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Osteoarthritis

What is osteoarthritis?

Osteoarthritis, also known as degenerative joint disease or degenerative arthritis, is the most common of the arthritis conditions. The condition tends to develop in men at an earlier age than in women. It results from the breakdown of cartilage (a smooth, cushioning substance) on the end of bones where they meet to form a joint, making the normally smooth surface rough or uneven, or when spurs develop at the edge of the bones in a joint.

The cause of osteoarthritis is not clear in many cases, but is thought to be related to heredity, the excessive wear and tear of joints resulting from overuse of a joint, obesity, misalignment of the bones forming a joint, the ageing process and muscle weakness. Most affected are weight-bearing joints such as the lower back, hips and knees. The hands are also commonly affected. Osteoarthritis commonly affects the elderly, though not all exhibit symptoms.

What are the symptoms of osteoarthritis?

The most common symptoms of osteoarthritis include:

  • painful joints, that usually worsen with exercise or repetitive use;
  • swelling of the affected joint;
  • creaking, pain and stiffness that restrict movement and occasionally disrupt sleep;
  • weakened muscles surrounding the affected joint, due to disuse; and
  • joint deformity — a formation of hard bony enlargements — for example, of the small joints of the fingers. Bony enlargement of the small joint at the end of the fingers is called a Heberden's node. Bony enlargement of the middle joint of the finger is called a Bouchard's node. Osteoarthritis of the joint at the base of the big toes leads to the formation of a bunion.

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, or due to other joint diseases, injury or deformity.

Osteoarthritis can be classified as primary, where there is no known cause, or secondary. Primary osteoarthritis is more common with ageing and may affect just a single joint or multiple joints — primary generalised osteoarthritis. Secondary osteoarthritis is generally the consequence of another disease or condition, such as repeated trauma or surgery to the affected joint, or abnormal joint structures from birth.

Some people may have congenital abnormalities of the joints — for example, Perthes' disease of the hips — that cause early degeneration and subsequently cause osteoarthritis.

What you can do

  • Consult a doctor who will determine the type of arthritis you have.
  • Rest the joint until the pain subsides to prevent further inflammation.
  • To ease the pain or stiffness of the joint, apply heat on the joint for about 15 minutes once or twice a day using a hot water bottle, towel, wheat pack or an infrared lamp.
  • Take painkillers or anti-inflammatories, as recommended by your doctor.
  • Discuss complementary therapies such as glucosamine and chondroitin with your doctor or pharmacist.
  • If you are overweight, try to reduce weight to lighten the load on weight-bearing joints.
  • Participate in regular exercise.

What your doctor can do for you

There is no cure for arthritis, so beware of ‘miracle cures’. Your doctor may prescribe anti-inflammatory medicine. They may recommend occupational therapy or physiotherapy, which includes exercises and heat treatment. Occasionally, joint injections can be used to give temporary relief. In severe cases, surgery may be suggested, such as a hip or knee replacement. The type of surgery will depend on your age and the severity of the disease. In the elderly with severe arthritis, joint replacement can give good results.

Preventing flare-ups of osteoarthritis

  • Try to avoid excessive trauma to your joints, but continue to exercise.
  • Avoid a particular activity temporarily if the affected joint starts to hurt.
  • If you are overweight, try to reduce weight.
  • Always try to maintain a good posture.

 

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