Osteoarthritis

Osteoarthritis is the most common form of arthritis. It is often referred to as wear and tear arthritis as it involves the thinning and breakdown of the cartilage lining, which cushions and protects the joints, where two bones meet. The bone may lose shape and thicken at the ends or produce bony spurs. It causes pain in the joints and surrounding soft tissues and limits the range of movement of a joint.

Osteoarthritis affects many joints including the large, weight bearing joints of the hips and knees and also the spine, hands, feet and shoulders. There are several reasons for the development of osteoarthritis including age, being overweight, heredity factors, and joint damage from a previous injury or during early development of a joint. The severe pain of osteoarthritis can be very painful and disabling.

What causes osteoarthritis?

Osteoarthritis is caused by the wearing out of the cartilage covering the bone ends in a joint. This may be due to excessive strain over prolonged periods of time, due to other joint diseases, injury, or deformity. Primary osteoarthritis is commonly associated with ageing and general degeneration of joints.

Secondary osteoarthritis is generally the consequence of another disease or condition, such as repeated trauma, surgery to the affected joint, or abnormal joint structures from birth.

Some people may have developmental or congenital abnormalities of the joints that may cause early degeneration and subsequently cause arthritis.

Predisposing factors to osteoarthritis

Nonmodifiable

• Age
• Gender
• Race
• Genetics

Potentially modifiable

• Obesity
• Injury and joint trauma- in the knee from fractures and torn ligaments and cartilage (menisci)
• Mechanical stress
• Deformity and malalignment in the hip, growth abnormalities, or childhood hip problems
• Prior inflammatory disorders
• Endocrine and metabolic disorders

How can a doctor diagnose arthritis?

Doctors diagnose arthritis with a medical history, physical exam, x-rays and blood tests. There is no blood test for osteoarthritis.

Treatment options

Initial treatment for osteoarthritis is conservative with a balance of rest and exercise, avoiding vigorous weight bearing activities, education in arthritis management, support, joint protection such as walking aids or braces, and non invasive pain relief techniques. Pharmacy measures include analgesic and anti-inflammatory medication, complementary medication, possibly injections of cortisone/ corticosteroids into the joint. Osteoarthritis should be managed with combined non-pharmacological and pharmacological approaches.

Treatment of osteoarthritis focuses on decreasing pain and improving joint movement, and may include:

• Education and understanding
  
• Exercises to keep joints flexible and improve muscle strength
  
• Support, from health professionals and family
• Joint protection, to prevent stress or strain on painful joints e.g. suitable foot wear
• Weight control to prevent extra stress on weight bearing joints
• Physiotherapy and/ or heat or cold treatments.
• Medication approaches i.e. anti-inflammatory gels/rub ons, the use of non steroidal anti inflammatory medication such as paracetamol, non narcotic analgesics, complementary and alternative medications such as glucosamine with or without chondroitin, injections of glucocorticoids into the joint if needed, and biological therapies
• Surgery to relieve chronic pain in damaged joints