The Relationship Between Osteoarthritis And Peripheral Neuropathy

Osteoarthritis (OA) and peripheral neuropathy are two distinct diseases that affect different areas of the body. While both are degenerative conditions, osteoarthritis results in the breakdown of the soft tissue within the joints, whereas peripheral neuropathy involves damage to the nerves in the peripheral nervous system.

Despite these differences, the human body’s systems and processes are interconnected and interdependent. Consequently, even though each condition has its own specific causes and distinct symptoms, OA and peripheral neuropathy can share similar risk factors, occur simultaneously, or even influence each other casually.

Understanding the connection between OA and neuropathy can help in identifying early signs of these conditions and addressing their underlying causes. This guide will provide you with the essential knowledge to protect your musculoskeletal and neurological health effectively.

Understanding Joint And Nerve Degeneration

To understand how OA influences neuropathy and vice-versa, it is necessary to first look at each disease separately. Below is an overview of each disease, its symptoms, causes, and risk factors.

Osteoarthritis

Affecting 32.5 million adults in the US and an estimated 500 million people worldwide, osteoarthritis (OA) stands as the most prevalent joint degenerative disease globally. As a form of arthritis, OA is an inflammatory condition that gradually wears down the cartilage in the joint area. This cartilage is essential for cushioning and lubricating joint movements.

As the cartilage deteriorates, the surrounding bones, ligaments, and tendons are left vulnerable to friction and shock. This can lead to bone damage, reduced joint mobility, mechanical issues, and deformities.

Being a degenerative disease, OA is rarely the result of direct trauma. Instead, the most common risk factors include aging, genetic predispositions, poor posture, excessive stress, and overuse. Additionally, being overweight or regularly performing motions that place excessive load on the joints are significant risk factors.

Currently, OA is one of the leading causes of disability among older adults and impairs the productivity of over 8 million working-age individuals.

Peripheral Neuropathy

Peripheral neuropathy refers to the degenerative damage of nerves in the peripheral nervous system, which includes all nerves outside the brain and spinal cord. These nerves are crucial for transmitting motor and sensory signals from various parts of the body to the brain and facilitating autonomic functions such as breathing, digestion, and heartbeat.

Despite ongoing research, many aspects of peripheral neuropathy remain incompletely understood. However, erratic blood sugar levels caused by diabetes can damage blood vessels, leading to nerve death by cutting off their oxygen and nutrient supply. It is currently estimated that over 50% of individuals with diabetes suffer from some form of nerve damage.

In addition to diabetes, other risk factors for nerve damage include exposure to toxins like lead and mercury, physical trauma and collisions, hereditary diseases, infections such as HIV, and certain medications like chemotherapy. Smoking and alcohol use disorder are also risk factors, as the toxins in nicotine and alcohol can damage the protective myelin sheath around nerves.

Neuropathy can affect sensory, motor, or autonomic nerves, resulting in a variety of symptoms, including:

• Pain and discomfort starting in the hands and feet
• Loss of sensation in the extremities
• Inability to feel pain or hypersensitivity to touch
• A burning sensation or stabbing pain
• Spasms, cramps, and involuntary muscle movements
• Loss of balance and impaired coordination
• Loss of bladder or bowel control, erratic heartbeat, and digestive issues

If left untreated, neuropathy can lead to severe complications such as foot ulcers, an increased risk of falls, and the necessity for medical devices like pacemakers.

Can Arthritis And Neuropathy Occur Together?

Although both osteoarthritis and neuropathy are incredibly widespread conditions, understanding their comorbidity can be challenging. This is partly because their symptoms might overlap and each disease is often treated in isolation.

However, emerging evidence suggests that individuals with osteoarthritis may have undiagnosed neuropathy and vice versa. For instance, a 2021 study found that nearly 50% of patients with knee osteoarthritis also experienced neuropathic pain. The prevalence of this comorbidity was higher among patients with lower education levels, older age, and higher body mass index.

