Osteoarthritis

Osteoarthritis is the commonest form of joint problem, and is caused by the thinning of the cartilage between the joint surfaces, which normally acts as a lubricant and shock absorber. Osteoarthritis tends to affect the big joints, which carry most of the body's weight, such as the hips, knees and spine, but the joints in the fingers and hand can also be a problem. In severe cases the hip and knee joints can be replaced by surgery. (See also Arthritis & Rheumatism)

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Osteoarthritis

Osteoarthritis is by far the commonest form of arthritis, affecting between 3 and 6% of the population. The exact figure is uncertain, and because it starts very gradually, many people put down the joint pain and stiffness to just getting old, rather than having a diagnosis of osteoarthritis put into their medical records. Women are affected more than men at all ages. There is more osteoarthritis in the population as people are living longer, and some trends worryingly suggest a natural increase in the general population, irrespective of age.

Osteoarthritis mainly effects older people. It is unusual under the age of 45, but by the age of 65 up to 60% of the population may have detectable osteoarthritis in at least one joint, even if it does not cause any symptoms. It continues to effect more and more people right up to the age of 90.

Osteoarthritis is not a natural part of getting old, and you should not just accept pain and stiffness in your joints as 'just part of your age'. You should see your doctor for a diagnosis, and then become actively involved in making things better. The earlier you catch this the better.

Osteoarthritis is more common with some jobs that put an extra strain on your joints, such as lifting or bending; so manual work, joint injuries, and sports gives an extra chance of having it.

Osteoarthritis is caused by thinning of the cartilage lining the joints. Cartilage is nature's shock absorber, which stops bones rubbing together. Throughout life it is always being broken down by the body and replaced. Unfortunately after the age of about 25 the breakdown happens faster than the build up, and so cartilage tends to thin with the passing of the years. This brings the bones closer together, to the stage where they are close enough to cause pain, and the closer rubbing of the bones can cause inflammation. It can also be caused by damage to the joints by injury.

Osteoarthritis tends to affect the big joints, which carry most of the body's weight, such as the hips, knees and spine, but the joints in the fingers and hand can also be a problem. It usually hits the body symmetrically, so both knees often go first, but one joint can be worse than the other. The joints stiffen when you are asleep, but it takes less than half an hour to get going in the morning. They also stiffen up if you don't move for a while, but this soon goes when you start moving about. Joints can be painful, and this gets worse the more you use them.

Joints can become swollen and distorted as extra bone is laid down in the joint. This is most commonly seen in the joints at the end of the fingers and knees, but can also effect the hips, thumbs and spine.

Treatment of osteoarthritis by your doctor will start with pain killers , however published studies into the pain relief given by different pain killers shows that they may not help that much. Paracetamol is normally used as a first choice of pain killer, as it is the safest, and it may be combined with codeine or it's relatives to make it a little stronger. Where there is inflammation in the joint, anti-inflammatory painkillers such as ibuprofen, or stronger prescription-only medicines can be used. Physiotherapy and exercises play an important part in treatment, and surgery, such as hip or knee replacements can replace very badly worn joints.

Becoming an 'expert patient' really helps. The more you can do to find out about your condition by reading any literature your doctor or rheumatologist recommends, the better you will be at managing your own condition. Osteoarthritis is one area where you need to actively manage your own condition. This will help you far more than sitting back and letting things happen.

Complementary treatments of osteoarthritis are very popular, and most people try them, because osteoarthritis is a long-term condition that can not usually be cured by your doctor. Unfortunately there is little reliable guidance on how to get the best out of complementary therapies. There is an increasing body of evidence published in medical journals that some of the complementary therapies such as glucosamine & chondroitin can be useful in slowing down the problems in osteoarthritis, and in some cases may even reverse the process. Cod liver oil or the newer fish oils rich in anti-inflamatory Omega-3 may also be of some help, especially where there is inflammation.

Look after your general health even more now. Proper exercise is important. Proper nutrition is important. Multivitamin and mineral supplements may be considered.

And if things get you down speak to your doctor, because however strong you think you are, it is easy to become depressed if you are often in pain.

Can you prevent osteoarthritis? Some things will minimise your risk of developing osteoarthritis, but you can not guarantee that you will never get it. Keep to a normal weight. Try not to damage joints by injury or overuse. Eat a good diet, and keep active and fit, without overdoing it. Low dose glucosamine supplements started at any time after the age of 25 may theoretically help reduce cartilage thinning, but no published studies have investigated if this really works.