Spine, osteoarthritis

It is indicated in spasticity due to neurological disorders e.g., multiple sclerosis, chronic myelopathy, degenerative diseases of the spinal cord, cerebrovascular accidents and cerebral palsy painful muscle spasm associated with static and functional disorders of the spine (cervical and lumbar syndromes) painful muscle spasm following surgery e.g., for herniated intervertebral disc or for osteoarthritis of the hip. 

Bertin P, Keddad K, Jolivet-Landreau I. Acetaminophen as symptomatic treatment of pain from osteoarthritis. Joint Bone Spine. 2004 71 266-274. 

Osteoarthritis is a chronic disease which is characterised by pain and stiffness in the joints. It is not simply a disease caused by wear and tear, many factors can be involved. There is a loss of cartilage and a loss of joint space. There may be bony overgrowths at joint margins. The joints most commonly affected are those of the hands, the knees, hips and spine. 

Osteoarthritis (OA) is the most common form of joint disease and is a leading cause of disability in the elderly. The disease commonly affects the hands, spine, knees, and hips. Multiple joints may be affected in any one individual. The disorder is strongly associated with increasing age, and has been estimated to affect 2 to 10% of aU adults. It is responsible for approximately 68 million work-loss days/year, and for more than 5% of the annual retirement rate. Furthermore, OA is the most frequent reason for joint replacement, a cost to the community of billions of dollars per year. 

Kahan A, Lieu PL, Salin L. Prospective randomized study comparing the medicoeconomic benefits of Hylan GF-20 vs. conventional treatment in knee osteoarthritis. Joint Bone Spine 2003 70 276-281. 

Viscosupplementation via intra-articular hyaluronic acid injections is a conservative treatment modality to be used in conjunction with other conservative management modalities including activity modification, physical therapy, analgesics, nonsteroidal anti-inflammatories (NSAIDS), and intra-articular corticosteroid injections. It is only approved by the FDA for treating osteoarthritis of the knee. Off-label use has been reported for treatment of osteoarthritis affecting the earpometacarpal joints of the thumb, apophyseal joints of the lumbar spine, hip, ankle, and foot [1, 34, 40, 92, 101]. 

Causes. Osteoarthritis is usually produced by a constant strain on a joint which produces a wearing away of the articular cartilage within the joint, especially the weight-bearing joints— the knees, hips, ankles, and spine. Overweight and stress can aggravate the disease. (See Fig. A-38.)... 

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