Thus, these two conditions can indeed coexist, and in some cases, one might even be a risk factor for the other. The following section delves deeper into the connection between OA and neuropathy.

How Does Osteoarthritis Affect Nerve Health

Not everyone with osteoarthritis (OA) will develop neuropathy, and not every instance of nerve damage will directly result in osteoarthritis. However, understanding the relationship between these two conditions can help patients gain a deeper insight into their symptoms, causes, and risk factors.

The Causal Relationship Between OA and Neuropathy

Let’s begin by understanding the connection between the joint and nerve systems. According to a hypothesis developed in 2019, nerves and joints rely on each other to maintain the health of the nervous and musculoskeletal systems.

The nerves surrounding the joints play a vital role in controlling blood flow to these areas and supplying the joint tissue with essential nutrients and oxygen. Conversely, the high levels of inflammation in joints affected by osteoarthritis (OA) can contribute to damage in the surrounding nerves.

This relationship results in the following main effects:

• Damaged nerves in the joint are unable to deliver position signals to the brain, which can lead to a loss of balance and coordination.
• Improper sense signaling can affect how the body distributes loads during movements, causing improper mechanics and worsening OA.
• Affected sensory nerves can interfere with how pain is experienced, leading to heightened OA discomfort.
• Deformities and improper mechanics, common in people with OA, can put pressure on and irritate nerves that would normally be unaffected by the same motions, leading to nerve damage.

Shared Risk Factors

Firstly, being overweight or obese is a leading cause of type 2 diabetes, which is the primary risk factor for neuropathy. Individuals with a high BMI are also more likely to develop osteoarthritis due to the excessive loading and stress on the joints.

Additionally, OA is an inflammatory disease, where the degeneration of soft tissue in the joint is caused by irritation and inflammation. Inflammation also plays a role in neuropathy by causing demyelination, the loss of the nerves’ protective sheath. Both inflammatory conditions can be exacerbated by the use of alcohol or nicotine.

Other factors that might contribute to both OA and neuropathy include aging, biomechanics, and genetics.

Symptoms Indicating Both Osteoarthritis And Neuropathy

Understanding the distinctions and commonalities between the symptoms of osteoarthritis (OA) and peripheral neuropathy is essential for early detection and effective treatment that goes beyond merely alleviating pain.

Osteoarthritis (OA) affects nearly 33 million adults in the United States. This degenerative joint disease often shows up in the fingers and toes, similar to peripheral neuropathy, which impacts the body’s extremities by damaging the peripheral nerves.

However, OA is not limited to these areas and can affect most joints throughout the body. The symptoms of OA differ from those of peripheral neuropathy, and patients who are accustomed to nonsurgical treatments for neuropathy may need different approaches to manage OA effectively.

Below are some of the key indicators that a patient may be dealing with both OA and neuropathy.

Nerve Pain

Peripheral neuropathy manifests as tingling, burning, and numbness in the extremities.

Nerve pain is notoriously challenging to treat due to the wide range of symptoms it presents. Common and well-known symptoms of peripheral neuropathy include tingling, burning, and numbness in the extremities. This is because the nerves in the hands and feet are typically the first to be affected, as they are responsible for carrying the most apparent motor and sensory signals to the brain.

When nerve damage occurs, patients often experience heightened, burning, or stabbing pain, frequently accompanied by unfamiliar sensations or abnormal responses to stimuli (e.g., feeling pain in response to typically painless stimuli).

The location of nerve pain depends on which nerves are damaged. In patients affected by both OA and neuropathy, nerve pain might concentrate around the joints and become more pronounced during joint movements. More commonly, this pain affects the nerves that connect joints, such as those in the hands, feet, wrists, ankles, elbows, and knees.

Joint Pain

Osteoarthritis (OA) typically presents with symptoms such as bone spurs, joint stiffness, and localized pain. In some cases, patients also experience peripheral neuropathy alongside OA.

