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Osteoarthritis

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Osteoarthritis



Introduction 

Osteoarthritis is a condition that causes the joints to become painful and stiff. It is the most common type of arthritis in the UK.

The severity of osteoarthritis symptoms can vary greatly from person to person, and between different affected joints. For some people, the symptoms may be mild and may come and go, whereas others can experience more continuous and severe problems.

Almost any joint can be affected by osteoarthritis, but the condition most often causes problems in the knees, hips, and small joints of the hands.

The pain and stiffness in the joints can make carrying out everyday activities difficult for some people with the condition.

When to seek medical advice

You should see your GP if you have persistent symptoms of osteoarthritis so they can try to identify the cause.

To help determine whether you have osteoarthritis, your GP will ask you about your symptoms and examine your joints.

What causes osteoarthritis?

Osteoarthritis occurs when there is damage in and around the joints that the body cannot fully repair.

It's not clear exactly why this happens in some people, although your chances of developing the condition can be influenced by a number of factors, such as your age and weight.

Osteoarthritis usually develops in people over 45 years of age, although younger people can also be affected.

It is commonly thought that osteoarthritis is an inevitable part of getting older, but this is not quite true. You may in fact be able to reduce your chances of developing the condition by doing regular, gentle exercises and maintaining a healthy weight.

Managing osteoarthritis

Osteoarthritis is a long-term condition and can't be cured, but it doesn't necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are also available to reduce the symptoms.

Mild symptoms can sometimes be managed with simple measures including regular exercise, losing weight if you are overweight, wearing suitable footwear and using special devices to reduce the strain on your joints during your everyday activities.

If your symptoms are more severe, you may need additional treatments such as painkilling medication and a structured exercise plan carried out under the supervision of a physiotherapist.

In a small number of cases, where the above treatments haven't helped or the damage to the joints is particularly severe, surgery may be carried out to repair, strengthen or replace a damaged joint.

Symptoms of osteoarthritis 

The main symptoms of osteoarthritis are pain and stiffness in your joints, which can make it difficult to move the affected joints and do certain activities.

The symptoms may come and go in episodes, which can be related to things such as your activity levels and even the weather. In more severe cases, the symptoms can be continuous.

Other symptoms you or your doctor may notice include:



joint tenderness



increased pain and stiffness when you have not moved your joints for a while



joints appearing slightly larger or more 'knobbly' than usual



a grating or crackling sound or sensation in your joints



limited range of movement in your joints



weakness and muscle wasting (loss of muscle bulk)



Osteoarthritis can affect any joint in the body, but the most common areas affected are the knees, hips, and small joints in the hands. Often, you will only experience symptoms in one joint or a few joints at any one time.

Osteoarthritis of the knee

If you have osteoarthritis in your knees, it is likely both your knees will be affected over time, unless it has occurred as the result of an injury or another condition affecting only one knee.

Your knees may be most painful when you walk, particularly when walking up or down hills or stairs.

Sometimes, your knees may 'give way' beneath you or make it difficult to straighten your legs. You may also hear a soft, grating sound when you move the affected joint.

Osteoarthritis of the hip

Osteoarthritis in your hips often causes difficulty moving your hip joints. For example, you may find it difficult to put your shoes and socks on or to get in and out of a car.

You will also usually have pain in the groin or outside the hip. This will often be worse when you move the hip joints, although it can also affect you when you are resting or sleeping.

Osteoarthritis of the hand

Osteoarthritis often affects three main areas of your hand: the base of your thumb, the joints closest to your fingertips and the middle joints of your fingers.

Your fingers may become stiff, painful and swollen and you may develop bumps on your finger joints. But over time the pain may decrease and eventually disappear altogether, although the bumps and swelling can remain.

Your fingers may bend sideways slightly at your affected joints or you may develop painful cysts (fluid-filled lumps) on the backs of your fingers.

In some cases, you may also develop a bump at the base of your thumb where it joins your wrist. This can be painful and you may find it difficult to perform some manual tasks, such as writing, opening jars or turning keys.

When to seek medical advice

You should see your GP if you have persistent symptoms of osteoarthritis so they can try to identify the cause.

To help determine whether you have osteoarthritis, your GP will ask you about your symptoms and examine your joints.

