Osteoarthritis (OA) is a chronic disease and the most common form of chronic arthritis. It is characterised by joint pain, stiffness and swelling, and mainly affects the hands, knees and hips. As the population ages, and there is an increased rate of obesity, the number of Australians with OA is expected to rise from 2.2 million in 2015 to almost 3.1 million by 2030.
Changes that may occur with OA may include:
- Inflammation of the tissue around a joint
- Damage to joint cartilage – this is the protective cushion on the ends of your bones that allows a joint to move smoothly
- Bony spurs growing around the edge of a joint
- Deterioration of ligaments (the tough bands that hold your joint together) and tendons (cords that attach muscles to bones).
OA can affect any joint but occurs most often in the knees, hips, finger joints and big toe. Osteoarthritis can develop at any age, but OA most frequently occurs in people aged >55 years. 1 in 5 Australians (22%) over the age of 45 have osteoarthritis.
OA is different to osteoporosis. Osteoporosis is a condition where the bones become fragile and brittle, causing them to break more easily.
What are the symptoms of Osteoarthritis?
The symptoms of OA vary from person to person, and your symptoms will also depend on which joints are affected. OA typically tends to come on slowly, over months or even years. The most common symptoms are pain and stiffness of the joints. These sensations are usually worse with activity initially but can be more constant with long-term progression of OA. Joint pain and stiffness can become severe enough to make daily tasks difficult or impossible to perform. These symptoms may affect your ability to do normal daily activities, such as walking, climbing stairs or even opening jars.
Other common symptoms may include clicking noises, grating sensations, or a loss of flexibility in a joint.
Key symptoms of osteoarthritis include:
- Stiffness in the morning or after prolonged sitting
- Pain with prolonged periods of walking or standing
- Difficulty with activities such as stair climbing and stair descending
- Joint swelling
- Clicking, clunking, crunching or catching within the joint
- Reduced joint flexibility (ie bending and straightening the knee)
- Altered joint shape and size
- Altered leg posture (eg, ‘knock knees’ or ‘bow legs’)
- A feeling of instability or giving way in the joint
- Feeling of weakness in the surrounding muscles
What is the main cause of osteoarthritis?
Osteoarthritis is a common form of arthritis that affects millions of people worldwide. Some of the risk factors for osteoarthritis include:
- Age: The risk of developing osteoarthritis increases with age
- Gender: Women are more likely to develop osteoarthritis than men, especially after age 50
- Joint injury or overuse: Injury or overuse, such as acute trauma and repetitive stress on a joint, can damage a joint and may increase the risk of osteoarthritis in that joint
- Obesity: Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. This stress increases the risk of osteoarthritis in that joint. Obesity may also have metabolic effects that increase the risk of osteoarthritis
- Genetics: People who have family members with osteoarthritis are more likely to develop osteoarthritis
It’s important to note that some of these risk factors, such as age and genetics, cannot be controlled. However, there are some modifiable risk factors, such as maintaining a healthy weight that can help decrease the risk of developing osteoarthritis, or progressing OA and making it worse over the long term.
How do I know if I have Osteoarthritis?
OA is often diagnosed based on your age and history, your symptoms and a physical examination by your physiotherapist. An X-ray may show the narrowing and changes in the shape of your joint, however, x-rays can not diagnose or predict how much pain or stiffness you will have. An x-ray that shows joint damage does not always mean you will have a lot of pain or problems.
On the other hand, your joint may be very painful despite your X-rays being normal. Blood tests are only helpful to rule out other types of arthritis, and should only be done under the advice of your GP.
Osteoarthritis symptoms commonly fluctuate, sometimes being better or worse, depending on activity. The symptoms may initially only be with activity but as OA progresses, knee pain may be experienced at rest or during the night.
What is the best treatment for osteoarthritis?
Strategies that can be used to help you manage your symptoms include
- Activity modification
- Supportive bracing
- Exercise program tailored to your abilities and condition
- Strengthening your muscles
- Managing swelling
- Decreasing stiffness
- Using walking aids
- Maintaining a healthy weight
Your GP might also discuss with you taking medications (NSAIDS and analgesics) or in severe cases even a referral to a surgeon for joint replacement surgery – ie Total Knee replacement- if you are unable to function well and manage your symptoms over a long period of time. It is always advised to try conservative and proactive management before going down a surgical pathway.
Building an Allied health team can also be an important part of living with OA. Dietitians can help you maintain a healthy weight and eat well to reduce inflammation. Psychologists can also be useful as it is natural to feel scared, frustrated, sad and sometimes angry. Be aware of these feelings and get help if they start affecting your daily life.