Osteoarthritis
DEFINITION
Osteoarthritis (OA) is a condition that affects the
joints.
joints.
DESCRIPTION
In a normal joint, the ends of the bones are covered by a
layer of cartilage. Cartilage helps the joint move smoothly and
cushions the ends of the bones. In OA, the cartilage breaks down
and becomes thin. This leaves the ends of the bones unprotected,
and the joint loses its ability to move smoothly.
layer of cartilage. Cartilage helps the joint move smoothly and
cushions the ends of the bones. In OA, the cartilage breaks down
and becomes thin. This leaves the ends of the bones unprotected,
and the joint loses its ability to move smoothly.
There are three characteristics of OA:
- Damaged cartilage – the strong, smooth surface that lines the
bones and allows joints to move easily and without
friction, - Bony growths developing around the edge of the joints,
and - Mild inflammation of the tissues around the joints
(synovitis).
Any joint in the body can be affected by OA. The joints most
commonly affected are the knees, hips and small joints of the
hands.
commonly affected are the knees, hips and small joints of the
hands.
Who develops osteoarthritis?
OA usually develops in people who are over 50 years of age,
and it is more common in women than in men. It is commonly thought
that OA is an inevitable part of ageing, but this is untrue.
Younger people can also be affected by OA, often as a result of an
injury or another joint condition.
and it is more common in women than in men. It is commonly thought
that OA is an inevitable part of ageing, but this is untrue.
Younger people can also be affected by OA, often as a result of an
injury or another joint condition.
SIGNS AND SYMPTOMS
Osteoarthritis is most likely to occur in the joints of the
knees, hips or hands. The main symptoms are:
knees, hips or hands. The main symptoms are:
Pain,
Stiffness (which is worst in the morning but improves
movement, and
movement, and
Difficulty moving the affected joints.
In some cases, Osteoarthritis does not produce symptoms. In
most cases, symptoms occur in one joint or a few joints at any one
time. Symptoms may develop slowly. Other symptoms of Osteoarthritis
may include:
most cases, symptoms occur in one joint or a few joints at any one
time. Symptoms may develop slowly. Other symptoms of Osteoarthritis
may include:
- Joint tenderness,
- Increased pain and stiffness after sitting or resting for a
while, - Joints appearing slightly larger,
- Grating or crackling sound or sensation in the joints,
- Limited range of movement in the joints,
- Weakness and muscle wasting (loss of muscle bulk), and
- Warm joints.
TREATMENT OPTIONS
As with all conditions, your Doctor should be consulted to
diagnose and treat this condition. Osteoarthritis cannot be cured.
Treatment for the condition can ease the symptoms and allow you to
continue with normal activities. In mild cases, treatment
strategies can include appropriate exercises and lifestyle changes
such as weight loss.
diagnose and treat this condition. Osteoarthritis cannot be cured.
Treatment for the condition can ease the symptoms and allow you to
continue with normal activities. In mild cases, treatment
strategies can include appropriate exercises and lifestyle changes
such as weight loss.
Your Doctor can recommend analgesics (painkillers) to manage
any pain. If pain persists, your GP may prescribe a non-steroidal
anti-inflammatory drug (NSAID). Sometimes, NSAIDs may not be
suitable for you if you have certain conditions, such as asthma or
a peptic ulcer. If you are unsure about whether NSAIDs are suitable
for you, you should speak to your GP. Children who are under 16
years of age should not take aspirin. Thermotherapy (warm and cold
packs) can also help to relive pain and stiffness.
any pain. If pain persists, your GP may prescribe a non-steroidal
anti-inflammatory drug (NSAID). Sometimes, NSAIDs may not be
suitable for you if you have certain conditions, such as asthma or
a peptic ulcer. If you are unsure about whether NSAIDs are suitable
for you, you should speak to your GP. Children who are under 16
years of age should not take aspirin. Thermotherapy (warm and cold
packs) can also help to relive pain and stiffness.
If your Osteoarthritis is causing you severe pain and
discomfort, or affecting your mobility, your GP may refer you for
treatment from a Physiotherapist or an Occupational therapist. An
Occupational Therapist can recommend devices which may help in
performing everyday tasks.
discomfort, or affecting your mobility, your GP may refer you for
treatment from a Physiotherapist or an Occupational therapist. An
Occupational Therapist can recommend devices which may help in
performing everyday tasks.
In the past, the only way to detect Osteoarthritis was through
an x-ray after the condition had progressed. Clinical research
shows that a different type of scan called an MRI (Magnetic
Resonance Imaging) may be able to detect small changes in cartilage
that indicate when a person is in the very early stages of
developing the disease. Lifestyle changes such weight loss and
appropriate exercise can then be implemented. This type of early
intervention may reduce the future need for medication and
surgery.
an x-ray after the condition had progressed. Clinical research
shows that a different type of scan called an MRI (Magnetic
Resonance Imaging) may be able to detect small changes in cartilage
that indicate when a person is in the very early stages of
developing the disease. Lifestyle changes such weight loss and
appropriate exercise can then be implemented. This type of early
intervention may reduce the future need for medication and
surgery.
