Osteoarthritis

What is osteoarthritis?

Osteoarthritis is the most common form of arthritis, it is also known as degenerative joint disease. Osteoarthritis is more common after the age of 45 and is also more common in women. Osteoarthritis commonly affects weight bearing joints such as the knees, hips, spine and feet. However, you may also get osteoarthritis on smaller joints like the fingers, called Heberden' s nodes (painful, bony growths usually at the end of the fingers) that can make the hands appear knobbly and sometimes out of shape. Osteoarthritis of the hands is more common in women as they go through the menopause.

Osteoarthritis can develop in any joint, especially if it has been badly injured or put under any unusual stress.

What causes osteoarthritis?

Osteoarthritis occurs as we get older (it is uncommon before the age of 40), and used to be called "wear and tear" arthritis. It occurs when the cartilage, a rubbery material that protects bones from rubbing against each other, thins and becomes weak. As osteoarthritis gets worse, the bones will begin to rub against each other when the joint is moved. This causes the bones to thicken and spread out, forming bony growths known as osteophytes, at various places in the joint. The joint then becomes inflamed, painful and difficult to move. Most cases of osteoarthritis will have no known cause.

What are the symptoms of osteoarthritis?

Symptoms of osteoarthritis vary with each patient, some people find the symptoms disabling where as others may have few symptoms. The following symptoms may indicate that you have osteoarthritis:

• Swelling and inflammation in one or more joints.
• Stiffness around the joints.
• Constant or recurring pain in a joint.
• Sudden difficulty in moving or using a joint.
• A crack or click noise may be heard when you move the affected joint.

The symptoms of osteoarthritis may become worse throughout the day, in damp weather or after periods of inactivity, for example sitting in the cinema.

If you suffer with osteoarthritis in the knees you may find you develop a limp. Long-standing osteoarthritis may eventually lead to the deformity of the affected joint. The knock-knees and bow legs seen in elderly people, is usually the result of long term osteoarthritis in both knees.

Am I at risk of osteoarthritis?

You may be at risk of osteoarthritis if:

• You are overweight. The knees are the joints most commonly affected in people who are overweight because of the extra weight placed on them.
• You are a woman.
• You have had repeated injuries or past fractures.
• You overuse or constantly strain a certain joint, for example from work related activities or hobbies. Osteoarthritis is common in former sportsmen.

Can I do anything to prevent getting osteoarthritis?

Though there is nothing you can do to prevent getting osteoarthritis, you should maintain a healthy diet and avoid being overweight. You should also ensure you get regular exercise, this will help prevent weight gain and joint stiffness.

How is osteoarthritis diagnosed?

Your doctor will normally suspect osteoarthritis from your symptoms and medical history. In some cases osteoarthritis may also be diagnosed from a physical examination of the joints, especially if it's a large joint that is affected. An x-ray of the affected area will usually confirm the diagnosis and determine how far the disease has progressed. Though there is no blood test for osteoarthritis you may have one to rule out other forms of arthritis.

How will osteoarthritis progress?

Osteoarthritis usually progresses slowly over a number of years and usually stays a mild problem, enabling most people to carry on living a normal life. Osteoarthritis can vary greatly in each person, some people may just have mild symptoms, while others may have difficulty moving the affected joint and the condition can become disabling. However, it is rare for osteoarthritis to progress to a disabling arthritis with severe deformities and there are many treatments available to improve symptoms.

How is osteoarthritis treated?

There is no cure for most types of arthritis, however, there is a large range of treatments available which are aimed at relieving pain, improving joint mobility and helping you live a normal life. Some people may only require a simple, daily exercise program to help ease the pain and improve movement in the joint.

To manage osteoarthritis it is important that you stay fit and exercise regularly. Regular exercise can help you reduce weight, strengthen the muscles which support the joints and improve the joints movement. Try exercise with minimal impact on the joints, such as swimming, walking and stationary cycling. A physiotherapist will be able to advise you about the right exercise routines to keep the muscles strong and promote mobility. Pain can also temporarily be relieved by heated pools/baths or by applying a warm heat pack (e.g. hot water bottle) to stiff joints, this helps ease pain and stiffness.

If you are finding the joints very painful, there are many drugs available to relieve pain and reduce inflammation around the joint. These drugs fall into three categories:

1. Analgesics (pain killers) such as paracetamol which help relieve pain. These are available over the counter at chemists.
2. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, which are available over the counter at chemists. There are also many stronger NSAID'S which can be prescribed by your doctor. These drugs normally start working within a few hours, they reduce inflammation and so reduce pain. However, if taken over a long period they may cause stomach problems.
3. Steroids, usually cortisone can be taken either in tablet form or via an injection directly into the affected joint for immediate relief. Steroids can have side effects if taken long term so they are usually only prescribed to control severe arthritis.

Your doctor may suggest that you wear a splint, support or a brace on the affected joints to prevent them becoming permanently bent and to keep them rested. A walking stick will also help reduce the weight and stress on a painful hip or knee joint. Your doctor will show you how to use it properly.

If arthritis is severe you may require surgery to replace the affected joint, nowadays hip and knee replacements are a very common operation.