OSTEOARTHRITIS (OA), also known as degenerative joint disease, is the most common form of arthritis. OA primarily involves the wear and tear of cartilage in the joints, leading to pain, stiffness, and limited movement. While it is often seen as a normal part of ageing, OA can significantly impact a person’s quality of life, leading to difficulty with everyday activities.
Osteoarthritis occurs when the cartilage that cushions the ends of the bones in the joints breaks down. Cartilage is a smooth, flexible tissue that allows bones to move against each other with minimal friction. As the cartilage erodes over time, bones begin to rub directly against each other, causing pain, swelling, and a decrease in joint flexibility. In severe cases, the bones may develop spurs, and the joint may lose its ability to function properly.
OA can affect any joint but is most commonly seen in weight-bearing joints such as the knees, hips, and spine. It can also affect the hands and fingers. The condition tends to develop gradually, and symptoms may worsen over time.
CAUSES AND RISK FACTORS
OA becomes more common with age. As people get older, the cartilage naturally wears down, making the joints more susceptible to the disease. Family history plays a role. Some individuals may inherit genes that make them more prone to developing OA. Past joint injuries or trauma, such as fractures or ligament tears, increase the risk of developing OA in that joint later in life.
Extra body weight puts added stress on weight-bearing joints like the knees and hips, increasing the risk of OA, especially in these areas. Women are more likely to develop osteoarthritis than men, particularly after menopause. Jobs that involve repetitive motions or heavy lifting can put strain on joints, increasing the risk of OA. People born with joint abnormalities or malformations may be at higher risk for OA as these conditions can lead to abnormal wear on the joint.
SYMPTOMS OF OSTEOARTHRITIS
Osteoarthritis symptoms vary depending on the severity of the condition and the affected joint. Common symptoms include:
JOINT PAIN: The most prevalent symptom, which worsens with activity and may improve with rest.
STIFFNESS: Especially in the morning or after periods of inactivity, joints may feel stiff or less flexible.
SWELLING: Inflammation within the joint can lead to visible swelling, making it tender to the touch.
DECREASED RANGE OF MOTION: As the joint becomes stiffer, it may become harder to move or bend it as freely.
CREPITUS: A crackling or popping sound when the joint is moved, caused by rough surfaces rubbing against each other.
JOINT DEFORMITIES: In advanced OA, joints may change shape, causing visible deformities such as enlarged knuckles or knees.
DIAGNOSIS
The diagnosis of osteoarthritis typically involves a combination of medical history, physical examination, and imaging tests. During the physical examination, doctors assess the affected joints for signs of tenderness, swelling, and limited movement.
To confirm the diagnosis and rule out other conditions, healthcare providers may recommend imaging tests such as:
X-RAYS: X-rays are often used to detect joint space narrowing, bone spurs, and changes in bone structure, all of which are indicative of OA.
MRI: Magnetic Resonance Imaging (MRI) provides detailed images of both bone and soft tissues, helping doctors to evaluate the extent of cartilage damage.
LAB TESTS: Blood tests can help rule out other forms of arthritis, such as rheumatoid arthritis.
TREATMENT OPTIONS
While there is no cure for osteoarthritis, several treatments can help manage symptoms and improve the quality of life for those affected by the condition. Treatment approaches are typically personalised and depend on the severity of the disease, the affected joints, and the individual's overall health.
Maintaining a healthy weight reduces stress on weight-bearing joints, particularly the knees and hips. Low-impact activities like swimming, cycling, or walking can help strengthen the muscles surrounding the joint, improve flexibility, and reduce pain. Physical therapy is often recommended to design personalised exercises that enhance joint function.
Over-the-counter medications like acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve) can help manage pain and inflammation. Creams and gels containing capsaicin or menthol can provide localised relief.
In some cases, corticosteroids may be injected into the joint to reduce inflammation and provide short-term pain relief. In cases of severe OA where other treatments fail, joint replacement surgery may be necessary. This involves replacing the damaged joint with a prosthetic one, commonly performed in the knee, hip, or shoulder.
Living with osteoarthritis involves understanding the disease and making proactive changes to reduce symptoms. In addition to medical treatment, adopting a healthy lifestyle is key. This includes staying active, maintaining a healthy weight, eating a balanced diet rich in anti-inflammatory foods, and using assistive devices like braces or canes to support affected joints.