Thursday, May 23, 2013

I went to my doctor for a regular check up and came out with osteoarthritis I didn't know I had. The X-rays show I'm about out of cartilage and walking with bone on bone. Why don't I have any pain or other symptoms of this problem? Can this be right?

Surprisingly, some people just don't have pain with osteoarthritis even with cartilage loss. Patients with painful OA usually have other symptoms such as swelling, breakdown of bone underneath the cartilage, and tendinitis or bursitis.

It's not clear why some people have painful symptoms and others don't. Clearly the majority of patients do have pain and other problems. In fact if scientists could find out why patients like you don't have pain the information might be able to help others.

Pain is less likely when only the cartilage is affected since cartilage doesn't have pain fibers. Damage to the underlying bone that does have many pain fibers can lead to severe pain. Some joints with OA seem less likely to be painful. For example hip OA is more likely to cause symptoms than OA in the hand.

Finally, the difference in patient-response to OA may be genetically linked. It's uncertain what those genetic factors may be.

Reference:

David T. Felson, MD, MPH. Risk Factors for Osteoarthritis. In Clinical Orthopaedics and Related Research. October 2004. Vol. 427S. Pp. S16-S21.'

This is an excerpt from eOrthopod.com, a website providing patients with clear, accurate and understandable information about their orthopedic and musculoskeletal conditions and injuries. eOrthopod.com includes a comprehensive library of multimedia web topics, news articles and FAQ database on musculoskeletal health. eOrthopod.com also hosts eOrthopodTV, in depth video interviews with practicing clinicians about the evaluation and treatment of common conditions and injuries of the muscles, bones and joints. For more information, visit eOrthopod.com.