What is Osteoarthritis?
Osteoarthritis (OA) is a common condition that affects millions worldwide. It happens when the cartilage that cushions your joints wears down, causing the bones to rub together. This can lead to pain, stiffness, and reduced mobility [1].
What causes it?
The exact cause of OA still needs to be fully understood, but it's likely due to a mix of factors. Ageing is a big one since cartilage naturally wears down over time. However, only some people develop OA as they age, and why it affects some people and not others remains unclear [2, 3].
Several factors can increase the risk of developing osteoarthritis. These include:
- ageing,
- genetics,
- obesity,
- previous fractures,
- repetitive stress,
- physically demanding jobs,
- and high-impact sports.
- Injuries like an anterior cruciate ligament (ACL) tear are common triggers for osteoarthritis [1, 4].
In some cases, osteoarthritis is secondary, meaning it develops due to an existing condition that damages the cartilage in a joint. Secondary osteoarthritis can result from trauma, joint misalignment, genetic disorders, metabolic or endocrine issues, nerve-related conditions, or diseases like Paget's disease, osteonecrosis, or infectious arthritis [1].
Can Osteoarthritis progression cause depression?
Osteoarthritis (OA) progression can indeed contribute to the onset of depression. This is particularly true for individuals with radiographic knee OA. As the disease progresses, it can lead to deteriorating psychosocial function, which can trigger depressive symptoms.
In conclusion, while osteoarthritis (OA) can increase the risk of depression, it's not the only factor at play. A mix of physical challenges, emotional stress, and lifestyle factors often contribute to the development of depression in people with OA.
Treatments for Osteoarthritis
Non-medical methods: Non-medical interventions are often the first step in managing osteoarthritis (OA). These include physical therapy to improve strength and flexibility, weight loss if needed, and assistive devices like braces, splints, or canes to enhance balance and mobility. These strategies can effectively reduce symptoms and improve quality of life [5].
Pharmacological treatments: When non-medical methods aren't enough, pharmacological treatments may be introduced. NSAIDs, available in oral or topical forms, are a common choice for managing OA pain and inflammation. However, they should be used cautiously, especially for individuals with a history of heart disease, stroke, or gastrointestinal issues [5].
Intra-articular corticosteroid injections can provide temporary relief but should be used sparingly, as repeated use may worsen joint damage. Other pharmacological options include serotonin-norepinephrine reuptake inhibitors (SNRIs), muscle relaxants, glucosamine and chondroitin supplements, viscosupplementation injections, and opioids. Depending on individual needs, these treatments can address symptoms to varying degrees [5].
If non-surgical and pharmacological treatments fail to provide sufficient relief, surgery may be an option. Surgical interventions, such as joint replacement, are typically reserved for severe cases and are considered a last resort [6].
Because OA affects people differently, finding the most effective treatment often requires tailoring approaches to individual symptoms, overall health, and lifestyle. Working closely with a healthcare provider is essential to creating a treatment plan that aligns with your needs.
Treatments for depression
Depression is a common and highly treatable disorder, with a variety of treatment options available. These treatments can be used alone or together as part of a comprehensive plan,
depending on the severity of the condition [7].
Pharmacotherapy
Pharmacotherapy is a widely used and effective option for treating depression. Medications such as antidepressants, mood stabilisers, and anti-anxiety drugs can help alleviate symptoms and improve overall mental health [8, 9]. Among these, Selective Serotonin Reuptake Inhibitors (SSRIs) are considered the gold standard in depression treatment and are often the first choice for many patients [10, 11, 12].
Other types of antidepressants, like Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) and Noradrenaline and Dopamine Reuptake Inhibitors (NDRIs), can also be effective, depending on individual needs and responses [13]. For those with treatment-resistant depression, combining different types of antidepressants may offer better results by targeting multiple pathways in the brain .
Psychotherapy
Psychotherapy, or talk therapy, is another widely used treatment for depression. One of the most effective methods is Cognitive Behavioral Therapy (CBT). This approach helps you identify negative thought patterns that may be contributing to your depression and teaches strategies to challenge and reframe them. By addressing these unhelpful ways of thinking, CBT can improve your mood and equip you with tools to manage depressive symptoms more effectively [9, 11,7 ]
Physical Therapy
Physical therapy treatments such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are also commonly used in the treatment of depression. ECT is often recommended for patients with severe depression or those who haven't responded to other treatments. TMS, on the other hand, is an effective option for individuals experiencing treatment-resistant depression [11, 12].
Complementary and Alternative Treatments
Complementary and alternative treatments can be valuable to your overall treatment plan. These options include acupuncture, St. John's wort, supplements, exercise, music therapy, and relaxation practices like meditation, yoga, and guided imagery [13].
Lifestyle Modifications
Lifestyle changes can play a significant role in managing depression. Regular physical activity, maintaining a healthy diet, getting adequate sleep, practising stress management, and nurturing social connections and healthy relationships are all effective ways to help manage depression symptoms [1, 5].