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• W1485609304 abstract "Osteoarthritis (OA) is the most common joint-related disorder. The prevalence rises steeply with age and is a major cause of pain and disability. In the over 65-year-old population, 12% suffer from symptomatic knee OA (1) while 13– 26 % suffer from symptomatic OA in at least one hand joint (2). Hip OA is much less common. The prevalence of radiographic change is much higher; in the elderly population 75% have evidence of hand OA and 30% of knee OA on plain radiographs (3). The term “osteoarthritis” is used to refer to a number of related conditions that can be broadly classified into two groups. Primary OA, which can be localised or generalised and more commonly affects peri-menopausal woman (especially involving the hand interphalangeal joints); or secondary OA which has an underlying cause such as an inflammatory arthritis (e.g. rheumatoid arthritis or crystal arthritis), mechanical damage (e.g. articular fractures), a congenital or developmental disorder or a metabolic or endocrine condition (4). An osteoarthritic joint may show varying degrees of inflammatory change, detectable clinically and histologically. It is uncertain to what degree these (and other) subdivisions of OA are useful in terms of therapy. This chapter addresses therapies for all forms of OA of limb joints. Much of the evidence that will be considered here does not distinguish between the various types, although where possible, efficacy in knee, hip and hand OA is described separately due to the differing natural history and prognosis of OA at these sites. Treatments for OA are limited. They consist of a combination of nonpharmacological and pharmacological approaches, which should be tailored to the individual according to their needs and stage of disease. They aim to relieve pain and stiffness and thereby improve function. It is recognised that pain arises from both intra-articular structures (bone or synovial tissue) and from peri-articular structures such as entheses, bursae or tendons. Sensitisation of peripheral nerves and central nervous system changes can also contribute to the persistence of pain over time. All patients should be offered education, advice and access to information in combination with physical approaches (e.g. strengthening exercises and physiotherapy, including aerobic fitness training) and lifestyle changes (e.g. weight reduction and dietary manipulation) as appropriate. Additional therapies include systemic drugs (e.g. analgesics, anti-inflammatory agents, supplements, and, recently, disease modifying treatment such as hydroxychloroquine) and surgery." @default.
• W1485609304 created "2016-06-24" @default.
• W1485609304 creator A5020501495 @default.
• W1485609304 creator A5088307413 @default.
• W1485609304 date "2012-03-02" @default.
• W1485609304 modified "2023-09-24" @default.
• W1485609304 title "Topical and Regional Treatment for Osteoarthritis" @default.
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