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Osteoarthritis is one of the most common forms of arthritis, which refers to inflammation of joint. There are two types of osteoarthritis, primary and secondary osteoarthritis. This article outlines the differences between these two diseases.

Arthritis, which simply refers to joint inflammation, is comprised of more than a 100 different subtypes. One of the most common subtypes is known as osteoarthritis.

Osteoarthritis develops when the cartilage that is present at the end of bones in the joints starts to break down and the joints don’t move smoothly anymore. The breakdown of cartilage causes the bone to react by growing more bone, also known as bone spurs. At the same time, the breakdown of the cartilage causes the cartilage to not stretch anymore, causing it to be damaged more easily. The joints may become inflamed and swollen, causing even more damage to the cartilage. When there is significant breakdown of the cartilage, the bones will start to touch each other in the joints, causing you to feel pain and stiffness. The joints will have problems moving through a range of motions.

Osteoarthritis can be primary or secondary. The disease process that takes place in osteoarthritis, described above, occurs in both types of osteoarthritis. However, patients in these two categories have different reasons that cause the breakdown of the cartilage in the first place.

Primary osteoarthritis: What you need to know

Primary osteoarthritis is known as “wear and tear” osteoarthritis — this is the most prevalent kind. Primary osteoarthritis usually develops in people around the ages of 55 to 60. It's no surprise that it's associated with age, since people who have used their joints longer are more likely to wear them out, causing this type of osteoarthritis. In fact, some experts suggest that if we live long enough, we will all get this type of osteoarthritis, whether it be mild or severe.

Secondary osteoarthritis: The most important facts

Secondary osteoarthritis generally develops due to a specific cause and not just because you have used a joint for a long time. Hence, it can occur at any age and generally develops around 45 or 50. These are the risk factors that are associated with the development of secondary osteoarthritis:

  • Injury. Often, patients who get secondary osteoarthritis develop it due to a facture they experienced when playing a sport or being in a car accident. Osteoarthritis likely won’t develop at the time of the injury but you are more likely to experience osteoarthritis at a later time point if you have sustained such an injury. Hence, you are likely to develop secondary osteoarthritis at a younger age compared to primary osteoarthritis.
  • Weight. Being overweight or obese leads to a higher risk of developing secondary osteoarthritis as extra weight on the body puts extra pressure on the joints every day, causing the joints to wear out faster. One study showed that every extra pound of weight you put on adds three pounds of pressure to the knees and six pounds of pressure to the hips.
  • Sedentary lifestyle. Inactivity or leading a sedentary lifestyle is associated with weight gain, which, as mentioned above, leads to secondary osteoarthritis. Furthermore, being inactive causes the muscles and tendons that surround a joint to become weak. Strong muscles are associated with keeping joints properly aligned and stable. Physicians suggest that low-impact exercises such as walking and swimming can help keep the muscles and tendons strong.
  • Genetics. Some people have genes that predispose them to develop osteoarthritis. Specifically, researchers have found that arthritis that affects the hands tends to be genetic in women and run in families. Osteoarthritis in the knee and hip also has a genetic component and seems to be inherited in families.
  • Other diseases. The presence of other diseases that are associated with inflammation, such as rheumatoid arthritis, can actually increase your risk of developing secondary osteoarthritis later on in life.
Hence, the important thing for people to remember is to avoid the risk factors that are under your control that can make you more susceptible to developing secondary osteoarthritis. It is important to exercise to keep muscles and tendons strong, and to lose or maintain a healthy weight.

Treatment: How is osteoarthritis managed?

Unfortunately, there is no cure for osteoarthritis. There is no specific treatment that can help repair damaged cartilage. Hence, treatment for both primary and secondary osteoarthritis is the same. Treatment aims to relieve symptoms, reduce inflammation and pain, minimize permanent damage to joints and maintaining or improving joint functioning.

Some treatment for osteoarthritis include:

  • Medications. The types of medications that are often used for treatment of osteoarthritis include use of acetaminophen (Tylenol), non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (advil) or naproxen (aleve), or stronger prescription NSAIDs, and duloxetine (Cymbalta), which is an anti-depressant that has been shown to improve chronic pain including osteoarthritic pain.
  • Physical therapy. Working with a physical therapist can help teach you strategies and develop exercise programs that are specifically suited to you. These exercises can help strengthen your muscles, improve your range of motion and decrease inflammation and pain.
  • Occupational therapy. Occupational therapists can help make everyday tasks easier by showing you how to do things that add less stress on joints.

Other treatments include cortisone injections, lubrication injections, realigning bones and in extreme cases, joint replacement surgery.

  • Samson, David J., et al. "Treatment of primary and secondary osteoarthritis of the knee." Evid Rep Technol Assess (Full Rep) 157.157 (2007): 1-157.
  • Doherty, Michael, Iain Watt, and Paul Dieppe. "Influence of primary generalised osteoarthritis on development of secondary osteoarthritis." The Lancet 322.8340 (1983): 8-11.
  • Murray, R. O. "The aetiology of primary osteoarthritis of the hip." The British journal of radiology 38.455 (1965): 810-824.
  • Solomon, L. "Patterns of osteoarthritis of the hip." The Journal of bone and joint surgery. British volume 58.2 (1976): 176-183.
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