Joint Pathologies: Theories & Management
Joint diseases arise from mechanical, inflammatory, autoimmune, metabolic, infectious, and traumatic factors.
Osteoarthritis (OA)
Theories:
- Wear-and-tear (cartilage degeneration)
- Biomechanical overload
- Low-grade inflammation
Management:
- Lifestyle modification (weight loss, low-impact exercise)
- NSAIDs, acetaminophen
- Intra-articular injections (steroids, hyaluronic acid)
- Joint replacement surgery
Rheumatoid Arthritis (RA)
Theories:
- Autoimmune response against synovium
- Genetic predisposition (HLA-DR4, family history)
- Environmental triggers (smoking, infections)
Management:
- DMARDs (methotrexate, sulfasalazine)
- Biologics (TNF inhibitors)
- Physiotherapy & joint protection
- Surgery in severe deformities
Gout
Theories:
- Metabolic (uric acid overproduction)
- Renal underexcretion of uric acid
- Dietary excess (purine-rich foods, alcohol)
Management:
- Acute: NSAIDs, colchicine, corticosteroids
- Long-term: Allopurinol, febuxostat
- Lifestyle: Reduce alcohol, avoid red meat/seafood, hydration
Bursitis
Theories:
- Overuse/trauma
- Infection (septic bursitis)
Management:
- Rest, ice, NSAIDs
- Corticosteroid injections
- Antibiotics for septic bursitis
Tendonitis
Theories:
- Overuse microtrauma
- Degenerative aging changes
- Inflammatory changes
Management:
- RICE protocol
- NSAIDs
- Physiotherapy, stretching
- Surgical repair for ruptures
Joint Injuries (Sprains/Dislocations)
Theories:
Management:
- Trauma (sports, accidents)
- Biomechanical weakness
- RICE, immobilization
- Pain relief medications
- Surgical stabilization if severe