What is Osteoarthritis?
Osteoarthritis is a condition that affects your joints, causing pain and stiffness. It’s by far the most common form of joint disease, affecting people all over the world and at least 8 million people in the UK.
What causes Osteoarthritis?
Almost anyone can get osteoarthritis but certain factors can increase your risk, for example if you’re in your late 40’s or older, you’re overweight or you’re female (for most joints, especially the knees and hands, osteoarthritis is more common and more severe in women).
What might Osteoarthritis feel like?
The main symptoms of osteoarthritis are:
Pain – The pain tends to be worse when you move your joint or at the end of the day. If you have severe osteoarthritis, you may feel pain more often.
Stiffness – Your joints may feel stiff after rest, but this usually wears off as you get moving.
A grating or grinding sensation (crepitus) – Your joint may creak or crunch as you move.
Swelling – The swelling may be hard (caused by osteophytes) or soft (caused by synovial thickening and extra fluid), and the muscles around your joint may look thin or wasted.
Not being able to use your joint normally – Your joint may not move as freely or as far as normal. Sometimes it may give way because your muscles have weakened or your joint has become less stable. Exercises to strengthen your muscles can help to prevent this.
Your symptoms will often vary for no clear reason. Some people find that changes in the weather make the pain worse, especially damp weather along with falling atmospheric pressure. Others find the pain varies depending on how active they’ve been. In more severe cases, the pain might not go away. It might stop you sleeping and cause difficulties in your daily activities.
There are some great resources on the Arthritis UK website, where these images are from.
How do the symptoms of Osteoarthritis progress?
Symptoms of OA can vary. That may start severe but settle down or pain and stiffness can progress and worsen. What you do and how you manage your OA can really impact on the progression of symptoms. Keeping active and taking part in regular exercise is one of the best ways of helping your OA.
Possible complications of osteoarthritis include an increased risk of developing gout and chondrocalcinosis.
Gout is a common type of inflammatory arthritis, which is caused by high levels of urate that lead to sodium urate crystals forming in and around your joints. The changes that osteoarthritis causes in cartilage can encourage crystals to form within your joint. If you have both osteoarthritis and a high level of urate in your blood, you’re at an increased risk of developing gout.
Chondrocalcinosis or calcification is the formation of calcium pyrophosphate crystals in your cartilage. It can happen in any joint, with or without osteoarthritis, but it’s most likely to occur in a knee already affected by osteoarthritis, especially in older people.
How is Osteoarthritis diagnosed?
Osteoarthritis is usually diagnosed based on your symptoms and the physical signs that your doctor finds when examining your joints. this can include:
- joint tenderness
- creaking or grating (crepitus) sounds
- bony swelling
- excess fluid
- reduced movement
- joint instability
- muscle thinning
X-rays are the most useful test to confirm osteoarthritis, although you probably won’t need one. They can’t really show how much pain or disability osteoarthritis is likely to cause. Some people have a lot of pain from fairly minor joint damage, while others have little pain from more severe damage.
Rarely, an MRI scan of your knee can be helpful. This will show the soft tissues (cartilage, tendons, muscles) and changes in your bone that can’t be seen on a standard x-ray
What is the best treatment for Osteoarthritis
Besides painkillers, steroid injections or surgery (when causing severe pain or mobility problems), the best treatment, according to the National Institute for Health and Care Excellence (NICE), is exercise.
NICE recommendations include:
- advising patients to participate in exercise as a ‘core treatment’
- offering weight loss interventions for patients who are obese or overweight
- providing patients with holistic assessments
Exercise can help to manage some of the symptoms of arthritis. As Physiotherapists we provide advice and education on exercise, pain relief and ways to manage your condition. We can teach you how to improve your joint movement and your walking, as well as how to strengthen your muscles.
When you see us at goPhysio, we will assess your problem and give you tailored advice and a treatment programme. This may include some hands on treatments, an exercise programme and modifications to your lifestyle.
Prognosis for Osteoarthritis
It’s impossible to predict how osteoarthritis will develop for any one person. It can sometimes develop over just a year or two and cause a lot of damage to your joint, which may then cause some deformity or disability. But more often osteoarthritis is a slow process that develops over many years and results in fairly small changes in just part of your joint. This doesn’t mean it won’t be painful, but it’s less likely to cause severe deformity or disability. Sometimes the condition reaches a peak a few years after the symptoms start and then remains the same, or it may even improve.