What is Osteoarthritis?

Osteoarthritis is a disease of the joints affecting most of us in one way or another as we age. Around 80% of people over the age of 50 are affected. The process begins with the cartilage wearing thin and disjointed and over time, it could be totally grinded to nothing. At the same time, the joint capsule thickness enhances and more synovial (lubricating) fluid is created which causes swelling in the joint. Ultimately, osteoarthritis can effect any and every joint in the human body, but it's usually apparent in the fingers, knees, hips and spine.

What are the Symptoms of Osteoarthritis?

• Joint stiffness and pain. This can improve with physical activity but is usually worse again after periods of inactivity.

• Backache.

• Reduced flexibility of movement in affected joints.

• Possible swelling of affected joints.

• Possible grating of the joint on movement.

• It is not usually associated with redness or heat of the affected joint.

Who is Most at Risk?

Osteoarthritis is not hereditary, but the following factors are associated with an increased risk of developing the condition:

• obesity. Being overweight can add strain on the joints.

• stress on joints caused by one's work or physical activity or ageing

• injury to the joint lining, caused by a previous injury.

How is Osteoarthritis Diagnosed?

• Medical history and examination by a professional healthcare practitioner

• An X-ray examination will determine whether a patient has osteoarthritis.

Often there won’t be a correlation between the level of pain and the severity of arthritis as shown by the X-ray. It is the level of pain and the issues associated with movement that are decisive factors when making the diagnosis. Laboratory blood tests may be performed to rule out any inflammatory forms of arthritis.

How is Osteoarthritis Treated?

• Exercise should be the nucleus of treatment for people with osteoarthritis, regardless of age, co-morbidity, pain severity or disability. Exercise should focus on local muscle strengthening and general aerobic fitness.

• Weight loss if the person is overweight or obese. Use of suitable footwear.

• Pain can be relieved by applying heat to stiff and painful joints for 20 minutes up to three times a day. Various deep-heat lotions, heating pads, infrared lamps, hot baths, etc can be used.

• Cold packs may also be of help. Use for between 5 and 10 minutes at a time on an hourly basis up to six times a day.

• Swimming in a heated pool.

• Severe osteoarthritis of the neck spine can be eased by wearing a soft collar.

• Massaging the muscles around the joints.

• Sleeping on a firm orthopaedic mattress to ease the pain in the spine.

• Mild to moderate disease can usually be managed successfully with simple over-the-counter painkillers, such as paracetamol (eg Panadol), aspirin (eg Disprin) or ibuprofen (eg Nurofen) (a non-steroidal anti-inflammatory drug).

• A GP may prescribe non-steroidal anti-inflammatory drugs (NSAIDs/COX-2 inhibitor) if this is appropriate for you, or a stronger codeine-based painkiller (opioids).

• Assessment for bracing/joint supports/insoles for people with joint pain or instability.

• Assistive devices (for example, walking sticks and tap turners) for people with specific problems with daily activities. Expert advice may be required from occupational therapists or disability equipment assessment centre.

When would surgery be considered?

Should the patient's condition deteriorate to the point where they have been offered all of the core treatments and are still experiencing joint symptoms that have a substantial impact on their quality of life, eg their mobility is severely affected, they may be advised by their GP to consider the possibility of surgery to replace a knee or hip joint.

Following surgery, the patient will stay in hospital for up to two weeks and a period of physiotherapy and rehabilitation is necessary to recover muscle strength.

Modern artificial joints are expected to function for up to 20 years. Future prospects In spite of great progress with artificial joints, there are unfortunately still many people who have to live with their osteoarthritis and the daily pain it can cause. Patients may still have to visit their GP to have their condition monitored and the treatment plan discussed.

The GP can offer advice to help patients understand the condition and better cope with it.

How Can Osteoarthritis Be Prevented?

It is not usually possible to prevent the condition occurring completely. Maintaining a normal weight for height and body structure, keeping physically active and avoiding excessive stress on the joints as you get older, can reduce the severity and effects of osteoarthritis.

More information

The organisations below can provide more information and support for people with osteoarthritis.

• Arthritis Research UK

• Arthritis Care

• Your local Patient Advice and Liaison Service (PALS) may also be able to give you further information and support.