Historical and Current Perspectives on Management of Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis (OA) is a slowly evolving but active disease of degeneration of the articular cartilage associated with symptoms of joint pain, stiffness, and limitation of movement. Typically, these symptoms tend to be worse with weight bearing and activity and improve with rest. Physical examination often reveals tenderness on palpation, bony enlargement, crepitus on movements, and limitation of joint movement. OA can occur in any joint but is most common in the hip, knee, and the joints of the hand, foot, and spine. OA is the most prevalent disease in our society and the second most common cause of disability in the elderly in the Western world, second only to cardiovascular disease [1]. In fact, more than 75% of persons above 70 years of age show some radiographic evidence of OA [2]. The World Health Organization (WHO) figures of worldwide estimates are that 9.6% of men and 18% of women aged more than 60 years have symptomatic OA [3]. The prevalence of OA increases with age because the condition is not reversible. Men are affected more often than women among those aged less than 45 years, whereas women are affected more frequently among those aged more than 55 years [4]. The prevalence of OA is only likely to rise further, due to a variety of reasons. Life expectancy has steadily increased over the years and continues to do so. The triad of increasing numbers of elderly people, obesity, and lack of exercise plaguing Western society at the moment is likely to have a significant effect on the burden of OA facing people and society in the next few decades.