits the range of movement and increases the risk of further joint injuries.
The last stage, maturation, reflects the scar formation, wound contraction, and the replacement of type 3 collagen in the scar with type 1 collagen of the healthy skin. This stage indicates the resolution of the normal healing cycle. In chronic inflammatory conditions, the wound does not reach this stage and results in catastrophic results. 
Osteoarthritis Treatments That Are Not Effective
Following treatment options only provide temporary pain relief, while some may even worsen the clinical presentation of osteoarthritis joints.
- Ice and heat application
- Electric stimulation
- Foam roller
- Stretching of muscles associated with joint
- Strength exercises during inflammation
How to Treat Osteoarthritis Pain?
To alleviate osteoarthritis pain, treatments should address both the inflammation and proliferation stages of the healing cycle.
The inflammatory stage of the healing cycle can be modulated by the following:
- An individual should take enough rest and reduce stress on the affected joint
- MagnaHeal is an anti-inflammatory device that is composed of neodymium, a rare magnet, which is covered by anti-inflammatory substances. MagnaHeal 1 is used for mild inflammation and has a magnetic force length of about 2 inches. MagnaHeal 2 has a magnetic force length of 3 inches and is used to treat a deeper and more severe form of inflammation. This device employs a magnetic field to exert a calming effect on the underlying structures. 
- Diet has a significant role in the wellbeing of the body. Consuming refined carbohydrates, alcohol, trans fat, and other related foods decreases the ability of the body to heal and increases the risk of internal inflammation. The anti-inflammatory diet contains fruits, legumes, green tea, turmeric, ginger, black pepper, and other essential substances that reduce the propensity for inflammation. The diet also helps control osteoarthritis symptoms. 
- People who suffer from hormonal imbalances and lack the essential nutrients to carry out the healing process effectively, often suffer from chronic inflammatory conditions. ‘AskASTR’ is a program designed to evaluate and identify nutritional deficiencies in an individual.
The proliferative stage of healing should be simultaneously regulated to relieve osteoarthritis pain. The target areas are scar tissue, fascia restrictions, and trigger points. Trigger points or muscle knots reduce the degree of stretch and elicits pain while stretching. Fascia restrictions refer to the adherence of fascia layers that restrict movement and cause pain. Limited range of motion will cause the joint surfaces to rub against each other and worsen the joint damage. Two main layers of fascia are superficial and deep fascia. Deep fascia comprises aponeurosis, epimysium, perimysium, and endomysium that cover a group of muscles, single muscle, bundle of muscle fibers, and single fiber respectively.
- A1 Tool is used for releasing superficial and aponeurotic fascia restrictions.
- A3 Tool is used for releasing superficial scar tissue and trigger points.
- A5 Tool is used for deep mechanical stimulation and releases deep scar tissue, trigger points as well as epimysium, perimysium, and endomysium fascia restrictions.
Apart from regulating inflammation and proliferation stages, an individual should remain active and only perform pain-free activities. Also, the activities that elicit joint pain should be discontinued immediately. Other non-surgical treatment options include anabolic and anti-catabolic drugs, regenerative stem cell therapy, dietary supplementation of active vitamin D, gene therapy, and anti-inflammatory drugs. 
Osteoarthritis is a common ailment among older individuals, particularly women. The wear and tear of joints are common among individuals who repetitively use their joints and are prone to joint-related injuries such as athletes. The clinical outcomes of osteoarthritis are determined by how the healing cycle proceeds. In chronic inflammatory conditions, the inflammation and proliferation stages are under-regulated and lead to immense pain and a limited range of movement at the joint. Various treatment modalities such as the use of release tools, MagnaHeal, and consuming a proper diet with supplements are helpful for alleviating osteoarthritis pain.
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