Osteoarthritis is a condition that currently approximately 1 million people in the UK see their GP about each year.1
Osteoarthritis is characterized by joint degeneration and loss of cartilage. The joints most susceptible are the weight bearing joints which are the knees, hips and big toes, as well as the hands.
Osteoarthritis can affect males and females alike but is more prevalent in females.
It can develop at any age, although it occurs more frequently in older people from the age of 50 onwards. It is commonly believed that osteoarthritis is an inevitable part of getting older, however this is not necessarily true, as many people can have no signs or symptoms at all, and it is also a condition that can affect children.
Other than age there are no known causes of osteoarthritis. However it is believed that injuries such as broken bones or mechanical damage to a joint can be a trigger, as well as issues such as weight gain, hormonal factors and most recent research suggests genetic predisposition.
It is important to differentiate between Osteoarthritis and Rheumatoid arthritis. Rheumatoid arthritis is an inflammatory disease that not only affects joints but also internal systems, and it can only be diagnosed by specialist testing such as blood tests. Osteoarthritis, however, is a specific change in the cartilage of the joint.
What actually occurs in Osteoarthritis:
Osteoarthritis develops when changes in cartilage (the strong, smooth tissue that lines the bone surface and allows joints to move easily without friction) occur. The cartilage can become brittle, the underlying bone of the joint can become thicker to reduce the load on the joint and bony outgrowths form.
The joint membrane and capsule can then thicken which in turn leads to a narrowing of the space inside the joint. This all leads to a stiff joint that can become inflamed, swollen and painful to move. At a more advanced stage occasionally part of the cartilage can break away from the bone leaving the bone ends exposed. These may then rub against each other and the ligaments become strained and weakened. This can cause alot of pain.
The symptoms of osteoarthritis vary greatly from person to person, and between different affected joints. The severity of symptoms can also vary. For example, a joint may be severely damaged without causing symptoms, or symptoms may be severe without affecting the movement of a joint.
Treatment of Osteoarthritis
There is no cure for osteoarthritis, but the symptoms can be eased with a number of different treatments.
Treatments include non-drug treatments such as physiotherapy and weight loss, medications such as painkillers and anti-inflammatorys, and surgery.
Physiotherapy plays an important role in managing arthritis. It can help you to maintain independence through improved mobility, strength and flexibility.
Physiotherapists have a detailed understanding of the body. In an assessment, the physiotherapist will examine your posture, joints, muscles, amongst other things. They will ask about the activities which cause you pain.
They will be able to offer you advice and design a personalised treatment plan which may involve exercises, massage and pain relief techniques. It is usual to have around six sessions with a physiotherapist.
Most people who have arthritis may never need surgery. However, if your joints are very damaged and other treatment is not helping, surgery may be suggested. If this is the case, you will be referred to an orthopaedic surgeon for an operation such as joint replacement, removing bone protrusions, joint fusions, removing inflamed joint linings.
Many people with arthritis find complementary and alternative therapies helpful. Complementary therapies are often used alongside conventional treatment. They do not cure arthritis, but they may help to ease symptoms. The British Acupuncture Society states that in treating chronic arthritic pain, acupuncture is believed to stimulate the nervous system releasing endorphins and other neurohumoral factors, thus aiding pain relief.2 It can also help reduce inflammation and improve muscle stiffness and joint mobility, by increasing local microcirculation.3
Eating a well-balanced, healthy diet is important when you have arthritis. As well as providing you with all the nutrients you need for good joint health, this will help you maintain a healthy weight. Carrying extra weight adds extra pressure on weight bearing joints such as the back, hips, knees, ankles and feet. Losing even a few kilos can make a significant difference.4
Exercise can be the last thing you want to do when in pain from your arthritis. However, exercising is one of the best ways of keeping pain at bay. Exercise can give a better range of movement through the joints, increase muscle strength, and decrease any stiffness. The right kind of exercise will not make your arthritis any worse.Your physiotherapist can help you to pick an exercise programme to suit you, such as walking, cycling and swimming.
Self Help Tips
Being diagnosed with arthritis can be a confusing experience. People often express feelings of shock, annoyance and worry. These feelings are completely normal as you adjust to the diagnosis and begin to look for ways to help yourself. Learning about your condition will help you know how to best approach treatment. Self-management is about using your own resources to help manage your condition. There is much you can do for yourself.
Some of the following tips from the Arthritis Care Association may help to relieve pain and keep you mobile:
- do exercises to strengthen your muscles will reduce pain and stress on your joints – a physiotherapist can help with this
- pace yourself - try to balance rest with activity
- massage painful joints and muscles, to relax muscles and improve blood flow
- Have warm baths or use heated pads or hot water bottles to reduce stiffness and ease tension
- On swollen or hot joints using some ice wrapped in a damp cloth can help reduce inflammation
- loose weight if you are overweight, to reduce strain on your weight-bearing joints
- attend relaxation classes and do breathing exercises to relax the body and ease pain
- try complementary therapies
The Arthritis Care Association have a helpline number and also leaflets to read. Please see www.arthritiscare.org.uk for further advice.
2British Acupuncture Council Fact Sheet www.acupuncture.org.uk/research-fact-sheets
3Komori, 2009, British Acupuncture Fact Sheet www.acupuncture.org.uk/research-fact-sheets
4 Arthritis Care Association www.arthritiscare.org.uk