Living with osteoarthritis

As osteoarthritis is a long-term condition, it is important you get the right support to help you cope with any issues such as reduced mobility and advice on any necessary financial support.

As well as support from your healthcare team, it is important to look after your own health and wellbeing. This includes taking your medicine regularly and adopting as healthy a lifestyle as possible.

Some people may also find it helpful to talk to their GP or others who are living with the same condition as there may be questions or worries you want to share.

Causes of osteoarthritis 

Osteoarthritis occurs when there is damage in and around the joints that the body can't fully repair. The exact causes are not known but there are several factors thought to increase your risk of developing the condition.

As part of normal life, your joints are exposed to a constant low level of damage. In most cases, your body will repair the damage itself. Usually, the repair process will pass unnoticed and you will not experience any symptoms.

However, in cases of osteoarthritis, the damage to the joints is not fully repaired and instead some of the cartilage (the protective surface that allows your joints to move smoothly) in the joint can be lost, bony growths can develop, and the area can become slightly inflamed (red and swollen).

These changes are what cause the typical symptoms of pain, stiffness and swelling.

Contributory factors

It is not known why problems develop in the repair process in cases of osteoarthritis, although, several factors are thought to increase your risk of developing the condition. These include:



Joint injury – Osteoarthritis can develop in a joint damaged by an injury or operation. Overusing your joint when it has not had enough time to heal after an injury or operation can also contribute to osteoarthritis in later life.



Other conditions (secondary arthritis) – Sometimes, osteoarthritis can occur in joints severely damaged by a previous or existing condition, such as rheumatoid arthritis or gout. It is possible for secondary osteoarthritis to develop many years after the initial damage to your joint.



Age – Osteoarthritis is not a normal part of ageing, but your risk of developing the condition does increase as you get older. Most cases affect adults who are 45 years of age or older.



Family history – In some cases, osteoarthritis may run in families. Genetic studies have not identified a single gene responsible, so it seems likely that many genes make small contributions.



Obesity – Research into the causes of osteoarthritis has shown that being obese puts excess strain on your joints, particularly those that bear most of your weight, such as your knees and hips. As a result, osteoarthritis can often be worse in obese people.



Although it is not possible to prevent osteoarthritis altogether, making some lifestyle changes to reduce your risk of joint injury and maintain a healthy weight may lower your chances of developing the condition.

Diagnosing osteoarthritis 

There is no definitive test to diagnose osteoarthritis, so your GP will ask about your symptoms and examine your joints to help determine whether you have the condition.

Your GP may suspect osteoarthritis if:



you are 45 years of age or older



you have joint pain that gets worse the more you use your joints



you have no stiffness in your joints in the morning, or stiffness that lasts no longer than 30 minutes



If your symptoms are slightly different from those listed above, this may indicate that you have another joint condition. For example, prolonged joint stiffness in the morning can be a sign of rheumatoid arthritis.

Further tests – such as X-rays or blood tests – are not usually necessary to confirm a diagnosis of osteoarthritis, although they may be used to rule out other possible causes of your symptoms, such as rheumatoid arthritis or a fractured bone.

Treating osteoarthritis 

There is no cure for osteoarthritis, but the condition doesn’t necessarily get any worse over time and a number of treatments are available to help relieve the symptoms.

The main treatments for osteoarthritis include lifestyle measures – such as maintaining a healthy weight and exercising regularly – medication to relieve your pain, and supportive therapies to help make everyday activities easier.

In a few cases, where other treatments have not been helpful, surgery to repair, strengthen or replace damaged joints may also be considered.

 




Lifestyle changes 

 

 

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Exercise

Exercise is one of the most important treatments for people with osteoarthritis, whatever your age or level of fitness. Your physical activity should include a combination of exercises to strengthen your muscles and exercises to improve your general fitness.

If osteoarthritis causes you pain and stiffness, you may think exercise will make your symptoms worse.

But usually, regular exercise that keeps you active and mobile and builds up muscle, thereby strengthening the joints, will improve symptoms.

Exercise is also good for losing weight, improving your posture and relieving stress, all of which will ease symptoms.

Your GP, or possibly a physiotherapist, will discuss the benefits you can expect from your exercise programme and can give you an exercise plan to follow at home.

It's important to follow this plan because there is a risk that doing too much exercise too quickly, or doing the wrong sort of exercise, may damage your joints.

