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Osteoarthritis: It's Not 'Just' Arthritis

Updated: Feb 16

Osteoarthritis stands as the prevailing manifestation of arthritis, which unfortunately often leads to its dismissal and the underestimation of its consequences.

Frequently, we encounter individuals asserting phrases like 'it's merely the result of wear and tear,' 'inevitably, we will all experience it,' or my personal favourite, 'it's a minor case of arthritis' 😤.

These casual remarks belittle the substantial anguish and incapacity that osteoarthritis (OA) inflicts upon numerous


If you have personally experienced OA or have an acquaintance who has, you are undoubtedly aware of its potential to profoundly influence every facet of existence. Persistent agony, fatigue, inflexible and swollen joints, weakened muscles, as well as sensations of anxiety, depression, and sleep disturbances, can all impede an individual's capacity to partake in social, community, and professional engagements as much as they would wish.


So, no, it’s not ‘just’ arthritis.


Let’s look at what it is...

 

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What Is Osteoarthritis?


As widely understood, OA ranks as the prevailing type of arthritis. While it predominantly emerges in individuals aged 45 and above, it can also manifest in younger age groups.

Its impact often concentrates on weight-bearing joints, including the knees, hips, feet, and spine. Additionally, the joints in the hands, particularly the thumbs, commonly fall under its influence.

Although it was once perceived as an inescapable aspect of growing older, attributed to years of joint wear and tear, our current understanding recognizes it as a multifaceted ailment that can arise from various contributing factors.

 

Osteoarthritis And Your Joints

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To gain insight into the impact of OA on your body, it's beneficial to acquire some knowledge about your joints.

Joints are the junctures where bones converge, supported by a collaboration of bones, muscles, ligaments, and tendons, enabling you to flex, extend, and maneuver. Enveloping the terminations of your bones lies a delicate layer of tissue known as cartilage. This tissue acts as a smooth, cushioning barrier, absorbing shocks, facilitating seamless joint motion, and preventing bone-to-bone friction.

Encircling the majority of your joints is a robust capsule that secures your bones in position. The interior of this capsule is lined with the synovial membrane, responsible for producing synovial fluid. This lubricating fluid serves to both oil and nourish the cartilage and other components within the joint.

In the context of OA, the cartilage gradually loses its resilience and begins to deteriorate. In some instances, fragments of cartilage may detach and float within the synovial fluid. Due to the compromised cartilage surface, the joint experiences stiffness and pain when in motion.

Over time, the cartilage degradation can reach a point where it no longer acts as a cushion between the adjacent bones. In response, the body initiates a repair process, leading to the formation of additional bone. These growths are referred to as bone spurs or osteophytes. While not always symptomatic, bone spurs can at times induce discomfort and limit the range of joint mobility.

 

OA Causes And Risk Factors


  • Age: Individuals beyond the age of 45 face heightened susceptibility.

  • Weight: Being overweight or obese contributes to the risk.

  • Genetics: The genetic inheritance you receive can influence OA development.

  • Coexisting Conditions: Conditions like rheumatoid arthritis and gout can inflict joint damage that subsequently leads to OA.

  • Gender: Among OA patients, three out of five are women.

  • Repetitive Movements: Professions involving repetitive actions such as prolonged kneeling, squatting, or heavy lifting can raise the risk.

  • Notable Injury or Strain: Substantial injury, surgical procedures, damage, or excessive use of a joint can also be contributing factors.

Signs And Symptoms


The manifestations of OA may differ among individuals. Among the prevalent symptoms are:

  • Discomfort, rigidity, and swelling of the joints (inflammation)

  • Sensations of grinding, friction, or a crunching feeling during movement (crepitus)

  • Weakened muscle strength

These symptoms can occasionally intensify, particularly in instances of stress, emotional distress, excessive exertion, or inadequate sleep. Such occurrences are termed as flares or flare-ups.


Diagnosing OA


If you've been grappling with joint discomfort, it's crucial to engage in a conversation about your symptoms with your physician. Swiftly obtaining a diagnosis ensures prompt initiation of treatment, which ultimately enhances your prospects for optimal results.

To determine your condition, your doctor will conduct a series of examinations and tests, potentially encompassing:

  • Reviewing your medical history: Your doctor will inquire about your symptoms, familial medical background, and any other prevailing health concerns.

