A B C D E F G H I J K L M N O P R S T U V W

OSTEOARTHRITIS

What is Osteoarthritis ?

Within a joint, the ends of the bone are covered by a thin layer of cartilage. This has the consistency of rubber and acts as a shock absorber for the joint. The bone-ends are surrounded by a membrane (synovium) which produces a little fluid, both to help oil the surfaces and feed the cartilage. These parts are encased in a tough capsule and strengthened by ligaments. Osteoarthritis is the result of excessive wear and tear of a joint. The cartilage gets thinned and worn away exposing the bone underneath. The bone becomes hard and brittle, sometimes crumbling or becoming deformed. As the two bone-ends rub on each other this leads to a grating sensation and pain on moving the joint. The joint is often stiff and moves badly. Pain and stiffness are worse after exercise or at the end of the day. As the bones become deformed this leads to bony swelling of the joint. The lining of the joint may also get inflamed, producing too much fluid and a soft, swollen joint. The joint is then red, hot, and tender to touch and move.

How does Osteoarthritis occur ?

It is not known exactly why cartilage degenerates in some joints producing osteoarthritis. However, if the joint was abnormal at birth or damaged in early life then the osteoarthritis is more likely to develop in later life.

Why does Osteoarthritis occur ?

Osteoarthritis is commoner in older people but it can start in young adults. It tends to run in families. Excessive strain from overweight, or overuse as in professional sportsmen, may result in cartilage damage.

Treatment Involved for Osteoarthritis

There are lots of ways to relieve the symptoms of osteoarthritis. These are important in the early stages when symptoms are mild. You must firstly reduce the strain on that joint. Identify and stop any activity which puts repeated heavy strain on a joint and causes pain. Reducing weight will help the most, especially if the spine, hip or knees are affected. It is important to keep fit and mobile. PHYSIOTHERAPY helps strengthen the muscles around a joint. This helps protect it. Exercises and local treatment such as ice packs or electrical treatments will help relieve pain and improve function. A course of treatment usually involves a few hours physiotherapy spread over 2 weeks or so. This is followed by an exercise routine for you to continue at home on a long-term basis. HYDROTHERAPY is supervised exercises in a specially warmed pool over a short course of a few weeks. It is an enormous help, as exercise can be done in a non-weight bearing environment. PAINKILLERS like paracetamol often help symptoms and make it easier for you to get about. They are best used for a bad spell of pain rather than all the time. ANTI-INFLAMMATORY drugs may help the pain in osteoarthritis because mild inflammation is often present. They should be taken as needed, and not regularly. However, their effect does vary in different patients. INJECTION OF STEROID (cortisone-like) drugs into a joint or inflamed ligament may help you. It is not advisable to have injections repeatedly or frequently. SURGERY is a very successful option for severe osteoarthritis of the hip. Hip replacement usually entails a 2 week hospital stay followed by physiotherapy. It can result in complete pain relief in that hip and much improved mobility. Knee operations are as reliable and experience in this and other joint surgery is rapidly improving all the time. Most people know their joints are complaining from overuse, obesity or overactivity. They can alter and adapt their life to fit in with their joint symptoms. Physiotherapists and occupational therapists can always advise you on exercise routines and joint care. Other treatments may be helpful in osteoarthritis. It has not been proven conclusively that dietary factors are important. It may be worth discussing the role of complementary therapies in managing your arthritis with your doctor.

During Treatment for Osteoarthritis

Your joints will probably improve with advice and treatment. You may find exercises difficult but the muscles will gradually strengthen over a few months. Painkillers such as paracetamol do not cause any side-effects. Stronger ones are seldom needed but dihydrocodeine, codeine, co-dydramol, and co-proxamol may cause constipation. There are over 40 anti-inflammation drugs and their effect on pain relief varies from person to person. They should always be taken after food, and discontinued if they cause indigestion. People with stomach ulcers should avoid them altogether. They may cause fluid to accumulate which results in swollen ankles. If this occurs consult your doctor. Steroid injections into joints may relieve pain in a very impressive way. Too many, however, may lead to worsening joint damage.

If Osteoarthritis is Left Untreated

Although osteoarthritis comes on gradually over years it often stays a mild problem. It is rare for it to progress to a crippling arthritis with severe deformities. The pain may even get easier as years go by. Without replacement surgery, people with severe arthritis of the hips or knees may become housebound and wheelchair bound.

Effects on Family of Osteoarthritis

A positive approach to the trouble helps enormously. Life must be kept full and as interesting as before. Your family should try to provide continuing help and support, to avoid the heavy strains which may worsen joint symptoms and increase damage.