Osteoarthritis: Joint efforts
Do you often suffer from joint pains that make routine daily tasks difficult to handle... Or cancel outdoor trips, even to the supermarket, simply because your limbs aren't quite with you or your neck feels like it might break away any minute?
Osteoarthritis is a very common condition which can affect any joint in the body. It’s most likely to affect the joints that bear most of our weight, such as the knees and feet. Joints that we use a lot in everyday life, such as the joints of the hand, are also commonly affected.
According to Versus Arthritis, a UK-based charity, osteoarthritis usually starts from the late 40s onwards. This may be due to bodily changes that come with ageing, such as weakening muscles, weight gain, and the body becoming less able to heal itself effectively.
In a healthy joint, a coating of tough but smooth and slippery tissue, called cartilage, covers the surface of the bones and helps the bones to move freely against each other. When a joint develops osteoarthritis, part of the cartilage thins and the surface becomes rougher. This means the joint doesn’t move as smoothly as it should.
When cartilage becomes worn or damaged, all the tissues within the joint become more active than normal as the body tries to repair the damage. The repair processes may change the structure of the joint, but will often allow the joint to work normally and without any pain and stiffness. Almost everyone will develop osteoarthritis in some of our joints as we get older, though we may not even be aware of it.
Many people worry that exercising will increase their pain and may cause further joint damage. However, while resting painful joints may make them feel more comfortable at first, too much rest can increase stiffness. One shouldn’t be afraid to use one's joints.
The main symptoms of osteoarthritis are pain and sometimes stiffness in the affected joints. The pain tends to be worse when you move the joint or at the end of the day. Your joints may feel stiff after rest, but this usually wears off fairly quickly once you get moving. Symptoms may vary for no obvious reason. Or you may find that your symptoms vary depending on what you’re doing.
The affected joint may sometimes be swollen. The swelling may be hard and knobbly, especially in the finger joints, caused by the growth of an extra bone. Or it could be soft, caused by thickening of the joint lining and extra fluid inside the joint capsule.
Also, the joint may not move as freely or as far as normal, and it may make grating or crackling sounds as you move it. This is called crepitus.
Sometimes the muscles around the joint may look thin or wasted. The joint may give way at times because your muscles have weakened or because the joint structure has become less stable.
Commonly affected joints
Osteoarthritis of the knee is very common. This is probably because your knee has to take extreme stresses, twists and turns as well as bearing your body weight. Osteoarthritis often affects both knees.
Osteoarthritis of the hip is also common and can affect either one or both hips. The hip joint is a ball-and-socket joint which normally has a wide range of movement. It also bears a lot of your weight. Hip osteoarthritis is equally common in men and women.
The hand and wrist
Osteoarthritis of the hands usually occurs as part of the condition nodal osteoarthritis. This mainly affects women and often starts around the time of the menopause. It usually affects the base of your thumb and the joints at the ends of your fingers, although other finger joints can also be affected.
The back and neck
The bones of your spine and the discs in between are often affected by changes that are very similar to osteoarthritis. In the spine, these changes are often referred to as spondylosis. Although they are very common, they aren’t the most common cause of back and neck pain.
The foot and ankle
Osteoarthritis of the foot generally affects the joint at the base of your big toe. However, osteoarthritis of the mid-foot is also quite common. The ankle is the least commonly affected part of the foot.
The shoulder consists of two joints, either of which can be affected by osteoarthritis - a ball-and-socket joint, where the upper arm meets the shoulder blade – called the glenohumeral joint, and a smaller joint where the collarbone meets the top of the shoulder blade – called the acromioclavicular joint.
The elbow joint isn’t commonly affected by osteoarthritis. When it is affected, it often follows either a single serious injury or a number of more minor injuries.
It’s important to get an accurate diagnosis if you think you have arthritis, as different types of arthritis often need very different treatments. The diagnosis of osteoarthritis is usually based on:
your symptoms – how and when they started, how they’ve developed, how they affect your life, and any factors that make them better or worse
a physical examination – your doctor will check for tenderness over the joint, creaking or grating of the joint (crepitus), bony swelling, excess fluid
weakness or thinning of the muscles that support the joint.
There’s no blood test for osteoarthritis, although your doctor may suggest you have them to help rule out other types of arthritis.
X-rays aren’t usually helpful in diagnosing osteoarthritis, although they may be useful to show whether there are any calcium deposits in the joint.
In rare cases, an MRI scan of the knee can be helpful to identify other possible joint or bone problems that could be causing your symptoms.
Tips for managing pain
Warmth and cold
Applying a hot-water bottle, wrapped in a towel to protect your skin, or a wheat-bag that you heat up in a microwave can help to ease pain. An ice pack, again wrapped in a towel to protect your skin, often helps to reduce swelling and discomfort. Ice can be applied for up to 20 minutes every couple of hours.
Splints and other supports
There’s a range of different splints, braces and supports available for painful joints. These can be particularly helpful if osteoarthritis has affected the alignment of a joint. It’s best to seek professional advice from an occupational therapist or physiotherapist before choosing one, so you can be sure it’s suitable for your needs.
Choosing comfortable, supportive shoes can make a difference not only to your feet, but also to other weight-bearing joints including the knees, hips and spinal joints. In general, the ideal shoe would have a thick but soft sole, soft uppers, and plenty of room at the toes and the ball of the foot. If you have particular problems with your feet, then it’s worth seeing a podiatrist for more specific advice.
If your leg sometimes ‘gives way’ then a stick may help you feel less afraid of falling. When held in the opposite hand, it can also help to reduce pressure on a painful knee or hip. It’s best to get advice from a healthcare professional, as your reason for using a stick will determine which side you should use it on.
If you have arthritis, you’ll find that good posture can help to put less strain on your joints. When your posture is good, your body will feel more relaxed. Think about your posture throughout the day. Check yourself while walking, at work, while driving, or while watching T and make suitable amendments to reduce discomfort as well as support painful joints.