Losing weight

Being overweight or obese often makes osteoarthritis worse as it can place some of your joints under increased strain.

To find out if you are overweight or obese, use the healthy weight calculator.

If you are overweight, try to lose weight by doing more physical activity and eating a healthier diet.

Discuss any new exercise plan with your GP or physiotherapist before you start. They can help plan a suitable exercise programme for you. Your GP and practice nurse can also advise about how to lose weight slowly and safely.

Living with osteoarthritis  

With the right support, you can lead a healthy, active life with osteoarthritis. Osteoarthritis doesn’t necessarily get worse and doesn’t always lead to disability.

Self-care

Self-care is an integral part of daily life. It means you take responsibility for your own health and wellbeing with support from those involved in your care. Self-care includes things you do each day to stay fit, maintain good physical and mental health, prevent illness or accidents, and effectively deal with minor ailments and long-term conditions.

People living with long-term conditions can benefit enormously if they receive support for self-care. They can live longer, have less pain, anxiety, depression and fatigue, have a better quality of life and are more active and independent.

Living healthily

A good diet and regular exercise will help keep muscles strong and control your weight, which is good for osteoarthritis and also has other health benefits.

Take your medication

It is important to take your medication as prescribed, even if you start to feel better. Continuous medication can sometimes help prevent pain, although if your medications have been prescribed ‘as required’, you may not need to take them in between painful episodes. If you have any questions or concerns about the medication you're taking or any side effects you think you may be experiencing, talk to your healthcare team.

It may also be useful to read the information leaflet that comes with the medication, which will tell you about possible interactions with other drugs or supplements. Check with your healthcare team if you plan to take any over-the-counter remedies, such as painkillers, or any nutritional supplements, as these can sometimes interfere with your medication.

Regular reviews

Because osteoarthritis is a long-term condition, you'll be in regular contact with your healthcare team. A good relationship with the team means that you can easily discuss your symptoms or concerns. The more the team knows, the more it can help you.

Vaccinations

People with long-term conditions such as osteoarthritis are often encouraged to get an annual flu jab each autumn to protect against flu.

You may also be advised to get a pneumoccocal vaccination. This is a one-off injection that protects against a serious chest infection called pneumococcal pneumonia.

Want to know more?



Arthritis Research UK: arthritis and daily life



Arthritis Care: living with arthritis






Talk to others 

 

 

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Many people find it helpful to talk to other people who are in a similar position to them. You may find support from a group or by talking individually to someone who has osteoarthrits.

Patient organisations have local groups where you can meet other people with the same condition.

The Arthritis Care helpline is open 10am to 4pm weekdays. You can also email them atHelplines@arthritiscare.org.uk.

Preventing osteoarthritis 

It is not possible to prevent osteoarthritis altogether. However, you may be able to minimise your risk of developing the condition by avoiding injury and staying as healthy as possible.

Look after your joints

Exercising regularly can help keep your joints healthy, but take care not to put too much stress on your joints, particularly your hips, knees and the joints in your hands.

Avoid exercise that puts strain on your joints and forces them to bear an excessive load, such as running and weight training. Instead, try exercises such as swimming and cycling, where your joints are better supported and the strain on your joints is more controlled.

Try to maintain good posture at all times, and avoid staying in the same position for too long. If you work at a desk, make sure your chair is at the correct height, and take regular breaks to move around.

Keep your muscles strong

Your muscles help support your joints, so having strong muscles may help your joints stay strong too.

Try to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (such as cycling or fast walking) every week to build up your muscle strength and keep yourself generally healthy.

Exercise should be fun, so do what you enjoy, but try not to put too much strain on your joints.

Lose weight if you are overweight or obese

Being overweight or obese can increase the strain on your joints and increase your risk of developing osteoarthritis. Losing weight if you are overweight may therefore help lower your chances of developing the condition.

To find out whether or not you are overweight or obese, use thehealthy weight calculator.

Want to know more?



Arthritis Care: taking care of joints



Arthritis Research UK: exercise and arthritis



Arthritis Research UK: diet and arthritis



 

 





 

X-rays can also allow doctors to assess the level of damage to your joints, but this is rarely helpful as the extent of damage visible on an X-ray isn’t a good indicator of how severe your symptoms are.

 



Osteoarthritis