Chronic Conditions

Osteoarthritis


Cartilage is a rubbery tissue whose main function is to act as a cushion in between the bones at various joints. Osteoarthritis refers to the progressive “wear-and-tear” of joint cartilages.


Symptoms

• Pain and stiffness
• Changes in shape and occasional swelling of affected joints

Although osteoarthritis can affect most joints, the most commonly affected are at the hands, knees and spine. 

 

Diagnosis  

 

Diagnosis is made primarily based on the patient’s symptoms and signs. Imaging tests may be done to exclude other causes for joint pain, and evaluate the severity of the condition. X-rays are often the only imaging investigation required. The loss of joint cartilage can be revealed by narrowing of the space between the ends of the bones in the joint. Other tests that may be performed include blood tests, which are useful in ruling out other causes for joint pains.

 



 



Treatment of osteoarthritis is aimed at preserving function, relieving pain and slowing down the damage done to joints: 

Weight loss (for overweight and obese patients) through directed exercise and appropriate diet can help relieve the load on the knee and hip joints, helping to reduce the rate of joint “wear-and-tear”.

Physical therapy and exercise programs improve flexibility and strengthen the muscles surrounding the joints. Proper muscle strengthening helps to take off the load from affected joints, preventing further worsening of joint damage. Patients who perform appropriate and regular exercises are known to experience much less pain and require much less medications for their condition. Do note that special directed exercises are necessary for the treatment to be beneficial.

Medications include a variety of painkillers which are usually taken as required. Patients should avoid taking them on a regular basis, unless pain is constant. Proper physical therapy and exercise programs can help reduce the need of pain killers. Supplements such as glucosamine/chondroitin may be used, but there is little scientific evidence that they help repair damaged cartilage.

Surgery is usually the last resort, reserved for severe arthritis that significantly limits essential daily activities (e.g. walking to the bus stop). Your family doctor may refer you to an Orthopaedic Surgeon when he/she feels that you may benefit from surgery, such as a joint replacement.


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  1. What puts me at greater risk for osteoarthritis?

Some of the risks may include:

  • Older age. The risk of osteoarthritis increases with age.
  • Gender. Women are more likely to develop osteoarthritis, though it isn't clear why.
  • Joint injuries. Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis.
  • Body weight. Carrying more body weight puts added stress on your weight-bearing joints, such as your knees.
  • Certain occupations. If your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop osteoarthritis.
  2. When should I consider surgery?
When conservative (non-surgical) treatment for osteoarthritis fails, and pain in a specific joint disables an active individual, surgery may restore patient comfort and normal activity. Keep in mind that surgery relieves pain more than it restores range of motion. The best candidate for surgery is the patient who has a definite interruption in some activity of daily living (e.g. unable to walk more than a block or awakens from sleep with pain in the affected joint) and who has not been helped sufficiently by exercise and drug therapy. The type of surgery suggested will depend on your age, activity level, and the joint involved.
  3. What type of exercise is best for osteoarthritis?
It's important to exercise regularly and appropriately if you have osteoarthritis. Exercise can help to ease pain and stiffness and keeps your joints and muscles strong and flexible. You should follow a programme that includes exercises to strengthen your muscles and improve your range of movement.

You should aim to do some physical activity every day. It’s important that you include at least two weekly activities to build up muscle strength, such as exercising with weights. Your family physician or physiotherapist will be able to advise you and lead you through the proper exercises that you should do, based on the region of joint affected and your general level of fitness.

Swimming is particularly good for osteoarthritis. It can soothe your joints and ease stiffness. The water also supports your joints and muscles while you exercise.