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Saturday, November 14, 2015

Most Common Disease of elder: The Clinical trials and Studies edition of Musculo-Skeletal disorders(MSDs) - Osteoarthritis: The Causes and Risk Factors

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia
                              

                                   Osteoarthritis 

Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone.  University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).

The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).
              
                      The Causes and Risk Factors

A. Causes
1. Process of wear and repair
Osteoarthritis (OA), a widespread degenerative disease of skeletal joints(34) and is often associated with senescence in vertebrates. arising from long term wear and tear, heavy long-term use or specific injuries(35). Improper repair process of injure of joints can also result of symptoms of Osteoarthritis (OA)(36) in old age(37), according to TCM.

2. Nutrient deficiency and overload
Poor nutritional conditions experienced early in life are linked to greater prevalence of osteoarthritis (OA)(35)(38), such as vitamin D. On the other hand, nutrient overload and metabolic surplus, such as obesity may contribute to early onset of osteoarthritis (OA)(38).

3. Cartilage
Cartilage is a flexible connective tissue cushioned the ends of bones in your joints and allowed the joints to move smoothly. Rough or wears down cartilage due to aging or damage can causes pain due to bone in the joint rubbing against another bone(39)(40).
The above causes of Osteoarthritis (OA) may also be the result of injure(35), overuse(15)(16), Rheumatoid Arthritis(41), etc.

4. Etc.

B. Risk factors
Aging changes in the musculoskeletal system contribute to the development of OA by making the joint more susceptible to the effects of other OA risk factors(39)(40)
1. Abnormal biomechanics
The biomechanics of the foot and ankle is important to the normal function of the lower extremity(42). Abnormal biomechanics can cause abnormal stress and eventual breakdown of connective tissue and muscle(42) of that can lead to early onset of  Osteoarthritis (OA)(43).

2. Joint injury and obesity 
According to the University of Calgary, joint injury and obesity were associated with an increased risk of OA of the knee and hip(44). Dr. Rogers LQ and the research team at the Southern Illinois University School of Medicine indicated that the high and low joint stress from physical activity (PA)
ate associated to reduce risk of the disease(45). In obesity, according to Duke University Medical Center, it is one of the most significant, and potentially most preventable, risk factors for the development of osteoarthritis due to a strong association between body mass index and osteoarthritis of the hip, knee, foot and hand(46)(47).

3. Age-related sarcopenia(48)(49) and increased bone turnover(49) have found to be associated to the development of OA(49). Other suggested that Osteoarthritis development in the injured joints is caused by pathways of joint-related mechanisms and deconditioning of the musculoskeletal system(50). As well as intra-articular pathogenic processes initiated at the time of injury(51).

4. Normal Aging 
Normal aging in humans is associated with declines in skeletal muscle mass and strength and increased muscle fatigability (sarcopenia)(52).

5. Muscle strength
Reduced muscle strength due to ageing, injure or other conditions is regarded as a risk factor for pain and disability in osteoarthritis (OA)(53)(54).

6. Gender
Women are susceptible to the greater risk for the development of  osteoarthritis (OA), but research in sex and gender differences in osteoarthritis to date, may not be appreciated by the orthopedic community, according to Mayo Clinic(56)(57)

7. Genetic 
 Asian are at higher risk to develop osteoarthritis, according to research of  Praxisklinik für Unfallchirurgie und Orthopädie(57)(58), due to  genetic polymorphisms associated with osteoarthritis and related end-points(58).

8. Deformation of bone
People who were born with defective joints or cartilage are at increased risk of developing osteoarthritis(59)(60).

9. Physical activity
People who involve in activity such as sport are at higher risk to develop osteoarthritis, if injure(61).

10. Occupations
Certain occupations are associated to the increased risk of osteoarthritis, especially to workers involving repetitive movements that stress on a particular joint(61)(62).

11. Deficiency in DNA repair
Progeroid human DNA repair syndrome trichothiodystrophy may be associated to the to the development of osteoarthritis(63).

12. Other diseases and conditions may have a higher risk of developing the condition.
a. Gout
Gout is a type of arthritis as a result of uric acid builds up in blood causes of joint inflammation(64). According to a total of 4249 completed questionnaires returned (32%) from 359 attendees, 164 cases of gout were clinically confirmed, there is highly significant association existed between the site of acute attacks of gout and the presence of OA(65).

b. Rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease, causing the attack of flexible (synovial) joints, inflammation of the surrounding tissues and many tissues and organs. Patients with heumatoid arthritis (RA) are associated to increase risk of OA due to progression of aging(66).

c. Paget’s disease of the bone
Paget’s disease of bone is a condition a chronic disorder of excessive and abnormal bone remodeling result in excessive breakdown and formation of bone tissue causing pain, misshapen bones, fractures, and arthritis in the joints near the affected bones(67) with prevalence trends of doubling each decade from the age of 50 onwards, causing bone pain, depending on skeletal sites involved and range from secondary osteoarthritis to malignant degeneration(68).

d. Septic arthritis
Septic arthritis is a condition of inflammation of a joint as a result of bacterial or fungal infection causes of osteoarthritis(69).

9. Etc.

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References
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