Osteoarthritis: What is it?

Also called "wear and tear" arthritis or degenerative joint disease, osteoarthritis (OA) is the progressive breakdown of the joints' natural shock absorbers. This can cause discomfort when you use the affected joints - perhaps an ache when you bend at the hips or knees, or sore fingers when you type. Most people over 60 have some degree of OA, but it also affects people in their 20s and 30s.

Osteoarthritis: Symptoms

The symptoms of osteoarthritis tend to develop slowly. You may notice pain or soreness when you move certain joints or when you've been inactive for a prolonged period. The affected joints may also be stiff or creaky. Typically, osteoarthritis leads to morning stiffness that resolves in shortly afterwards. When osteoarthritis affects the hands, some people develop bony enlargements in the fingers, which may or may not cause pain.

Osteoarthritis: Where does it hurt?

In most cases, osteoarthritis develops in the weight-bearing joints of the knees, hips, or spine. It's also common in the fingers, thumb, neck, and big toe. Other joints are usually not affected unless an injury is involved.

Osteoarthritis: What causes it?

Every joint comes with a natural shock absorber in the form of cartilage. This firm, rubbery material cushions the ends of the bones and reduces friction in healthy joints. As we age, joints become stiffer and cartilage is more vulnerable to wear and tear. At the same time, repetitive use of the joints over the years irritates the cartilage. If it deteriorates enough, bone rubs against bone, causing pain and reducing your range of motion.

Risk factors you can’t control

One of the major risk factors for osteoarthritis is something none of us can control - getting older. Gender also plays a role. Over the age of 50, more women than men develop osteoarthritis. In most cases, the condition results from normal wear and tear over the years, but some people have a genetic defect or joint abnormality that makes them more vulnerable.

Risk factors you can control

Because injured joints are more vulnerable to osteoarthritis, doing anything that damages the joints can raise your risk. This includes sports that have a high rate of injury and jobs that require repetitive actions, such as bending the knees to install flooring. Obesity is another risk factor -- it has been linked specifically to osteoarthritis of the knees and hips.

Impact on daily life

Osteoarthritis affects each person differently. Some people have few symptoms despite the deterioration of their joints. Others experience pain and stiffness that may interfere with daily activities. If bony knobs develop in the small joints of the fingers, tasks such as buttoning up a shirt can become difficult. Osteoarthritis of the knees or hips can lead to a limp. And osteoarthritis of the spine can cause debilitating pain and/or numbness.

Diagnosing osteoarthritis

To help your doctor make an accurate diagnosis, you'll need to describe your symptoms in detail, including the location and frequency of any pain. Your doctor will examine the affected joints and may order X-rays or other imaging studies to see how much damage there is, and to rule out other joint conditions. In many cases, blood tests are used to rule out other forms of arthritis.

Long-term complications

Unlike rheumatoid arthritis, osteoarthritis does not affect the body's organs or cause illness. But it can lead to deformities that take a toll on mobility. Severe loss of cartilage in the knee joints can cause the knees to curve out, creating a bow-legged appearance (shown on the left). Bony spurs along the spine (shown on the right) can irritate nerves, leading to pain, numbness or tingling in some parts of the body.

Treatment: Physiotherapy

There is no treatment to stop the erosion of cartilage in the joints, but there are ways to improve joint function. One of these is physiotherapy to increase flexibility and strengthen the muscles around the affected joints. The therapist may also apply hot or cold therapies such as compresses to relieve pain.

Support devices

Supportive devices, such as finger splints or knee braces, can reduce stress on the joints and ease pain. If walking is difficult, walking sticks, crutches, or walking (Zimmer) frames may be helpful. People with osteoarthritis of the spine may benefit from changing to a firmer mattress and wearing a back brace or neck collar.

Medication for OA

When osteoarthritis flares up, many patients find relief with over-the-counter pain and anti-inflammatory medication, such as aspirin, ibuprofen or paracetamol. Pain-relieving creams or sprays can also help when applied directly to the sore area. If pain persists despite the use of tablets or creams, your doctor may suggest an injection of corticosteroid directly into the joint.

Osteoarthritis and weight

If you're overweight, one of the most effective ways to relieve pain in the knee or hip joints is to shed a kilo or so. Even modest weight loss has been shown to reduce symptoms of osteoarthritis by easing the strain on weight-bearing joints. Losing weight not only cuts down on pain, but may also reduce long-term joint damage.

Osteoarthritis and exercise

People with osteoarthritis may avoid exercise out of concern that it will cause pain. But low-impact activities such as swimming, walking or cycling can improve mobility and increase strength. Training with light weights can help by strengthening the muscles that surround your joints. For example, strengthening the quadriceps can reduce pain in the knees. Ask your doctor or physiotherapist (if you visit one) which exercises are best for you.

Is an operation for you?

If osteoarthritis interferes significantly with everyday life and the symptoms don't improve with physiotherapy or medication, a joint replacement operation is an option. This procedure is used for those with severe OA and replaces a damaged joint with an artificial one. The knee and hip are the joints that are replaced most often.

Preventing osteoarthritis

The most important thing you can do to ward off osteoarthritis is keep your weight in check. Over the years, extra weight puts stress on the joints and may even alter the normal joint structure. Preventing injuries is also important. Take precautions to avoid repetitive motion injuries at work. If you play a sport, use proper equipment and follow safety guidelines.

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