Osteoarthritis is the most common form of arthritis, affecting around 10 percent of adults in New Zealand. People of any age can develop osteoarthritis but it usually starts after the age of 40.
Osteoarthritis can affect any joint of the body but most commonly occurs in the hands and weight-bearing joints such as feet, ankles, knees, hips, and spine.
What is osteoarthritis?
Osteoarthritis affects the whole joint including bone, cartilage, ligaments and muscles. Although often described as simply due to ‘wear and tear’, it is now thought to be the result of a number of factors including inflammation, injury or ageing.
In healthy joints, cartilage acts as a shock absorber and provides a smooth surface between the bones to allow easy movement. When a joint develops osteoarthritis, the cartilage thins and becomes rough. In some cases, the cartilage breaks down, leaving the bones unprotected and no longer able to move smoothly. Bones may lose shape and thicken at the end, creating bony spurs.
Osteoarthritis is a chronic condition that can develop over many years. If not managed well, it can cause great pain and disability, but early treatment and self-care can slow the progression of the condition and minimise pain.
Who gets osteoarthritis?
Factors that may increase the risk of getting osteoarthritis include:
Age: Ageing means muscles become weaker and the body is less able to heal itself. However, osteoarthritis is not an inevitable part of ageing. Many people grow old without showing signs of the disease.
Gender: Women are more likely to develop osteoarthritis than men.
Family history: Osteoarthritis of the fingers and hands often runs in families, particularly for women.
Excess weight: Carrying extra weight puts more stress on weight-bearing joints such as hips, knees and spine and can increase the risk of injury. It is now also thought that fat-loving gut bacteria contribute to joint inflammation.
Joint injury: Osteoarthritis can occur in joints that have been damaged by a previous injury through sport or an accident. Surgery to repair injuries, especially knee surgery, can increase the risk of osteoarthritis up to seven times.
Occupation: Hard repetitive physical activity can damage joints, leading to osteoarthritis in later life. Examples include farmers, construction workers, dancers and professional athletes.
Other joint conditions: Sometimes other forms of arthritis can damage joints, for example, rheumatoid, gout and septic arthritis. People who are born with or develop malformed joints are also at greater risk of developing osteoarthritis.
See your doctor if you have the following signs for more than two weeks:
- Stiffness of the joint after getting out of bed or sitting for a long time
- Pain in or near the joints when moving or at rest
- Swelling in or near the joint
- Muscle weakness
- Painful creaking or cracking when moving joints.
How is osteoarthritis diagnosed?
A doctor will consider your symptoms and examine you physically. It’s important for you to be able to describe when and where the pain occurs and how it is affecting your movement. There is no blood test for osteoarthritis. X-rays and MRI scans can be used to confirm osteoarthritis but results may be inconclusive; what shows on the image may not reflect the level of pain or disability you are experiencing.
How can I manage my osteoarthritis?
Although there is no cure, there are many ways to relieve your symptoms and limit their impact on your life. Your health team is there to guide you, but you can take the lead in looking after yourself and your condition.
Painkillers are often prescribed to reduce pain and stiffness, but they do not treat the arthritis itself. Paracetamol is the simplest and safest painkiller. Others include:
- combined painkillers – paracetamol together with an opiate like codeine
- non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or creams and gels that can be rubbed into the skin. These reduce pain and swelling but may have side-effects.
- steroid injections into the joint – this is usually for extremely painful osteoarthritis.
It is important to discuss the benefits and potential side-effects of any medications with your doctor or specialist.
The right kind of exercise will not damage your joints but will help reduce pain, and increase your flexibility and overall fitness. Stretching, strengthening and aerobic exercises are essential to:
- maintain and restore normal joint movement
- reduce pain and stiffness
- improve muscle strength
- manage your weight
- increase energy and sense of wellbeing.
Useful forms of exercise include tai chi, walking, swimming, and hydrotherapy (gentle exercise in a heated pool). Don’t forget that everyday activities like housework and gardening are also excellent forms of exercise.
Heat and cold
Heat encourages blood circulation and may reduce pain and stiffness in an arthritic joint. Having a hot shower in the morning may help you get ready for the day ahead. Do not apply heat to an inflamed joint, which will already feel warm. Use a cold pack instead to reduce pain by restricting blood flow to the area.
You can reduce strain on your joints by using ‘gizmos and gadgets’. Supportive cushioned footwear will act as shock absorbers for your feet, knees, hips and back. Using a walking stick will help reduce the weight and stress on a painful hip or knee. Try modifying your home or workplace to avoid unnecessary activities and practise good posture to reduce tension on muscles and joints.
Stress and fatigue can make pain worse. Learn how to pace yourself, set priorities and plan your day around what you can realistically achieve. Practise relaxation techniques to ease the tension and pain out of your body.
Research shows that some complementary products and therapies can be helpful in managing the symptoms of osteoarthritis, while others have mixed results. Health supplements may interact with other medications, and what works for your friend may not work for you, so it’s best to check with a registered therapist, doctor or specialist before starting any complementary product or therapy.
An extensively damaged joint may require surgery to replace or repair it. The most common joint replacements are hips and knees. However, if osteoarthritis is managed and treated effectively in the early stages, the need for ‘last resort’ surgery may be avoided.
Arthritis costs the economy $12.2 billion a year
48% of those with arthritis are of working age
Women are more affected by arthritis than men
People of any age can develop arthritis, including young children