Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. Osteoarthritis (OA) is a condition which can affect any joint in the body. It’s most likely to affect the joints that bear most of our weight, such as the knees and feet.
Joints that we use a lot in everyday life, such as the joints of the hand, are also commonly affected. It occurs when the cartilage or cushion between joints breaks down leading to pain, stiffness and swelling pain. This happens slowly and usually gets worse over time.
OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe. Osteoarthritis can develop at any age but tends to be more common in people aged over 40 years or those who have had joint injuries.
OA is a top cause of disability in older people. The goal of osteoarthritis treatment is to reduce pain and improve function. There is no cure for the disease, but some treatments attempt to slow disease progression. However, osteoarthritis is different to osteoporosis. Osteoporosis is a condition where the bones become fragile and brittle, causing them to break more easily.
What causes osteoarthritis?
It’s still not clear exactly what causes osteoarthritis. In a healthy joint, a coating of tough but smooth and slippery tissue, called cartilage, covers the surface of the bones. This helps the bones to move freely against each other. When a joint develops osteoarthritis, part of the cartilage thins and the surface becomes rougher. This means the joint doesn’t move as smoothly as it should.
When cartilage becomes worn or damaged, all the tissues within the joint become more active than normal. During this time, the body tries to repair the damage. The repair processes may change the structure of the joint. But will often allow the joint to work normally and without any pain and stiffness. However, the repair processes don’t always work so well. Changes to the joint structure can sometimes cause or contribute to symptoms such as pain, swelling or difficulty in moving the joint normally.
Who gets OA?
We do know it isn’t simply ‘wear and tear’ and that your risk of developing osteoarthritis depends on a number of factors such as:
- Your age. Osteoarthritis is more common in older people because they have been using their joints longer.
- Your gender. Women are more likely to develop osteoarthritis than men, especially after age 50.
- Your job. People who have jobs that require the same movement over and over are at higher risk.
- If you are an athlete. Athletes are at risk because they use their joints so much.
- Injuries to a joint can increase the risk of arthritis in the joint later on.
- Excess weight can make arthritis worse in the knees, hips, and spine.
- Damage from a different kind of joint disease, such as rheumatoid arthritis or gout.
What are the symptoms?
The symptoms of OA vary from person to person. Your symptoms will also depend on which joints are affected. OA tends to come on slowly, over months or even years.
The main symptoms of osteoarthritis are pain and sometimes stiffness in the affected joints. The pain tends to be worse when you move the joint or at the end of the day. Your joints may feel stiff after rest, but this usually wears off fairly quickly once you get moving. Symptoms may vary for no obvious reason. Or you may find that your symptoms vary depending on what you’re doing.
The affected joint may sometimes be swollen. The swelling may be:
- hard and knobbly, especially in the finger joints, caused by the growth of extra bone
- soft, caused by thickening of the joint lining and extra fluid inside the joint capsule.
The joint may not move as freely or as far as normal, and it may make grating or crackling sounds as you move it. This is called crepitus. Sometimes the muscles around the joint may look thin or wasted. The joint may give way at times because your muscles have weakened or because the joint structure has become less stable.
How is osteoarthritis diagnosed?
Your doctor will ask you questions about your pain. He or she will probably ask you if your joint pain gets worse with activity and better with rest. Your doctor will examine you to see if you have trouble moving your joint. Your doctor may order an X-ray of the joint that is causing you problems to see what is causing the pain. Blood tests can help rule out other forms of arthritis.
In rare cases, an MRI scan of the knee can be helpful to identify other possible joint or bone problems that could be causing your symptoms.
How do you treat osteoarthritis?
Currently, there is no cure for OA. While there are treatments that can effectively control symptoms. Your doctor will help you create a plan that is right for you. He or she will treat you with a combination of therapies that can include the following.
One of the most beneficial ways to manage OA is to get moving. While it may be hard to think of exercise when the joints hurt, moving is considered an important part of the treatment plan. Studies show that simple activities like walking around the neighborhood or taking a fun, easy exercise class can reduce pain. This can also help maintain (or attain) a healthy weight.
Strengthening exercises build muscles around OA-affected joints. It eases the burden on those joints and reducing pain. Range-of-motion exercise helps maintain and improve joint flexibility and reduce stiffness. Aerobic exercise helps to improve stamina and energy levels. Eventually, it also help to reduce excess weight. Talk to a doctor before starting an exercise program.
Applying a hot-water bottle, wrapped in a towel to protect your skin, or a wheat-bag that you heat up in a microwave can help to ease pain. An ice pack, again wrapped in a towel to protect your skin, often helps to reduce swelling and discomfort. Ice can be applied for up to 20 minutes every couple of hours.
Your doctor will probably recommend taking over-the-counter medicines to manage your pain. These are medicines you can buy without a doctor’s prescription. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and relieve pain. They include aspirin, ibuprofen (one brand name: Advil), and naproxen (one brand name: Aleve). Other pain relievers may help you feel better, such as acetaminophen (one brand name: Tylenol).
Your doctor can also prescribe medicine for you. This could be prescription pain relievers or prescription NSAIDs used to treat certain types of arthritis. Medicine should be used wisely. You only need the amount that makes you feel good enough to keep moving. Using too much medicine may increase the risk of side effects.
Weight loss and diet
If you’re overweight, then losing even a small amount of weight can make a big difference to your symptoms. This is especially for weight-bearing joints (the hips, knees, back and feet).
The best way of losing weight is by following a healthy, balanced diet. Cut down on the number of calories you get from high-fat and sugary foods, but make sure that you’re including all the key food groups in your diet so you don’t miss out on essential nutrients. Gradually increasing how much physical activity you do will also help with weight loss.
Special supportive devices can help people who have arthritis stay independent. These devices help protect your joints and keep you moving. Devices include:
Talk to your doctor if you think a special device may help your arthritis.
Choosing comfortable, supportive shoes can make a difference. This is not only to your feet, but also to other weight-bearing joints including the knees, hips and spinal joints. In general, the ideal shoe would have a thick but soft sole, soft uppers. It also need plenty of room at the toes and the ball of the foot. If you have particular problems with your feet, then it’s worth seeing a podiatrist for more specific advice.
Joint surgery can repair or replace severely damaged joints, especially hips or knees. A doctor will refer an eligible patient to an orthopaedic surgeon to perform the procedure.
It’s not possible to prevent osteoarthritis altogether. However, you may be able to minimize your risk of developing the condition by avoiding injury and staying as healthy as possible. The following may help:
- Try to not overuse any joints.
- Try to avoid jobs or activities that require repetitive movement.
- Maintain a healthy body weight.
- Do strength-training exercises to keep the muscles around your joints strong. This is especially important for weight-bearing joints, such as the hips, knees, and ankles.
- Avoid lifting heavy things.
- Don’t pull on objects to move them — push them instead.