CURRENT TREATMENT OPTIONS
- Appropriate exercises can help maintain healthy cartilage,
increase the range of motion of a joint and strengthen surrounding
muscles. Exercises may include stretching, strengthening and
postural exercises. Exercise should be balanced with rest of
painful joints. - The combination of weight loss and exercise is significantly
better than either one of these interventions alone in reducing
pain and improving function in overweight patients with knee
Osteoarthritis - Very soft chairs, recliners, mattresses or car seats may worsen
symptoms. Your Doctor may recommend using straight-backed chairs,
firm mattresses and bed boards. Back supports or braces may be
needed if the Osteoarthritis affects the spine. - Physical therapy such as heat treatment, splints or supports
and massage may be suitable for certain affected joints. - Analgesics, NSAIDs, and injected steroids are drugs that may be
prescribed for the treatment of pain and inflammation associated
with Osteoarthritis. - Surgery for Osteoarthritis is only needed in a small number of
cases. There are a number of different types of surgery. You may
have surgery to smooth the surfaces of your joints or restore
cartilage (an arthroscopy), or you may have surgery to replace your
whole joint, or to fuse it into position.
DIET HINTS
Osteoarthritis may, in some cases, respond to dietary
changes.
changes.
- The diet generally should be rich in fish oils such as salmon,
tuna, mackerel and mullet. Fish oils may help to regulate the
inflammatory process. - It is recommended that you include vitamin C rich foods in the
diet. - Foods rich in silicon may be beneficial for Arthritis
sufferers. These include wholegrain cereals, nuts and
apples. - Weight control is important. This will help minimise the load
on inflamed joints. (See the Weight Management Diet topic for more
information). - Certain food groups such as the “nightshade” vegetables
(potato, tomato, eggplant, chilli and capsicum) and salicylate-rich
foods (see examples in the Hives and Hyperactivity Diet topic) may
aggravate Osteoarthritis. Check for food sensitivities,
particularly dairy and wheat. This should be assessed on an
individual basis with the help of a qualified Dietitian.
VITAMINS/MINERALS/HERBS
Nutritional supplements are only to be used if the dietary
vitamin intake is inadequate.
vitamin intake is inadequate.
- Glucosamine can reduce joint pain and rebuild cartilage.
- Chondroitin is often combined with glucosamine for use in
Osteoarthritis. - MSM can act as a pain reliever and due to its anti-inflammatory
actions can benefit osteoarthritis sufferers. Arthritic joints have
been shown to be lower in sulfur than healthy joints. Sulfur is an
integral component of cartilage. MSM contains sulfur which can be
delivered to the affected areas. - Ginger has been found to inhibit inflammation in the body and
reduce the pain of arthritis. - Fish Oil supplementation can help to decrease the severity of
Osteoarthritis and regulate the number of molecules in the body
which cause inflammation. - Bromelain may assist symptoms of pain in osteoarthritis as has
a natural anti-inflammatory effect. - Cayenne cream contains the key ingredient capsaicin. It assists
pain relief by inhibiting the production of substance P, a chemical
involved in sending pain messages to the brain. Cayenne cream
should be used topically for symptomatic relief. - SAMe is an excellent supplement to assist in reducing the
symptoms of osteoarthritis due to its anti-inflammatory effects.
. - Herbs such as devil’s claw, feverfew, and white willow bark
have traditionally been used to relieve the pain and inflammation
associated with osteoarthritis. - Boswelia may relieve swelling and inflammation in
osteoarthritis.
ORGANISATIONS & SUPPORT GROUPS
See the Arthritis Foundation of Australia topic on the
Healthpoint.
Healthpoint.
PHARMACIST’S ADVICE
- Follow the diet hints.
- Paracetamol or NSAIDs (nonsteroidal anti-inflammatories) may be
suggested for pain relief. Paracetamol is considered suitable to
ease the pain of Osteoarthritis. Ask your Pharmacist for advice as
there are possible side effects. - Paracetamol and codeine in combination may be recommended for
Osteoarthritis pain which does not respond to paracetamol. Codeine
may cause constipation in some people. - A variety of over-the-counter topical analgesics are available.
These are usually creams or gels which may be rubbed into the
painful area several times a day. Such creams should not be applied
to broken or irritated skin, and hands must be washed well after
application. If it is your hands that are being treated, wear a
pair of light cotton gloves to prevent creams from getting into the
eyes. Creams may interact with oral medications, so always ask your
Doctor or Pharmacist before commencing a new treatment. - Ask your doctor about the most suitable exercise Programme for
this condition. (See the Osteoarthritis – Exercise topic for more
information). - Relief from Osteoarthritis may be obtained from heat treatment,
splints and/or supports. Ask your Pharmacist for advice. - Functional aids such as walking sticks or forearm support
crutches are available. Ask your Pharmacist for advice and see the
Arthritis – Bathroom Aids, Arthritis – Dressing Aids, Arthritis –
Gardening Aids and Arthritis – Grooming Aids topics on the
Healthpoint. - Lose weight if necessary. Excess weight increases the risk of
Osteoarthritis of the knee. Weight loss can reduce the severity of
pain in the knee and hip. Ask your Pharmacist for advice. - Consider taking the supplements recommended in this topic.