  • Physical assessment: An examination will involve scrutinizing joint swelling and its adjoining areas, along with evaluating the joint's range of motion. Additionally, your doctor will palpate and listen for signs of grinding, friction, or creaking within the joint.

  • While imaging techniques like X-rays, ultrasounds, or MRI scans aren't standard tools for diagnosing OA, they might be deemed necessary if uncertainty surrounds your diagnosis. Blood tests may also be considered in certain cases.

Treating OA


There’s no cure for osteoarthritis; however, your symptoms can be effectively managed with exercise, weight management, medicines, and self-care.


Physical Activity:


Due to the persistent misconception of joint deterioration through use, individuals often worry that engaging in exercise while experiencing OA will exacerbate joint harm. Contrarily, regular exercise can effectively alleviate certain symptoms (e.g., pain, stiffness), enhancing joint mobility and strength. Moreover, it facilitates the movement of synovial fluid within the joint, crucial for nutrient provision and waste removal.

Exercises targeting the full range of joint motion are pivotal for retaining joint flexibility, often compromised by OA. Additionally, bolstering the surrounding muscles is paramount as increased muscle strength equates to better load-bearing capacity. Consequently, joint support and protection are enhanced.

An all-encompassing exercise regimen aimed at enhancing muscle strength, joint flexibility, balance, coordination, and overall fitness yields optimal outcomes. Commence exercise gradually, incrementally escalating duration and intensity over subsequent weeks and months. Collaborating with a physiotherapist or exercise physiologist can lead to a tailored exercise plan suiting your needs.


Weight Management:


The presence of excess weight significantly heightens the vulnerability to developing OA and intensifies its severity. Moreover, surplus weight imposes undue pressure on weight-bearing joints, particularly the hips, knees, and feet, exacerbating discomfort and damage.

The volume of body fat also holds significance, as fat releases molecules contributing to persistent low-grade inflammation throughout the body. Consequently, this augments inflammation levels within OA-affected joints.

In light of these factors, maintaining a healthy weight is pivotal for individuals with OA. Consultation with your doctor or a dietitian can provide guidance on adopting safe and effective weight loss strategies, if necessary.

Weight reduction often constitutes a prolonged journey, marked by challenges, especially when pain restricts physical activity. However, the positive aspect is that even modest weight loss can mitigate pain and bolster exercise capacity. Therefore, gradual, feasible alterations in dietary and exercise habits can yield substantial results. Though time, dedication, and support are requisite components.


Medications:

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While no medications can alter the underlying OA progression, in conjunction with exercise, weight management, and self-care, they can furnish temporary pain alleviation and sustain activity levels.

Predominantly employed medications for OA encompass:


  • Non-steroidal anti-inflammatory medications (NSAIDs), such as ibuprofen: Available over-the-counter or by prescription, these come in oral or topical forms. Caution is advised with oral NSAIDs, which should be taken at low doses and for short periods due to potential side effects.

  • Paracetamol: Despite offering modest pain relief, it might aid some individuals in increasing their activity levels. A consultation with your GP can help determine its appropriateness.

  • Corticosteroid injections: These might be beneficial when alternative treatments prove ineffective. However, the number of yearly injections is restricted due to potential harm.

Self-Care:


Diverse strategies exist to mitigate symptom impact, including:

  • Educating Yourself: Enhancing comprehension of OA and its personal effects facilitates informed healthcare decisions.

  • Pain Management: Given pain's prevalent nature in OA, learning effective pain management strategies is crucial.

  • Collaborative Healthcare Approach: Active partnership with your healthcare team, including your GP and physiotherapist, ensures comprehensive OA management.

  • Joint Protection: Implementing support tools like ergonomic equipment or walking aids reduces joint strain. Occupational therapists provide guidance on aids and modifications.

  • Utilizing Supports: Taping, knee braces, and orthotics may aid knee and foot OA; professionals like physiotherapists and podiatrists can offer advice.

  • Enhancing Sleep: Addressing sleep problems is pivotal, as quality sleep positively influences symptoms.

  • Stress Management: Stress exacerbates symptoms; effective stress management techniques prove beneficial.

  • Balanced Diet: While no specific OA diet exists, maintaining a balanced diet aids overall health and weight control.


 

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