Osteonecrosis sounds intimidating even before you know the meaning of the word. A form of arthritis in which the bone loses its access to the body's blood supply, osteonecrosis literally means "death of the bone."
Without blood, the bone breaks downs and gradually disintegrates. This breakdown process is known as a vascular necrosis.
The process can be quite debilitating. It begins when the afflicted bones become soft and porous. Eventually, as they receive a dwindling supply of blood, they become brittle and easy to break. The condition most often affects the joints of the hips, knees, and ankles, though roughly 90 per cent of osteonecrosis sufferers experience the disease in their hips.
The average age of onset for osteonecrosis is 38 years, much lower than most forms of arthritis. But it can also afflict the young. In fact, Legg-Calve-Perth's disease, a form of osteonecrosis, can develop in both young children and teenagers. It tends to affect the hip or femur more than other joints, and if it's not treated aggressively in its early stages, the femur head will usually attempt to heal on its own, often healing in a collapsed position that causes pain and stiffness.
What's the cause of osteonecrosis, and is there anything you can do to prevent it?
Most instances of osteonecrosis occur after the joint has suffered a trauma or injury. A fracture or dislocation of the joint can actually block the supply of blood to the bone, which in turn causes the onset of osteonecrosis. Studies have determined that approximately 20 per cent of those who suffer from a hip injury will develop osteonecrosis, though keep in mind that these are generally significant traumas. A bump or a bruise is not likely to lead to an onset of osteonecrosis.
The most significant early sign of osteonecrosis is pain.
Patients commonly note an aching feeling and generalized pain in the area of the affected joint. It may start out as a mild pain, primarily related to physical activity that places pressure on the bones, such as walking or lifting. It's often difficult for sufferers to pinpoint the precise location of the pain. In other words, they have trouble describing exactly where the pain originates. For example, individuals often report feeling pain in their groin area when the true inflammation is located in the hips.
Limited motion, joint stiffness, and muscle spasms are also signs of osteonecrosis, though these are less apparent in the early stages of the disease. As the osteonecrosis progresses they become more noticeable. However, they can come and go, making them more difficult to pin down for both the sufferer and the physician.
Treatment varies according to each patient's circumstances. To fight the inflammation, some doctors prescribe corticosteroids. However, most steroid-based drug medications cannot be taken for an extended period of time since they may cause dangerous side effects. Your doctor will be able to decide if this is an appropriate treatment option for your specific case.
Drug therapy is generally used in conjunction with other treatment options. These options may include dietary changes, special exercise routines, and in severe cases, surgical intervention. The use of special assistive devices such as walkers and crutches can also be used to deal with the effects of this often confounding condition.
Osteoarthritis has no cure but you can treat its symptoms
Acetaminophen is often recommended because it relieves pain with the fewest side of effects. Over-the-counter NSAIDs such as aspirin and ibuprofen reduce inflammation as well as pain and may be helpful. However, these drugs can irritate the stomach. To prevent irritation, try coated aspirin or take medication with meals.
If the pain is severe, your doctor may prescribe stronger NSAIDs and, rarely, corticosteroid injections, shot directly into your joints. Topical therapy, with creams that contain aspirin compounds, may also relieve pain. Along with drug therapy, exercise, and physical therapy, alternative arthritis treatments may also bring relief.
Self-treatment for Osteoarthritis
Self-care is also a valuable tool in treating arthritis. Learning to pace yourself during the day and getting enough rest at night are two of the most important ways to help yourself if you have osteoarthritis. Rather than think about what you can no longer do, focus on what you can do instead.
Regular exercise increases joint protection by stimulating the production of synovial fluid, which coats the ends of the joints. Like oil, this thick substance lubricates your joints and may help prevent further damage.
Gently moving the joints and stretching the muscles and tendons are the best ways to relieve strain on painful joints, improve body alignment, and help you feel more relaxed and in control of your disease. You should do a few simple, carefully controlled mobility and stretching movements once or twice daily, even when your joints are swollen and painful.
Rest is also important because it can lessen inflammation. The key is balance. Adjust the amount of rest and exercise according to the stage of your disease and how you feel each day. Too much inactivity makes the conditions worse, but too much exercise puts you at risk for exhaustion, injury, and more pain.
Exercise as much as you can to increase movement and strength, improve the functioning of the joints, and create better all-round physical well-being. Learn to listen to your body and know when it is telling you to take things easy.
Surgery for Osteoarthritis
Your doctor may recommend surgery if your joints are severely damaged. One procedure, called osteotomy, corrects bone deformity by cutting the bone and repositioning it.
Osteotomy is usually done on the knee.
Total joint arthroplasty involves resurfacing, or refining, the ends of the bones so they can move more freely against each other. This term is also used for total joint replacement in which the joint is removed and a metal, ceramic, or plastic device is inserted in its place.
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