Osteoarthritis (OA) is a rheumatic disease, in which the cartilage in the joints is getting thinner and softer. The cartilage may eventually even disappear completely. The patient suffers from pain and stiffness. The disease mainly occurs in the joints of the hands, knees and hips. Osteoarthritis can lead to severe limitations and significantly affects daily functioning.
Cause
The risk of osteoarthritis increases with age. But the disease can also be part of a rheumatic disorder, so a person might have to deal with it at young age. Genetic predisposition often plays a role then. Risk factors are:
- Long-term (over)loading the joints, for example due to overweight.
- Heavy physical work.
- Frequently and intense sports.
- Other diseases of the joints, such as arthritis and gout.
- Hip dysplasia.
- Fractures or sports injuries.
Cold and a humid climate are not causes of osteoarthritis, but often do affect the symptoms. Of all rheumatic diseases, osteoarthritis is the most common.
Symptoms
The main symptoms of osteoarthritis are pain and stiffness. This is caused by the loss of cartilage, the rubbing of bones over each other and bone accretions. Characteristic is the so-called ‘starting pain’ when a patient starts moving after a period of rest. However, pain may also occur at rest, for example when lying on bed at night. Due to the pain, the patient tends to move the joint less and less. This causes stiffness and weakens the muscles around the joint.
Osteoarthritis can affect any joint, but is most common in the neck, (low) back, knees, hips, hands (thumb and fingers), toes (big toe) and shoulder.
Diagnosis
In order to make the diagnosis of osteoarthritis, the doctor usually has enough information from the story of the patient about his or her symptoms and a physical examination. An X-ray is sometimes made. Depending on the symptoms, additional examination, such as blood test, may be carried out in order to exclude other conditions.
Treatment
Osteoarthritis cannot be cured. The treatment is therefore aimed at controlling the pain and maintaining the best possible function of joints and muscles. The following treatments are used:
- Medication. If pain exists, but doesn’t prohibit daily activities, first painkillers are prescribed. Paracetamol may be adequate to mild symptoms, more serious symptoms require NSAIDs. These are anti-inflammatory drugs, which reduce any inflammatory response in the joints. In case of severe pain, it’s possible to give an injection into the painful joint with hormones or with cartilage-constructive substances, including hyaluron acid.
- Physical therapy. Simultaneously with drug treatment, the patient can also have physical therapy. Under the guidance of a physical therapist, the patient performes exercises in order to maintain flexible joints. The physical therapist can also provide heat treatment.
- Surgery. If wear of the joints is at an advanced stage, so that nothing can help to reduce the pain anymore, surgery may be done. An artificial joint is placed then. The patient gets, for example, a hip or knee prosthesis. During surgery, joint ends can also be made more smooth or loose pieces of bone can be removed from the joint.
Prognosis
Osteoarthritis is a chronic condition, that doesn’t cure and slowly gets worse. If a clear cause can be found for the osteoarthritis, such as a cruciate ligament injury, then that’s a positive sign that the disease won’t occur in other joints. If no clear cause can be found, it is more likely that osteoarthritis will also develop in other joints.
Considerations
- If a person has osteoarthritis, it’s important to continue exercising regularly. Exercise keeps joints supple, makes muscles stronger and improves condition. Heart and lungs get stronger as well. In case of overweight, it’s important to lose weight.
- For people with osteoarthritis, the following sports are suitable: walking, cycling, swimming or moving in warm water, Nordic walking and yoga.
- During exercise, it’s important to maintain a good posture. For example, try to keep the back straight and the shoulders relaxed. Try not to force during exercise; slow down when feeling pain.
