Osteoarthritis

Osteoarthritis (OA) is commonly known as a type of arthritis that older people get, and that is usually the case. It was also seen as a disorder caused by overuse of joints, “wear and tear” arthritis to some. However, we now know that isn’t entirely true. Your joints are going to be used a lot throughout your life, but that doesn’t automatically mean that you’re going to develop Osteoarthritis. Rather, it’s a disease of the joints that needs care, attention and treatment.

In this guide we’ll take a thorough look at all the latest news and research into Osteoarthritis and provide a holistic guide to the disease for both patients and their loved ones.

What is OA?

Osteoarthritis is classed as an arthritic disease which leads to pain and swelling in the joints. Our joints are cushioned by a smooth substance called cartilage, and when this breaks down it can cause all manner of problems for the affected joint. It tends to start in the hands, knees and neck but can affect any joint in the body. It’s certainly more common in women and those over 50 years of age, and it’s a progressive disease, meaning it tends to get worse over time.

What are the Symptoms?

Osteoarthritis tends to develop slowly over time and the symptoms can appear gradually. These include:

• Joint stiffness: first thing in the morning or after resting for some time.
• Inflammation
• Muscle weakness
• Pain in the joint after activity or late at night
• Cracking / clicking sound when using the joint
• Spurs: bony growths on the fingers

Depending on which joints are affected, you may experience specific symptoms in these areas. As Osteoarthritis progresses, the cartilage becomes more damaged and this will lead to worse symptoms.

What Causes Osteoarthritis?

We used to think that OA was caused through the general wear and tear of everyday life. Especially because it affects older people, it’s not surprising that this theory stuck for so long. But not everyone over the age of 50 develops Osteoarthritis, so researchers now consider it a disease with a few factors that may contribute to it.

• Your Genetics: People will family members who have Osteoarthritis are more likely to develop it.
• Your Age: People over 50 are more likely to develop OA due to their bones, muscles and connective tissues also aging and becoming naturally weaker.
• Biological Sex: Women are more likely to get Osteoarthritis than men.
• Prior Injury: Tears or breakages years earlier put that particular joint at more risk as you age.
• Obesity: Being overweight comes with a range of other health issues, and that weight can put more pressure on your joints.
• Overuse / Underuse: A specific job or profession that requires repetitive movements can put you at risk, but so can lack of exercise and weak muscles.

How do I get a Diagnosis?

Initially, you’ll need to see Rheumatologist. This could be because you’re experiencing pain in one or more joints, or stiffness in the morning combined with the risk factors as identified above. This doctor will take a full medical history, perform a physical examination and may carry out some additional tests, including an X-Ray and MRI. Additionally, blood tests may be required; to check for Rheumatoid Factor (RF) or for inflammatory markers, such as Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) which can indicate whether you have an arthritic condition.

They may also perform a test called a Joint Aspiration. One of your affected joints will be numbed, and a needle will be inserted to collect the fluid that surrounds your joint. This will then be sent off to be assessed for infection or crystals, which can help rule out other conditions.

What are my Treatment Options?

There is no cure for Osteoarthritis as of yet, and with the progressive nature of the disease, finding a dedicated individual plan for your condition is vital. Thankfully your specialist will be able to recommend a treatment plan that might fit your needs, and with your input will be able to tailor it throughout your disease experience.

Medication

Medication for OA is all about symptom reduction, and includes:

• Painkillers: Medications such as paracetamol are available from your local pharmacy, over the counter (OTC). Opioids can also be prescribed by your doctor, whilst Platelet-rich plasma (PRP) is available as an injection from your rheumatologist.
• Anti-Inflammatories: Non-steroidal anti-inflammatory drugs (NSAIDs) include Ibuprofen and aspirin and can be bought OTC. Corticosteroids are available via prescription as a tablet or injection.
• Counterirritants: These medications are available OTC and work by irritating the nerve endings with cool, hot or itchy sensations to take the focus off your pain.
• Alternatives: People with OA have also been prescribed an antidepressant called Duloxetine and an anti-epilepsy medication called Pregabalin to combat pain and inflammation.

Physical Therapy

Maintaining a healthy body is a holistic process and involves a mix of diet, exercise and balance in your life. You may be put in touch with an Occupational Therapist who can help you with all aspects of healthy living. They can identify a specific plan tailored to your needs and provide assistive devices to help you get around if necessary.

Exercise is highly recommended for people with Osteoarthritis. 150 minutes of weekly, gentle exercise in whatever form is favourable to you is the average amount required. Walking, yoga, swimming and other exercises or sports that are gentle on your joints are perfect.

You may also be advised to lose weight if you are overweight, as the extra pressure on your joints may impact your ability to reduce the pain and inflammation from OA. If this is the case, your doctor and therapist will be able to recommend an exercise and diet schedule for you.

Which brings up on to the next important part of a healthy lifestyle; your diet. You may need to change what you eat slightly to get as many nutrients as possible or be recommended supplements. You may be encouraged to quit smoking and cut down on your alcohol consumption, alongside maintaining a regular sleep pattern.

Psychological Therapy

Dealing with a chronic illness is difficult. It’s important to have a support network around you, not just of health specialists, but friends and family. Seek out counselling or therapy if you feel you are struggling with any aspect of your mental health. Depression rates among people with arthritis is highly elevated, as dealing with pain day after day for a long time has a detrimental effect on everyone eventually.

Therapists will be able to help you talk through your feelings and thoughts, helping to provide positive coping techniques, relaxation exercises and medication if needed.

Surgery

Surgery for Osteoarthritis is a last resort, as it usually means the replacement of one or more joints. This can be an intrusive and disruptive procedure and require you to make significant changes to the way you live. But it is highly beneficial to those who have no other options, and it can seriously improve your quality of life. Your doctor will be able to give you more advice on this.

How do I Manage my Symptoms and Live with OA?

Unfortunately, living with Osteoarthritis can bring additional problems. Having OA increases your risk of falls by 30%, with a 20% increase of fracture compared to someone without the disorder. Falling is a big issue for people with Osteoarthritis and part of the physical therapy you’ll receive will assess your living areas and overall mobility to negate your personal risk.
Medication side effects can also contribute to a fall risk as they may make you feel dizzy or light-headed. It’s important to speak to your doctor about all of the symptoms you experience when on medication, as they may be able to offer alternatives.
The joint pain you experience with OA can also make it more difficult to exercise, leading to you becoming overweight. This in turn increases your risk for other serious illnesses such as heart disease, diabetes and high blood pressure. Monitoring your weight and finding exercises and activities that work for you is a great way of reducing this risk.

Summary

Osteoarthritis is a very common type of arthritis that affects older people and causes pain and stiffness in one or more joints. There is no specific way you can develop osteoarthritis but maintaining a healthy lifestyle can help. Treatment plans consist of medication, physiotherapy, changes to diet and exercise. Osteoarthritis can put you at more risk of other illnesses and falls, so it’s important to get the care and support you need from your medical team, friends and family.