The problem of degenerative joint disease among construction workers

Background

Degenerative joint disease has been a very serious issue in the construction industry.  A review on “Occupational and genetic risk factors for osteoarthritis: A review” published on (PMS 8th Sept.; 2015) highlighted that heavy physical work load was the most common occupational risk factor for osteoarthritis also known as degenerative joint disease in several anatomical locations. Other factors include kneeling and regular stair climbing, crawling, bending and whole body vibration, and repetitive movements which are daily routine in the construction industry.

The review also stated that workers in several occupations are at increased risk for knee osteoarthritis. They included workers in construction, firefighting, agriculture, fisheries, forestry, and mining industry. In a case-control study, men who worked for 11–30 years in building and construction work had a 3.7 fold greater risk of developing knee osteoarthritis, after adjustment for confounding factors. Several studies have reported that male workers in manual labor occupations had higher odds of knee osteoarthritis.

 

About degenerative joint disease

Degenerative joint disease is a type of arthritis caused by inflammation, breakdown, and eventual loss of the cartilage of the joints. Degenerative arthritis is the most common form of arthritis, usually affecting the hands, feet, spine, and large weight-bearing joints, such as the hips and knees. It is also known as osteoarthritis or degenerative arthritis. The joints typically affected by degenerative arthritis include the knees, hips, big toes, fingers, and spine.

 

Epidemiology

Degenerative arthritis is the most common type of arthritis. In the United States, about 27 million people have degenerative arthritis. While it is most common type of arthritis among adults over 65 years old, anyone at any age can develop the disease. The risk of developing the disease does increase with age.

Prevalence of degenerative arthritis increases significantly after age 50 in men and after age 40 in women. Also, it is not uncommon for degenerative arthritis to develop years after an injury.

 

Causes of degenerative arthritis

Degenerative arthritis is divided into two (2); Primary and Secondary arthritis.

Primary osteoarthritis or degenerative arthritis is mostly related to aging. With aging, the water content of the cartilage increases and the protein makeup of cartilage degenerates. Repetitive use of the joints over the years causes damage to the cartilage that leads to joint pain and swelling. Eventually, cartilage begins to degenerate by flaking or forming tiny crevasses. In advanced cases, there is a total loss of the cartilage cushion between the bones of the joints; this will cause friction between the bones, leading to pain and limitation of joint mobility. Damage to the cartilage can also stimulate new bone outgrowths (spurs) to form around the joints. Osteoarthritis occasionally can be found in multiple members of the same family, implying a heredity (genetic) basis for this condition.

Secondary osteoarthritis is caused by another disease or condition. Conditions that can lead to secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, abnormal joints at birth (congenital abnormalities), gout, rheumatoid arthritis, diabetes, and other hormone disorders.

Symptoms of degenerative joint disease

A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.

Degenerative joint disease main symptoms includes:

  • Pain
  • Problems moving affected joints.
  • Stiffness – more severe on waking up in the morning, and improves within 30 minutes when the individual starts moving about.

In some cases people with osteoarthritis may have no symptoms. Symptoms are usually only felt in either one joint, or a just a few at any one time. In many cases the symptoms come on slowly.

Other signs and symptoms may include:

  • Affected joints are larger than usual
  • After not moving the joint for a while pain and stiffness may worsen
  • Joints are warm
  • Loss of muscle bulk
  • Tenderness in the affected joint
  • The affected joints will have a limited range of movements
  • The patient may experience a grating or crackling sound/sensation in the affected joint.

The knees, hips or hands are most commonly affected.

 

Management degenerative joint disease

Generally, there is no cure for degenerative joint disease, but treatments are available to manage symptoms. Long-term management of the disease will include:

  • Managing symptoms, such as pain, stiffness and swelling
  • Improving joint mobility and flexibility
  • Maintaining a healthy weight
  • Getting enough of exercise

 

Some specific actions that can help in degenerative arthritis include:

Change of lifestyle

For obsessed people, weight loss may be an important factor. Patient education has been shown to be helpful in the self-management of arthritis. It decreases pain, improves function, reduces stiffness and fatigue, and reduces medical usage. Patient education can provide on average 20% more pain relief when compared to NSAIDs alone in patients with hip osteoarthritis.

