Getting Older: Osteoarthritis
By Blandina Steinhauslin, AILO Florence
Arthritis is very common; however, it is not one single disease. Rather, it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions.
Of these, osteoarthritis is a condition that usually appears in people over 40 years of age and affects the joints that bear most of our weight, such as the knees and feet, or those that we use a lot in everyday life, such as the joints of the hand.
In a healthy joint, a coating of tough but smooth and slippery tissue, called cartilage, covers the surface of the bones and helps them to move freely against each other. When a joint develops osteoarthritis, part of the cartilage thins and the surface becomes rougher. This means the joint doesn’t move as smoothly as it should.
When cartilage becomes worn or damaged, the body tries to repair the damage. These repair processes may change the structure of the joint, but will often allow the joint to work normally and without any pain and stiffness. Almost all of us will develop osteoarthritis in some of our joints as we get older, although we may not even be aware of it.
However, the repair processes don’t always work this well, and changes to the joint structure can sometimes cause or contribute to symptoms such as pain, swelling or difficulty in moving the joint normally. For example, extra bone may form at the edge of a joint. Especially in the finger joints, this may be visible in the form of firm, knobbly swellings. The lining of the joint capsule (called the synovium) may also thicken and produce more fluid than normal, causing the joint to swell.
Symptoms
The main symptoms of osteoarthritis are pain and sometimes stiffness in the affected joints. The pain tends to be worse when you move the joint, or at the end of the day. Your joints may feel stiff after rest, but this usually wears off fairly quickly once you get moving. Symptoms may vary for no obvious reason - or you may find that your symptoms vary depending on what you’re doing. The affected joint may sometimes be swollen or may not move as freely or as far as normal, and it may make grating or crackling sounds as you move it, a phenomenon known as crepitus.
Risk Factors
Factors that may increase your risk of osteoarthritis include:
- Older age: the risk of osteoarthritis increases with age.
- Gender: women are more likely to develop osteoarthritis, although the reasons for this are not clear.
- Obesity: carrying extra body weight contributes to osteoarthritis in several ways, and the more you weigh, the greater your risk. 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 of osteoarthritis. Even injuries that occurred many years ago and seemingly healed can increase your risk of osteoarthritis.
- 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 osteoarthritis.
- Bone deformities: some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.
Treatment
There is no cure for osteoarthritis; the degenerative process can not be reversed. Nevertheless, symptoms can usually be managed effectively through lifestyle changes, physical and other therapies, medications, and surgery (for these, please consult your physician).
Lifestyle changes include losing weight: obesity, or even being somewhat overweight, increases the stress on your weight-bearing joints, such as your knees and hips. Even a small amount of weight loss can relieve some pressure and reduce your pain. Talk to a dietitian about healthy ways to lose weight. Most people combine changes in their diets with increased exercise.
Exercise can increase your endurance and strengthen the muscles around the affected joint, making the joint more stable. Try walking, biking or swimming. If you feel new joint pain, stop. New pain that lasts for hours after you exercise probably means you've overdone it, but it doesn't mean you have done any significant damage or that you should stop exercising. Simply resume a day or two later at a slightly lower level of intensity. Another major component to treatment is your own outlook on life. Your ability to cope despite the pain and disability caused by osteoarthritis often determines how much of an impact osteoarthritis will have on your everyday life.
Self-management is about making positive and healthy lifestyle choices, and acknowledging and addressing the physical and emotional effects of arthritis. Having arthritis affects everyone differently, so it’s up to you to learn and practice what helps you to live well and thrive.
Bibliography:
https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925
https://www.arthritis.org/about-arthritis/types/osteoarthritis/
https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis/