Osteoarthritis

What is Osteoarthritis?

Osteoarthritis is a very common condition which can affect any joint in the body. It mainly affects the joints that bear most of our weight and that we use repeatedly in daily life.

Our joints have a smooth yet strong cartilage tissue coating them. The cartilage covers the bones and allows them to move smoothly and is a shock absorber for our daily movements. As we use our joints everyday they are constantly undergoing repair , this is normal and happens to all joints.

In osteoarthritis the cartilage roughens and this stops the joint from moving as smoothly and can affect how well the joint is able to shock absorb. The body has processes that can repair the joint and this will often allow the joint to work normally and help reduce pain and stiffness in the early stages. Almost all of us will develop osteoarthritis in some of our joints as we get older with many people not even being aware of it. Conversely OA in the later stages can be very disabling affecting daily life.

Who gets Osteoarthritis?

Osteoarthritis is more common as we get older as our joints age with us, there are many factors that will influence why someone develops osteoarthritis. A previous history of fracture or trauma around or within the joint is a common reason. Genetics does also play a role in why some people develop osteoarthritis and why others don’t.

How do I know if I have Osteoarthritis?

Our clinicians can often diagnose Osteoarthritis based on your age, your symptoms, examination and health history. X-rays can on occasions be helpful to guide decision making and prognosis as well on rare occasions exclude other causes of a painful joint. Sometimes your clinician may suggest these tests if they are uncertain about the diagnosis and want to exclude other problems.

What are the symptoms?

Pain and stiffness is a very common symptom - usually worse first thing in the morning

Swelling of the joint

The affected joint may look a little larger than the opposite one

You may have difficulty walking and may find a walking aid helpful

The joint may not move as freely

It may make a grating or crackling sounds as you move. This is called crepitus.

The joint may give way at times if your muscles have become weak

The symptoms of arthritis can vary from week to week, and even from day to day. Osteoarthritis is a long-term condition and knowing how to manage it yourself is very important.

How do I live with Osteoarthritis?

Toolkit:

Exercise

Regular exercise is very important to strengthen the muscles around the affected joints, to keep you fit, and to maintain a good range of joint movement. Find an activity that you enjoy i.e. swimming, walking or cycling and try and make a lifestyle change to include this in your weekly routine.

Weight Control

If you are overweight, try to lose some weight as the extra burden placed on your joints can make symptoms worse. Weight loss can make quite a difference to the pressure on your joints and help reduce your symptoms. Speak to your physiotherapist about referral to any local weight management programs in your area to support you in your weight loss journey.

Medication

Painkillers can help you to exercise and move with fewer symptoms and so might be an essential part of your longer term management of OA.

Injections

Injections can be very helpful at reducing pain and helping manage the symptoms of osteoarthritis. These injections are not a stand alone treatment and must be incorporated with the other methods mentioned here.

Surgery

For some patient suffering with debilitating and severe Osteoarthritis, joint replacement surgery can be very helpful and life changing. The team here work closely with a number of orthopaedic consultants should surgery be a viable option for you.

Can I do my normal activities?

You will recover faster and everybody will benefit if you can maintain your normal level of activity, but you may need to modify what you can do if the pain is not controlled well enough with the methods mentioned above. Activity modification rather than activity avoidance is the key. Try to stay active and remember to keep moving. At work, speak to your manager about any concerns you may have.

Activity Modification

We want to find the ideal level of activity for you as this will help improve your symptoms. Too much or too little activity can cause symptoms and complete rest is not advised. “Reaction Rules” are used to help you decide what level of activity is best. On this scale “0” means no pain at all and “10” means the worst pain imaginable.

It is common to get some reaction or pain with activity. If this is at 5/10 or below (it is an acceptable level of discomfort) and settles within 24 hours, you are doing an appropriate amount and can plan to gradually increase it over time.

If the pain is above a 5/10 and/or doesn’t settle within 24 hours, you are likely doing too much and will need to reduce your activities. Once symptoms settle, gradually build up your activity keeping within the green zones (0-5/10). Remember, these activity levels aren’t just for today, you should take into account the average of your activity over the week.