Osteoarthritis

What is Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis, and it occurs when the cartilage that cushions the ends of your bones wears down over time. Several factors can contribute to the development of osteoarthritis, often in combination.

What causes Osteoarthritis?

Some of the main causes and risk factors include:

1. Aging

As you get older, the cartilage in your joints naturally begins to break down and become thinner, making it more prone to wear and tear. Most people over 50 experience some form of osteoarthritis, although it can develop earlier.

2. Joint Injury or Overuse

Previous injuries (like fractures or ligament tears) or repetitive use of certain joints can damage cartilage. Over time, this increases the likelihood of developing OA in those affected joints. Athletes or people with jobs involving repetitive motions (e.g., heavy lifting) are at higher risk.

3. Genetics

Family history plays a role in OA risk. If your parents or siblings have had osteoarthritis, you may be more likely to develop it, especially in the knees, hips, and hands.

4. Obesity

Excess body weight puts additional stress on weight-bearing joints like the knees, hips, and spine. This added pressure accelerates the wear and tear of cartilage, making osteoarthritis more likely.

5. Gender

Women are more likely than men to develop osteoarthritis, especially after the age of 50. Hormonal changes during menopause might contribute to this increased risk.

6. Joint Misalignment or Abnormalities

If your joints are misaligned or if you have an abnormal joint shape (due to congenital conditions or developmental issues), the wear on the cartilage can be uneven, leading to osteoarthritis.

7. Other Medical Conditions

Certain conditions like diabetes or inflammatory diseases (e.g., rheumatoid arthritis) can increase the risk of developing OA.

8. Weak Muscles

Weak muscles around a joint may result in poor joint support, which can place more strain on the cartilage and lead to OA.

 

In many cases, a combination of these factors contributes to the development of osteoarthritis, and while some of these factors, like aging or genetics, can't be controlled, others—such as maintaining a healthy weight, avoiding joint injuries, and staying active—can help reduce the risk.

What are the symptoms of osteoarthritis? (list or dot point of symptoms)

The symptoms of osteoarthritis (OA) can vary from person to person, but they typically develop gradually and worsen over time. The symptoms can also fluctuate, and be cyclical with weather/seasons. Common symptoms include:

1. Joint Pain

Pain is the most common symptom. It tends to be worse after activity or at the end of the day, especially after long periods of use. The pain can occur in any joint affected by OA, but it's most common in the knees, hips, hands, and spine.

2. Stiffness

Stiffness in the affected joint is especially noticeable after waking up in the morning or after sitting or resting for a long period. This stiffness usually lasts for a short time, but it can make movement difficult.

3. Swelling

The joint may appear swollen, due to inflammation and the accumulation of fluid within the joint. This swelling may come and go, and it can cause discomfort.

4. Reduced Range of Motion

As OA progresses, you may notice that it becomes harder to move the joint through its full range of motion. This can affect the ability to perform certain activities, such as bending, walking, or reaching.

5. Grating or Popping Sensation

You might feel or hear a grating, creaking, or popping sensation when moving the affected joint. This is caused by roughened cartilage rubbing against bone surfaces.

6. Tenderness

The skin around the joint may feel tender when touched, particularly in the early stages of OA.

7. Weakness or Instability

If the muscles around the affected joint become weaker due to lack of use or compensation for pain, you may feel the joint is unstable. For example, the knee may feel as if it’s giving way when walking or standing.

8. Bony Growths (Bone Spurs)

In some cases, OA can lead to the formation of bone spurs (osteophytes), which are bony growths that develop at the edges of the joint. These can sometimes be felt or seen, especially in the hands or knees.

9. Flare-ups

OA symptoms may worsen temporarily due to certain activities, weather changes, or overuse, leading to flare-ups of pain and stiffness. These can last from hours to days.

Symptoms typically worsen over time, and the severity can vary. In some people, osteoarthritis may be relatively mild, with only occasional discomfort, while in others, it can lead to significant disability if left untreated or unmanaged.

If you're experiencing any of these symptoms, it’s a good idea to see your local doctor and/or allied health professionals for an evaluation and to discuss treatment options, and consider a referral to Dr Collins to discuss your management/treatment options.

How do you treat osteoarthritis?

The treatment for osteoarthritis (OA) focuses on managing symptoms, improving joint function, and slowing disease progression. While there is no cure for OA, a combination of approaches can help reduce pain, improve mobility, and enhance the quality of life. Treatment options include lifestyle changes, medications, physical therapy, and, in some cases, surgical interventions.

