Osteoarthritis (OA) | Causes and management

Osteoarthritis (OA) | Causes and management

Osteoarthritis (OA) is a condition that usually develops gradually, over several years, and affects a number of different joints. It used to be considered a wear-and-tear form of arthritis, but it is now thought there are many more factors than age and use that contribute to its development, including genetics, obesity and past injury.

It is more common in females than males. In females, it often develops after the menopause, which can lead to it being seen as part of the ageing process, although research into this is ongoing.

Osteoarthritis (OA)  | Causes and management

For some people who develop osteoarthritis, the changes are subtle and develop so gradually that they may hardly be noticed at first. For others, problems may significantly worsen over a number of years, but then may settle and become easier to manage. As the overall disease process develops, joints may become knobbly in appearance, but may or may not be painful. In some cases, these joints actually become pain free and, despite their appearance, do not prevent you from carrying out most everyday tasks.

What happens?

In osteoarthritis, cartilage becomes pitted, rough and brittle. The bone underneath the cartilage thickens and broadens out. In some cases, bony outgrowths (osteophytes) may form at the outer edges of the joint, making the joint appear knobbly. The synovial membrane and the joint capsule thicken, and the joint space narrows, which can lead to an increase in the amount of fluid in the joint.

Often there is some inflammation, and the joint may become stiff and painful to move and occasionally the fluid swells.
In worse cases, parts of the cartilage may become brittle and break away, exposing the ends of the bones, which can then rub against each other. This can cause the ligaments to become strained and weakened, which in turn causes a lot of pain and some changes in the shape of the joint.

Which joints are affected?

Osteoarthritis most commonly occurs in the joints of the hands, knees, hips, feet and spine.

How is it treated?

Your doctor will aim to minimize the effects of your arthritis and to reduce the symptoms, especially the pain. There are many medicines available to help manage the pain of osteoarthritis. You may be offered:

• Analgesics, which help to relieve pain

• Non-steroidal anti-inflammatory drugs (NSAIDs), which reduce inflammation and the pain caused by inflammation, or

• Steroids, which can be injected into the affected joint or taken in tablet form.

These medicines cannot cure your arthritis, but they will reduce the symptoms and the pain. If your arthritis becomes severe, particularly in your knees and hips, then your doctor may discuss with you the possibility of surgery, although this is usually considered only after all other suitable treatment possibilities have been explored.

If you agree, you may be referred to see an orthopaedic surgeon with a view to having the joint replaced. Joint replacement surgery is very successful and last at least 10–15 years, after which it is possible to have revision replacements.

What can you do?

You can help to reduce pain and the stress on your joints by taking up appropriate exercise. Finding the right exercise and relaxation techniques that work for you can help strengthen the muscles that support and protect your joints. If you are uncertain about what kind of exercise to do, a physiotherapist will be able to advise you.

The golden rule is: if you can move it, you can exercise it. In addition, massaging painful joints and muscles can help relieve discomfort and pain for many people. And attaining and maintaining an ideal weight can significantly help ease the strain on your weight-bearing joints.

While exercising and keeping fit and active can be very beneficial, relaxation techniques can also help. Relaxation classes help some people, as do other complementary therapies, such as acupuncture and aromatherapy.


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