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Osteoarthritis

osteoarthritis


Arthritis means inflammation of the joints.

A joint is where two bones meet. Joints allow movement and flexibility of various parts of the body. The movement of the bones is caused by muscles which pull on tendons that are attached to bone.  Cartilage is a hard, smooth tissue that covers the end of bones. Between the cartilage of two bones which form a joint, there is a small amount of thick fluid called synovial fluid. This fluid lubricates the joint which allows smooth movement between the bones.

What causes osteoarthritis?

All normal joints and joint tissues are constantly undergoing some form of repair because of the wear and tear that is placed on them through our daily activities. However, in some people, it seems that this repair process becomes faulty in some way and OA develops.
In joints with OA, the joint cartilage becomes damaged and worn. The bone tissue next to the cartilage can also be affected and bony growths can develop around the joint edges. These growths are called osteophytes and may be seen on X-rays.


Factors that may play a role in the development of OA include:

  • Age.
  • Genetics.
  • Obesity. Knee and hip OA are more likely to develop, or be more severe, in obese people.
  • Women are more likely to develop OA than men.
  • Previous joint injury, damage or deformity.
  • OA of the knee may be more common in elite athletes and elbow OA may be more common in people working with pneumatic drills.

Who gets osteoarthritis?

Primary OA develops in previously healthy joints. Most cases develop in people over 50.
Secondary OA develops in joints previously abnormal for a variety of reasons.

Which joints are affected?

Any joint can be affected by OA but the hips, knees, finger joints, thumb joints and lower spine are most commonly affected.

What are the symptoms?

  • Pain, stiffness, and limitation in full movement of the joint are typical.
  • Swelling and inflammation of an affected joint can sometimes occur.
  • An affected joint tends to look a little larger than normal.
  • You may have poor mobility and problems walking if a knee or hip is badly affected.
  • No symptoms may occur. Quite a number of people have X-ray changes that indicate some degree of OA but have no, or only very mild, symptoms.

Do I need any tests?

Your doctor can often diagnose osteoarthritis based on your age, your typical symptoms and examination of your affected joints. Your doctor may suggest X-rays or other tests if they are uncertain about the diagnosis and want to exclude other problems.

What is the outlook (prognosis)?

In many people, OA is mild, does not become worse, and does not make you any more disabled than expected for your age. However, in some people, the severity of OA and the disability it causes is out of proportion to your age. One or more joints may become particularly badly affected.Symptoms often wax and wane.

General measures to help treat osteoarthritis

  • Exercise
  • If possible, exercise regularly.
  • Weight control
  • If you are overweight, try to lose some weight as the extra burden placed on back, hips, and knees can make symptoms worse.
  • Wearing a knee brace.
  • Using shoe insoles.
  • The use of a special sticky tape which pulls the kneecap inwards.
  • Braces or supports may also be helpful for other joints affected by OA.
  • Walking aids
  • Physiotherapy

Occupational therapy

An occupational therapist may be able to help if you need aids or modifications to your home to cope with any disability caused by OA.

Medicines used to treat osteoarthritis

  • Paracetamol
  • Anti-inflammatory painkillers
  • Capsaicin cream
    • This cream is made from chilli peppers and it works by blocking the nerve signals that send pain messages to the brain. It may be helpful if you have knee or hand OA. It takes a while for the effects of this cream to build up and may take around one month to get the maximum benefit.
  • An injection of steroid medicine
  • Food supplements as a treatment
    • Glucosamine and chondroitin supplements have become popular in recent years. Glucosamine and chondroitin are chemicals that are part of the make-up of normal cartilage. The theory is that taking one or both of these supplements may help to improve and repair damaged cartilage.
    • Glucosamine and chondroitin are no wonder cures. One or both may possibly help in some cases. It may be worth discussing these supplements with your doctor.

Surgery for osteoarthritis

Hip and knee replacement surgery has become a standard treatment for severe OA of these joints. Some other joints can also be replaced. Joint replacement surgery has a high success rate.

Treatments that are not normally recommended

  • Hyaluronic acid
  • Topical rubefacients (heat rubs)
  • Arthroscopic lavage and debridement: This is an operation to wash out a joint and trim cartilage from a joint.

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