Each treatment plan should be tailored to the individual, depending on the severity of OA, the joints affected, and the person's overall health. It’s a good idea to work with your healthcare provider team to determine the most effective treatment strategy for your specific situation, Dr Collins would be pleased to be apart of your team to improve your quality of life.

1. Lifestyle Changes

  • Weight Management: If you're overweight, losing even a small amount of weight can significantly reduce the strain on weight-bearing joints, such as the knees and hips. Maintaining a healthy weight can reduce pain and slow the progression of OA.

  • Exercise: Regular low-impact exercise, such as swimming, walking, or cycling, can help strengthen the muscles around the affected joint, improve flexibility, and reduce stiffness. Physical therapy exercises specifically designed for OA can also be beneficial. The GLA:D program is highly recommended by Dr Collins.

  • Joint Protection: Using assistive devices like canes, braces, or special footwear can help reduce stress on the joints and improve mobility.

2. Medications

  • Pain Relievers: Over-the-counter (OTC) pain relievers such as paracetamol may help manage mild to moderate pain. For more severe pain, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can reduce both pain and inflammation.

  • Topical Treatments: OTC creams or gels that contain NSAIDs can be applied directly to the skin over the affected joint to provide localized pain relief.

  • Corticosteroid Injections: For moderate to severe pain, corticosteroid injections directly into the joint can provide temporary relief by reducing inflammation.

  • Hyaluronic Acid Injections: These injections lubricate the joint and may help reduce pain and improve movement, particularly in knee OA.

  • PRP (platelet rich plasma) joint injections: PRP injections are a relatively new treatment option for knee arthritis (osteoarthritis). PRP therapy uses your own blood to help stimulate healing and reduce inflammation in the affected joint.
    The effectiveness of PRP injections for knee arthritis varies from person to person. Some studies have shown promising results, with patients experiencing reduced pain and improved function, while others have found mixed or limited benefits. PRP is generally considered more effective in early stages of knee arthritis, before significant cartilage loss occurs.

  • Disease-Modifying Osteoarthritis Drugs (DMOADs): Although still under research, some drugs aim to slow or stop the progression of OA by targeting the underlying processes that cause cartilage breakdown. This is an emerging area of research and at present not recommended.

3. Physical Therapy

  • Strengthening Exercises: A physical therapist can design a program that strengthens the muscles around the affected joint, providing better support and reducing strain on the cartilage.

  • Range-of-Motion Exercises: These exercises help maintain or improve joint flexibility, reducing stiffness and improving movement.

  • Hydrotherapy: Exercises performed in water can be easier on the joints and help improve mobility and strength.

  • The GLA:D exercise program for hip and knee arthritis is recommended by Dr Collins.

4. Alternative Therapies

  • Acupuncture: Some people find acupuncture helpful in reducing OA pain and improving joint function, though evidence is mixed.

  • Supplements: Some individuals take glucosamine and chondroitin supplements to promote cartilage health, though scientific evidence on their effectiveness is limited/lacking.

  • Heat and Cold Therapy: Applying heat (e.g., warm compresses) or cold (e.g., ice packs) to the affected joint can help reduce pain and inflammation.

5. Surgical Treatment

If non-surgical treatments don't provide sufficient relief, or if OA significantly impairs your ability to function, surgery may be considered. Options include:

  • Arthroscopy: A minimally invasive procedure where a small camera is inserted into the joint to remove damaged tissue or repair cartilage.

  • Realignment: In some cases, realigning the bones in the joint can help reduce pain and improve function, particularly in knee or hip OA.

  • Joint Replacement Surgery: For advanced OA that severely limits movement and causes constant pain, joint replacement surgery (e.g., total knee or hip replacement) may be necessary. This involves removing the damaged joint and replacing it with an artificial one.

6. Complementary and Lifestyle Approaches

  • Mind-body techniques like mindfulness, meditation, or yoga can help with the mental and emotional aspects of dealing with chronic pain.

  • Dietary Changes: A diet rich in anti-inflammatory foods (such as omega-3 fatty acids, antioxidants, and vitamins C and D) may help manage symptoms, though diet alone cannot cure OA.

Orthopaedic Surgeon Melbourne

Utilising the latest techniques and technology Kade aims to return you to your best as soon as possible with optimised recovery via a multi-disciplinary and multi-modal approach.