Osteoarthritis – Coping with pain in your joints

Osteoarthritis is the most common form of arthritis, affecting millions of people. You get it when the cartilage on the ends of your bones in the joints wears down over time.

Although osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, knees, hips and spine.

The disease is irreversible but the symptoms can usually be effectively managed. Eating healthy and exercising, maintaining a healthy weight and other treatments may slow the progression of the disease and help improve pain and joint function.

If you have joint pain or stiffness that doesn’t go away, make an appointment with a doctor.

Osteoarthritis is a degenerative disease that worsens over time. Joint pain and stiffness may become severe enough to make daily tasks difficult. Some people are no longer able to work. When joint pain is this severe, doctors may suggest joint replacement surgery.

Symptoms

Osteoarthritis symptoms often develop slowly and worsen over time. Signs include:

• Pain. Your joint may hurt during or after movement.
• Tenderness. Your joint may feel pain when you apply light pressure to it.
• Stiffness. Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity.
• Loss of flexibility. You may not be able to move your joint through its full range of motion.
• Grating sensation. You may hear or feel a grating sensation when you use the joint
• Bone spurs. These extra bits of bone, which feel like hard lumps, may form around the affected joint.

Causes

Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates. Cartilage is a firm, slippery tissue that permits nearly frictionless joint motion. In osteoarthritis, the surface that is normally smooth of the cartilage becomes rough.

Eventually, if the cartilage wears down completely, you may be left with bone rubbing on the bone.

Risk factors

Factors that may increase your risk of osteoarthritis include:

• Older age. The risk of osteoarthritis increases with age.
• Sex. Women are more likely to develop osteoarthritis.
• Obesity. Increased weight puts added stress on weight-bearing joints, such as your hips and knees. In addition, fat tissue produces proteins that may cause harmful inflammation in and around your joints.
• Joint injuries. Injuries, such as those that occur when playing sports or from an accident, may increase the risk.
• Certain occupations. If your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop osteoarthritis.
• Genetics. Some people inherit a tendency to develop it.
• Bone deformities. Some people are born with malformed joints or defective cartilage.

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Diagnosis

The doctor will check for tenderness, swelling or redness, and for a range of motion in the joint. Your doctor may also recommend imaging and lab tests.

Imaging tests:

• X-rays. Cartilage doesn’t show up on X-ray images, but cartilage loss is revealed by a narrowing of the space between the bones in your joint. An X-ray may also show bone spurs.
• Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of bone and soft tissues, including cartilage.

Lab tests:

• Blood tests. Although there is no blood test for osteoarthritis, it will rule out other causes, such as rheumatoid arthritis.
• Joint fluid analysis. Your doctor may use a needle to draw fluid out of the affected joint.

Examining and testing the fluid can determine if there’s inflammation and if your pain is caused by gout or an infection.

Treatment

Osteoarthritis cannot be reversed, but symptoms can be effectively managed:

Medications:

Pain may be helped by certainmedications, including:

• Paracetamol. It has been shown to be effective for people with osteoarthritis who have mild to moderate pain. Taking more than the recommended dosage of painamol can cause liver damage.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, including ibuprofen, indomethacin and naproxen sodium, taken at the recommended doses, typically relieve osteoarthritis pain.

Stronger NSAIDs, available by prescription, may also slightly reduce inflammation along with relieving pain. NSAIDs can cause stomach upset, cardiovascular problems, bleeding problems, and liver and kidney damage.

• Amitryptiline. An antidepressant, this medication is also approved to treat chronic pain.

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