Physical measures

Moderate exercise is beneficial with respect to pain and function in those with osteoarthritis of the knee and hip. These exercises should occur at least three times per week.  Functional, gait, and balance training have been recommended to address impairments of position sense, balance, and strength in individuals with lower extremity arthritis as these can contribute to a higher rate of falls in older individuals.

Among people with hip and knee osteoarthritis, exercise in water may reduce pain and disability, and increase quality of life in the short term. Also therapeutic exercise programs such as aerobics and walking reduce pain and improve physical functioning for up to 6 months after the end of the program for people with knee osteoarthritis.

Physical and Occupational Therapy

Physical and occupational therapists can provide a range of treatment options for pain management including:

  • Ways to properly use joints
  • Heat and cold therapies
  • Range of motion and flexibility exercises
  • Assistive devices

If you discover these symptoms relating to degenerative arthritis, meet your doctor for examination and early management.

You can read more on the disease here

 

 

References

Sandmark H, Hogstedt C, Vingard E. Primary osteoarthrosis of the knee in men and women as a result of lifelong physical load from work. Scandinavian journal of work, environment and health. 2000 Feb;26(1):20–5. PubMed PMID: 10744173. Epub 2000/04/01. eng. [PubMed]

 

Muraki S, Akune T, Oka H, Mabuchi A, En-Yo Y, Yoshida M, et al. Association of occupational activity with radiographic knee osteoarthritis and lumbar spondylosis in elderly patients of population-based cohorts: A large-scale population-based study. Arthritis Rheum. 2009 Jun 15;61(6):779–86. PubMed PMID: 19479710. Epub 2009/05/30. eng. [PubMed]

 

O’Reilly SC, Muir KR, Doherty M. Occupation and knee pain: A community study. Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society. 2000 Mar;8(2):78–81. PubMed PMID: 10772236. Epub 2000/04/20. eng. [PubMed]

 

Amin S, Goggins J, Niu J, Guermazi A, Grigoryan M, Hunter DJ, et al. Occupation-related squatting, kneeling, and heavy lifting and the knee joint: A magnetic resonance imaging-based study in men. The Journal of rheumatology. 2008 Aug;35(8):1645–9. PubMed PMID: 18597397. Pubmed Central PMCID: 2758236. Epub 2008/07/04. eng. [PMC free article] [PubMed]

 

Holmberg S, Thelin A, Thelin N. Is there an increased risk of knee osteoarthritis among farmers? A population-based case-control study. International archives of occupational and environmental health. 2004 Jun;77(5):345–50. PubMed PMID: 15127209. Epub 2004/05/06. eng. [PubMed]

 

Kellgren JH, Lawrence JS. Rheumatism in miners. II. X-ray study. British journal of industrial medicine. 1952 Jul;9(3):197–207. PubMed PMID: 14944740. Pubmed Central PMCID: 1037404. Epub 1952/07/01. eng. [PMC free article] [PubMed]

 

Franklin J, Ingvarsson T, Englund M, Lohmander S. Association between occupation and knee and hip replacement due to osteoarthritis: A case-control study. Arthritis Res Ther. 2010;12(3):R102. PubMed PMID: 20497530. Pubmed Central PMCID: 2911890. Epub 2010/05/26. eng. [PMC free article] [PubMed]

 

Tuchsen F, Hannerz H, Jensen MV, Krause N. Socioeconomic status, occupation, and risk of hospitalisation due to coxarthrosis in Denmark 1981-99. Ann Rheum Dis. 2003 Nov;62(11):1100–5. PubMed PMID: 14583575. Pubmed Central PMCID: 1754366. Epub 2003/10/30. eng. [PMC free article][PubMed]

 

Andersen S, Thygesen LC, Davidsen M, Helweg-Larsen K. Cumulative years in occupation and the risk of hip or knee osteoarthritis in men and women: A register-based follow-up study. Occupational and environmental medicine. 2012 May;69(5):325–30. PubMed PMID: 22241844. Epub 2012/01/14. eng.[PubMed]

 

2 COMMENTS

  1. Great article and very well explained. I really appreciate the insight here in this post and confident it’s going to be helpful to me and many others. Thanks for sharing all the information.

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