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Osteoarthritis

What is Osteoarthritis?

Osteoarthritis is a degenerative process beginning in the articular cartilage. The irritation caused by the degeneration eventually leads to inflammation. Degenerative changes appear long before the onset of symptoms, and many cases (especially of spinal pain) have been wrongly diagnosed as osteoarthritis from signs of degeneration found on X-ray.

It usually manifests after middle age and, contrary to popular belief, is not just a normal ageing process. At the very least there will be factors that reduce the strength of articular cartilage or increase the forces to which it is subjected.

Predisposing causes :

Excessive load eventually damaging the cartilage

1) Total force is too great due to excess heavy work, obesity, dysfunction elsewhere throws excess weight onto the affected joint, eg: an ankle problem on the other leg.

2) The force is distributed through an area that is too small due to malalignment of joint, deformity (congenital or acquired), dysfunction elsewhere altering the line of weight distribution.

Previous injury or disease, e.g. gout, rheumatoid arthritis, damaging the cartilage.

Pathology

  • The cartilage becomes generally undernourished and wears most in the areas of increased stress, giving it an irregular and pitted appearance. Eventually it becomes calcified and pieces can flake off and become embedded in the synovium.
  • The underylying bone becomes sclerosed.
  • The joint capsule becomes more fibrous leading to a shrinking of the joint space and a reduced range of movement of the joint.
  • The bone at the margins of the joint can become hypertrophied, forming projections known as osteophytes.

Signs and Symptoms:

  • Pain - after rest and sustained use, at the end of passive range.
  • Tenderness around joint line.
  • Stiffness - initially only after rest but can increase until constant.
  • Deformity - capsule shrinkage, muscle weakness and wasting, swelling, osteophytes.
  • Giving way - due to nipping of synovial fringe or the presence of a loose body within the joint (possibly an osteophyte breaking off)
  • X-ray - a decreased joint space, sclerosis of pressure area and subchondral bone, presence of osteophytes.

Acupuncture Treatment

31/10/2006 - Acupuncture shows significant improvements in symptoms and quality of life in patients with chronic pain due to Osteoarthritis of the knee or the hip. More information on this research can be found here.

15/02/2006 - Researchers at the University of Maryland School of Medicine have found that traditional Chinese acupuncture significantly reduces pain and improves function for patients with osteoarthritis of the knee who have moderate or more severe pain despite taking pain medication. Patients receiving the acupuncture reported a 40 percent improvement in both pain and function from their baseline scores. More information on this research can be found here.

15/09/2005 - Acupuncture can reduce pain and improve joint functioning in the short-term for people with osteoarthritis of the knee. Click here to see the full research article.

Advanced Practitioner Information:

The following information is suitable for students and practitioners of Acupuncure/TCM and contains content which requires advanced knowledge in this field.

> Acupuncture & Traditional Chinese Medicine Treatment for Osteoarthritis.

References

This information has been used with permission from Close to the Bone by David Legge.

Related research archive articles:

1.)  Does needling sensation (de qi) affect treatment outcome in pain? Analysis of data from a larger single-blind, randomised controlled trial.

2.)  Randomised controlled trial of extraarticular gold bead implantation for treatment of knee osteoarthritis: a pilot study.

3.)  The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain.

4.)  Acupuncture treatment for chronic knee pain: a systematic review.

5.)  Acupuncture for chronic Osteoarthritis pain.

6.)  Acupuncture provides added benefit for people with osteoarthritis of the knee.


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