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One out of every seven consultations with family physicians are for osteoarthritis

17 Nov 2011

This rheumatic disease affects 24% of Spaniards aged 45 and olderIt is estimated that by 2020 osteoarthritis will become the fourth most common cause of disability because of the population’ longer life expectancy and progressive ageing.Apart from ageing, the other factors leading to the development of osteoarthritis are obesity, genetic predisposition and joint overuse.The role of family physicians is fundamental in the early detection of osteoarthritis because they are the medicine professionals most frequently consulted by the general population.

Madrid, November 17, 2011. It is estimated that more than seven million Spaniards suffer from osteoarthritis, which is the most common type of rheumatic disease. Pain is its most common symptom; in fact, one out of every seven consultations with family physicians are for osteoarthritis. This disease, which causes a certain degree or stiffness and limitation of movements, in its later stages can cause significant pain, even when resting. “This greatly affects the patients’ daily life. Moreover, the most severe cases might suffer from temporary or even from permanent disability,” points out Dr. Alejandro Tejedor, co-ordinator of the Rheumatology Group of the Spanish Society of Familial and Community Medicine (semFYC) as well as co-ordinator of the Symposium on Osteoarthritis: the Need for new Therapeutic Approaches”, which will be held tomorrow in Madrid, sponsored by Bioiberica Farma.

Osteoarthritis, which is caused by degeneration of the cartilage and mild joint inflammation, is directly linked to the ageing of joints; therefore, it is an age-related disease. Although it can also happen to young people who have suffered trauma or are affected by congenital joints problems, usually 24% of Spaniards suffer from osteoarthritis from the age of 40-45 onwards anywhere in the body (knee, spine, hands, and hip). Because of the high level of co-morbidity and the loss of quality of life suffered by osteoarthritis patients, according to Dr. Tejedor we have every reason to combine the efforts of different disciplines to improve the level of osteoarthritis care, and, in general, that of rheumatic diseases. He assured us that “as family physicians, we are in an enviable position to identify rheumatic disease patients and to give them medical care within its own environment. Collaboration between family physicians and rheumatologists will lead to better patient care. The results will be further improved if we raise awareness among the general population and make known the needs of osteoarthritis patients.”

It is expected that the number of osteoarthritis patients will duplicate in the coming years. In fact, by the year 2020 it will become the fourth most common cause of disability because of the increase in life expectancy and the progressive ageing of the population.

Key Factors for Diagnosis and treatment of Osteoarthritis
Although osteoarthritis cannot be cured,  patients can enjoy an almost normal life if provided with the proper treatment. This is the reason why a smooth communication between primary care physicians and rheumatologists is fundamental to correctly diagnose and to provide patients with the right treatment. It is estimated that about half of the persons experiencing osteoarthritis symptoms will have to receive pharmacological treatment. 

Nowadays, osteoarthritis is usually diagnosed following a set of clinical criteria further supported by imaging techniques such as radiology, echography, and magnetic resonance. This method “…causes a delays in the diagnosis of this disease, which might have been developing molecularly and metabolically for years before we can finally detect it”, explains Dr. Tejedor. To correct this problem, scientists are researching biological markers which will allow for early diagnosis, as well as improving prognosis and to better assess the evolution of the therapeutic measures adopted.

When a patient is diagnosed with osteoarthritis, physicians use pharmacological as well as non-pharmacological measures to control the disease and try to delay its development. “Among pharmacological therapies”, explains Dr. Tejedor, “there are several different types of treatments: treatments that alleviate symptoms, such as analgesics, non-steroid anti-inflammatory (pills or creams), major and minor opioides, and chondroprotectors, drugs of natural origin which reduce pain and delay the degenerative process affecting the joints. In view of the therapeutic arsenal at our disposal, it wold be better to use a combination of different drugs to provide maximum benefit with minimum risk”.

When the existing therapies cannot relieve the pain caused by very severe osteoarthritis, physicians cannot do other than resorting to reconstructive or replacement surgery (joint surgery) to eliminate pain and to restore joint function. However, the ACI or Autologous Chondrocyte Implantation, a technique consisting of repairing damaged cartilage by means of an implantation, has meant a great advance because in many cases joint prosthesis surgery can be avoided. “In any case”, points out Dr. Tejedor, “the treatments are  individualized, we must assess what is the best option for each individual patient”. 

Raising awareness, searching for solutions
Osteoarthritis is a disease of great personal, familiar, professional and social impact. Although persons suffering from osteoarthritis feel pain, they often ignore what is the cause of that pain, as well as the extent to which their quality of life can be affected by this disease. According to Dr. Tejedor, “along with the proper education, it is necessary to dedicate more time to the osteoarthritis patients, as it is being done now to other chronically ill persons such as diabetes or hypertension patients”. Along these lines, Dr. Tejedor stated that “the specific care to osteoarthritis should include giving to the patient information about the treatments to be followed, informing them about rehabilitation exercises to regain joint mobility, and giving them advice on diets to avoid obesity. These scientifically-proved recommendations are highly valued by patients as they quality of life improves immediately and their pain is reduced. In other words, they should learn how to coexist and to actively fight their disease”. 

On the other hand, it is also very important for patients to have access to a large range of rehabilitation and physical therapy services, as well as to better education and information about their disease and the care patterns that they must follow. “The latter task is not the exclusive job of health professionals, but also of government agencies. The solution to their problems will depend not only on the reduction of pain but also of different types of care. Let´s not forget that, in order to restore the use of its joint, these persons have to change completely their lifestyles; it is necessary to physically ‘re-educate’ them if they are to restore the use of that joint” he concluded.

For further information, please contact the semFYC press office at +34 91 787 03 00 (Luís Pardo/Mónica Villegas/Mónica Llorente)