Osteoarthritis (OA) is the commonest form of arthritis. It is also known as degenerative ("wear and tear") joint disease. It occurs most frequently in the hands, hips and knees.
In normal joints, cartilage, a rubbery material, covers the ends of each bone. Cartilage provides lubrication and acts as a cushion between the bones. When cartilage wears out (usually due to old age, or overuse), joint damage occurs; this is known as OA. Just like hypertension and diabetes, OA is a chronic condition. While it cannot be cured, many have learnt to cope well with it.
OA presents with recurring pain in the affected joint (s) or muscles around the joint after a period of prolonged or strenuous use, such as after a long walk or exercise. The pain may increase if you continue to use the joint, but usually subsides with adequate rest. Weather changes may make the pain worse, especially damp weather.
Mild stiffness usually sets in when the joints have been rested after some time; you may feel stiff in your hips and knees upon standing after prolonged sitting. Affected joints may swell after extended activity. Some experience clicking or cracking sounds on bending the joint. If the joint pain or stiffness worsens, it may interfere with your social activities and function.
There are several known causes and risk factors for OA and some of these include the following:
1. Joint injury/overuse or joint laxity - Repetitive stress on a joint can cause damage it.
2. Age - The risk of developing OA increases with age.
3. Obesity - Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. This stress increases the risk of OA in that joint.
4. Gender - Women are more likely to develop OA than men, especially after age 50.
5. Genetics - People who have family members with OA are more likely to develop it, especially OA involving hands.
What can I do to prevent or help my condition?
Maintaining a healthy weight, engaging in moderate exercise and eating a well-balanced diet can reduce the risk of developing OA. Early diagnosis may prevent further joint damage and deformity. Consult a doctor for advice.
While there is no cure for OA, it can be well-managed. If your overall treatment plan is effective, you should see improvements in pain, walking speed and distance within 4-8 weeks.
Physiotherapy and exercise
Many reduce their physical activity in response to pain and stiffness in their joints. This, however, leads to weakening of the muscles and ligaments around the joint and results in worsening OA. Physiotherapy is important for building up the strength in the surrounding muscles so that they can hold up the joint better, lessening the stress exerted on the joint.
Moderate, low impact exercises such as walking, swimming and/or cycling are recommended. These activities have a low risk of injury and do not put too much stress on the joints.
The pain resulting from OA may fluctuate and you may therefore be prone to doing more on ‘good’ days and resting on ‘bad’ days. This however is not ideal; learning how to pace your activities is key. Do ensure to speak to your physiotherapist about this.
Tai chi, acupuncture, yoga, massage and heat therapy are safe and may be effective.
For people who are overweight or obese, losing weight reduces pressure on joints. Reaching or maintaining a healthy weight can relieve pain, improve function and slow the progression of OA.
Most medications only help in reducing the pain and swelling associated with OA. Paracetamol (Panadol) may be used for mild pain while stronger medications like non-steroidal anti-inflammatory drugs (NSAIDs), or joint injections may be required for more severe pain and swelling. The effect of glucosamine is variable. Do speak to your doctor first before you try these medications.
In advanced cases of OA, surgery may be required to realign the joints, remove bone fragments or even replace the joint with an artificial part.