reply to this discussion 3 references needed osteoarthritis jensine – exclusivewritings.com

Osteoarthritis is a progressive joint disease in which the joints fail to repair after damage (Ferri, 2019). The Arthritis Foundation (2020) stated that this disease is also called wear and tear arthritis, primarily seen in those who are older than 50 years old and affecting women more than men. Ferri (2019) stated that over 30million Americans suffer from OA that are 60 years and older. This condition is special to me since my mother has this joint condition. For years my mother has also been active working on her garden if not at her actual job, but over the past few years it has been harder for her to fully grasp and be as active as she once was because of OA.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (2019) mentioned that some risk factors for OA are those who are overweight or obese, advance age, continued overuse of a joint, previously deformities to the joints, and a family history of OA. The cause of OA is unknown, but Badlissi (2018) stated that cartilage between the joints deteriorate over time and in later stages cause crepitus and bone remodeling that is not conducive to proper functioning or range of motion. During the physical assessment and examination, patients often complain of pain, joint stiffness, swelling, instability, weakness, and grating sounds in and around the specific joint (Arthritis Foundation, 2020). Further inspection and palpation of the joint can show warmth and swelling at the site, crepitus during range of motion, and for the hands at the proximal interphalangeal joints Bouchards nodes are seen or Heberdens nodes at the distal interphalangeal joints (Ferri, 2019).

There is no specific lab test for OA though a good history and physical along with radiology exams, lab work for ESR, CBC, rheumatoid factor is most often ordered regarding the suspicion of OA (Ferri, 2019). If there is severe swelling or effusions at the site, an arthrocentesis may be done in the office to evaluate for infection or other causes (Ferri, 2019). Treatment for acute, episodic, and chronic start with nonpharmacological modalities that include RICE rest, ice, compression with tape, wraps or sleeves, and elevation (Ferri, 2019). Tai chi, stress relieving activities, weight loss, and self-care have also been mentioned (Ferri, 2019; Arthritis Foundation, 2020; NIAMS, 2019). In acute and episodic pain NSAIDs are used for example diclofenac 35mg by mouth three times a day or as a first-line treatment topical steroids like NSAIDs or capsaicin can be used followed by the before mentioned (Badlissi, 2018). Celecoxib 200mg by mouth once a day may also be helpful for pain relief, but not for those who are already taking ASA 81mg per day (Badlissi, 2018). For chronic pain relief tramadol starting at 50mg by mouth as needed every 4-6 hours for pain can be prescribed as a mild opioid, but for those in which tramadol still does not work or ceases to work a referral to an orthopedic or pain management specialist may be needed regarding surgery or long standing opioid use (Badlissi, 2018).

A follow up in the office should be made any time there is a prescription ordered for a patient to evaluate its effects and management of the OA treatment and for side effects. Patient referrals to a specialist or consultations would be made in cases in which the above treatment plan is ineffective in both pain relief and patient’s ability to perform their daily lifestyle. Patient education is based on the functionality of what their everyday lifestyle is currently like and what their goal is. For example, creating a plan that the patient can adhere to with realistic goals in mind that are attainable. The family and friends can provide a strong social support system for the patient to aid in not only simple things like chores around the house or opening cans and jars, but also provide emotional support for the patient. As the aging population continues to grow, every day activities can become harder and harder to attain alone. With the assistance of social support, primary care providers, and a treatment plan that is patient specific, a patient diagnosed with OA can live a longer stronger life.

References

Arthritis Foundation. (2020). Osteoarthritis. Retrieved from https://www.arthritis.org/diseases/osteoarthritis

Badlissi, F. (2018). Osteoarthritis. Retrieved from https://online.epocrates.com/diseases/19211/Osteoa…

Ferri, F. Ferri’s Clinical Advisor 2019. [MBS Direct]. Retrieved from https://mbsdirect.vitalsource.com/#/books/97803235…

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2019). Osteoarthritis. Retrieved from https://www.niams.nih.gov/health-topics/osteoarthritis

ORDER NOW