When these conditions coexist, the areas around the affected joints may exhibit additional symptoms. If sensory nerves are involved, patients might feel stabbing and burning sensations. On the other hand, if motor nerves are affected, muscle spasms, cramps, and fasciculations may occur around the joints. This combination of symptoms can significantly impact mobility and overall quality of life.

Treatment Approaches

Both OA and neuropathy are clinically challenging to treat due to varying causes and symptoms. Healthcare providers might recommend surgical or non-surgical therapies to ease symptoms and treat underlying causes.

Surgical Options

Surgery is often considered a last resort for people struggling with osteoarthritis (OA) and is typically recommended only for patients dealing with severe, end-stage symptomatic conditions.

For neuropathy, surgery is most commonly performed when nerve pain is caused by conditions that place excessive pressure on the nerves, such as carpal or cubital tunnel syndromes. These procedures aim to decompress or release the nerves, which can lead to pain relief, though they do not reverse the neurological damage caused by neuropathy.

Here are some of the most common surgical options available today:

Osteotomy

Osteotomy is a surgical procedure designed to reestablish proper joint mechanics by reshaping the bones affected by OA. During the procedure, bone tissue is removed or reshaped, allowing the deformed bones to realign and continue to support joint movements effectively.

Arthroscopic Surgery

Commonly performed to repair damage caused by osteoarthritis of the knee, arthroscopy is a minimally invasive surgery involving the use of an arthroscope. This tube is inserted into the joint area through a small incision, allowing the surgeon to examine and address the damaged area. If further interventions are needed, the surgeon may use the arthroscope and other tools to reshape the bones and soft tissue to relieve pain and improve joint function.

Arthroplasty

A prominent surgical solution for OA, arthroplasty, was developed by Dr. John Charnley in the 1950s and 60s. This invasive procedure involves replacing the damaged joint with a prosthesis and continues to be a widely preferred method for treating severe osteoarthritis.

In a medical assessment and survey of advancements in treating OA, Professor K.D. Brandt of the Indiana University School of Medicine noted that “recommendation of total joint arthroplasty for the patient with OA, however, is tantamount to an acknowledgment of the failure of medical management. The surgical procedure is often performed after the patient has experienced years, or even decades, of pain and disability” (2004).

Patients familiar with the “medical management” referred to by Professor Brandt may not have considered that arthroplasty is typically recommended only after years or even decades of living with debilitating pain.

This means that even patients willing to undergo surgery to relieve their pain may not receive this recommendation from their doctor until they have endured long-term symptoms. While some may find immediate and lasting relief through surgery, others may understandably seek targeted, evidence-based solutions to manage their pain.

Our Approach to Managing Arthritis-Related Neuropathy

NextPain Care offers a comprehensive, evidence-based approach to managing and alleviating pain from osteoarthritis (OA) and neuropathy. 

We start with minimally invasive treatments, such as physical therapy and medication management, aimed at reducing pain and improving function. If these initial treatments are not sufficient, we offer advanced options like nerve blocks, spinal cord stimulation, or surgical interventions as necessary.

We are committed to providing a supportive and compassionate environment, ensuring that you feel comfortable and cared for throughout your treatment journey.

Combine Care For Two Conditions With NextPain Care

Understanding the relationship between osteoarthritis (OA) and neuropathy is challenging, but finding the right treatment doesn’t have to be. At NextPain Care, we offer a holistic approach that allows patients to relieve chronic pain and enhance their quality of life.

Our commitment to providing effective, evidence-based treatments prioritizes your well-being and comfort. Through a blend of minimally invasive and advanced treatment options, we strive to enhance the overall health of our patients. By creating a compassionate and supportive environment, we empower you to focus on your healing journey and achieve lasting relief.

We believe in a whole-body approach to pain management, taking into account lifestyle factors, genetics, and medical history. This personalized method ensures that each patient receives the most effective combination of treatments for the best possible outcomes.

Choose NextPain Care and take the first step toward a pain-free life. Let us help you reclaim your health and well-being with our comprehensive and compassionate care.