What is Osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis and in the UK nearly 8 million people are living with it. It’s a degenerative condition where the cartilage which protects your bones starts to deteriorate, causing damage to the joints. If you have this type of arthritis you’ll probably feel some pain or discomfort when you move the affected joints. As with other types of arthritis, symptoms will differ from one person to another. It affects people from their late 40s onwards, but the older you are the more likely it is you will have it.
There are several likely causes of osteoarthritis, including age, previous joint injury, your family history and obesity. Any joint can be affected by OA, but it most often occurs in the knees, hips and small bones of the hand. Treatment focuses on relieving any pain you might have and protecting your joints from further damage. In some cases surgery to replace the affected joints might be necessary.
As we age, most of us will have osteoarthritis to some degree, but there is plenty that can be done to relieve the symptoms and get the most out of life.
- Increased joint pain after activity
- Brief stiffness of the joints on waking up in the morning and also after periods of inactivity during the day
- Possible swelling around the affected joint or joints
- Sometimes a grinding noise when the joint is used
The symptoms vary in each case: some people will feel mild pain when moving the affected joints whilst others will find their mobility is severely restricted.
OA typically occurs in the knees, hips, knuckles and fingers – but any joint can be affected.
As with any visit to the GP, the starting point is going to be your symptoms: before your appointment try to think about what times of day you feel pain, for how long and which joints are affected. Tell the doctor as much as you can, because this will be key to the diagnosis. For example, is there a family history of osteoarthritis?
The doctor will usually examine your joints but probably won’t ask for a blood test or an X-ray except to rule out another condition – rheumatoid arthritis or gout, for example.
Once you are diagnosed with osteoarthritis your GP will discuss with you the best course of treatment according to the severity of your symptoms. It might be that you need to lose weight – especially if your knees are affected – or are given a programme of muscle-strengthening exercises. Sometimes you will be referred to a physiotherapist who will supervise your exercise. Where there has been extensive damage to the joints you might be referred to an orthopaedic surgeon to determine whether joint replacement surgery is an option for you.
Damaged cartilage does not heal, so the treatment of osteoarthritis focuses on relieving pain and protecting the joint or joints, and increasing our mobility.
Medication for pain relief: If you have only mild pain, then it may help you to take paracetamol – available over the counter from the chemist. If necessary, your GP might prescribe a stronger type of painkiller – a non-steroidal anti-inflammatory drug (NSAID). These drugs work by reducing inflammation and sometimes they come as a cream, which can be useful if your hands or feet are affected.
As with any form of medication, any other condition you have will be relevant to the prescription you are given, and not all medications are suitable for everyone. However, there are several more options your GP can explore if either paracetamol or NSAIDs don’t work, including opioids such as codeine, tramadol or corticosteroid (usually known as steroid) injections.
Tell your GP if the painkillers you are taking aren’t working: there are likely to be other options which will be effective.
Surgery: Not everyone is a candidate for surgery (if you have Parkinson’s Disease for example) but joint replacement surgery is sometimes undertaken where there has been severe joint damage: typically this will be a hip or knee replacement. For more details, read our separate guides to hip and knee replacement. There are other procedures which the orthopaedic surgeon might decide are better for you, avoiding a total joint replacement.
Exercise: If you have osteoarthritis, there are many benefits to exercise: it will help build up muscle and protect your joints from further damage, it can reduce pain and stiffness – and it will help control your weight. If you have osteoarthritis of the knee and you are overweight, getting your weight down will immediately reduce stress on the joint – and with it the risk of further damage.
For the sake of your joints, keep your weight under control.
You don’t need to spend money joining a gym, and for most people with osteoarthritis going for a walk is a better idea as it is a low-impact activity and an excellent way to build up your strength and stamina. If you have been referred to a physiotherapist, then you will be given a specific set of exercises to help the affected joints.
Yoga and tai chi can also be beneficial – these activities which involve gentle stretching can improve muscle strength and balance, and help overall mobility.
Always discuss what exercise would be beneficial for you with your nurse or doctor and avoid doing anything which puts extra strain on the joints – jogging or lifting heavy weights, for example.
Diet & Lifestyle: A healthy diet is a good thing in itself, and something we should all be aiming for at any stage of life and whatever the state of our health is. Eating healthily is especially important for people with osteoarthritis as it can help reduce the pressure of excess weight on joints. A good start is to eat plenty of vegetables, fruit and wholegrains, and to avoid processed foods wherever possible, as they contain more salt, sugar and fat. Broadly speaking, it is recommended we all follow the Mediterranean Diet, which means plenty of fruit, vegetables, pulses and oily fish.
Every extra pound of body weight increases the pressure on the knee joint by 3 – 4 pounds.
Many people take dietary supplements such as Vitamin D, which helps the body absorb calcium. Other osteoarthritis sufferers may take a supplement called glucosamine, which occurs naturally in the body and is believed by some to prevent further joint destruction. The evidence for this is far from conclusive, but there is no doubt that some people feel better when they’re taking it. It is not generally advised for diabetics as it can affect blood sugar levels in the body.
Always talk to your healthcare team before taking supplements. Apart from anything else, it could save you from wasting money.
Assistive devices & occupational therapy: Assistive devices (e.g. walking sticks, wall-mounted jar openers) have 2 basic aims: to alleviate pain and inflammation, and to improve mobility. Any device which reduces the stress on a joint can achieve this. In addition, your GP might have arranged for you to see an occupational therapist. This usually involves a visit to your home, where he or she will make recommendations about devices you could use or modifications you might make to your home to improve your mobility and help you carry out everyday tasks.
Complementary therapies: It’s not unusual for people diagnosed with osteoarthritis to try complementary therapies alongside their conventional treatments. These therapies include massage, heat and cold therapies or acupuncture. There’s generally no reason not to go ahead with a complementary therapy if it makes you feel better – but do discuss it with your rheumatologist or someone in the team first. As a rule, the NHS does not pay for these treatments but what is provided varies locally, so it’s worth asking before you pay yourself. The following link to the charity Arthritis Care UK’s website contains lots of useful information:www.arthritisresearch.org
Other useful sources of information:
Any information of a medical nature on this website is given to provide a general understanding of a medical condition or conditions.
No patient/doctor relationship is to be inferred and you should seek medical advice from a qualified practitioner.
Nothing on this site should be used as a substitute for competent advice from a qualified medical practitioner.