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How to live with osteoarthritis (what will help me day to day?)

Osteoarthritis is a health condition in which the natural cushioning of the joints wears away. The erosion of the cartilage in this fashion causes pain, swelling and other problems. Osteoarthritis can happen in any joint but it is most common in the knee, causing stiffness and problems with walking, standing, general movement and flexibility. When cartilage wears away, the bones of the joints rub against each other. Without the natural cushioning and shock absorption that the cartilage would normally provide, this can be painful.

Who suffers from osteoarthritis?

Osteoarthritis is a type of arthritis that is degenerative, resulting from general wear and tear. This usually occurs in people who are older and anyone over 45 is at risk. However, even young people and children can get osteoarthritis following an injury or infection. The condition is often due to age and simple over-use of the knees but it can also be a hereditary condition, while overweight people are at greater risk. Women are more likely than men to be sufferers.

Causes of osteoarthritis

Osteoarthritis is usually caused by older joints not being able to heal themselves as quickly and effectively as younger joints. This is why older people are at a greater risk of contracting the condition. There are many other risk factors. Repetitive stress injuries can cause the condition, for example, people in a job which involves a lot of heavy lifting, kneeling or squatting are at greater risk as this puts more pressure on the knee joint. Those who have suffered knee ligament damage, specifically the anterior cruciate ligament, are also more likely to see the onset of osteoarthritis of the knee in later life.

People who enjoy a significant amount of sport may also be at greater risk due to the pressures placed upon the knees from athletic activities, such as running. Conversely, having weak muscles around joints can also make osteoarthritis more likely to develop, so exercise is an important way in which to reduce your risk of developing the condition. For example, building up strength in the quads and hamstrings can protect the knee joints from stress.

Middle aged man with grey hair holding his knee in pain

There are certain chemical imbalances that can affect the body and its joints. People with metabolic disorders or iron deficiencies are at greater risk of developing osteoarthritis, as are those who already suffer with their joints from other related conditions, such as rheumatoid osteoarthritis. Any kind of joint stress or previous condition can elevate your chances of developing osteoarthritis in your knees or other joints.

Symptoms of osteoarthritis

Osteoarthritis has various symptoms, including swelling, pain on movement, a decrease in mobility, an increase in stiffness in the joint, weakness, loss of muscle bulk, cracking or creaking sounds on movement. These symptoms can be accompanied by a feeling of pain or discomfort that eases while at rest. Symptoms of stiffness or decreased mobility are usually worse first thing in the morning on waking and getting out of bed or after long periods sitting still.

Diagnosis of osteoarthritis

In order to diagnose your condition, a doctor will perform a thorough examination of your knee or the affected joint, in addition to asking questions about your medical history. You will need to say which movements cause pain and explain your exact symptoms to help the doctor give an accurate diagnosis and rule out any other potential causes. It is also important to disclose if any family members have arthritis or other conditions as there could be a hereditary factor. Other tests can be undertaken, such as x-rays to determine any bone damage, and MRI scans to look at the soft tissue. In order to rule out rheumatoid arthritis the doctor may also request a blood sample.

Doctor holding up an xray of a knee joint

Treatment of osteoarthritis

There are many different possible treatments and which will be the most effective depends on the root cause of the condition in each sufferer. Common treatments include losing weight if a patient is overweight, since any excess weight carried by the joints causes extra stress. Studies have shown that even a small amount of weight lost can give a huge reduction in pain from osteoarthritis.

Other studies have shown that deep massage, topical ointments and acupuncture can have a positive effect, while physiotherapy can provide significant relief and increase strength and flexibility in the knee.

Anti-inflammatory drugs may also help with pain, from over-the-counter options such as ibuprofen for mild to moderate pain to prescription drugs for severe pain. Another option is an injection to the affected area using steroids to help the strength of the joint through anti-inflammatory action, while hyaluronic acid can also be injected to give a boost of lubrication to the joint to ease movement and reduce stiffness.

Supportive garments may also be recommended for sufferers, such as braces and strong support bandages. ‘Unloader braces’ can be used to remove weight from the area of the knee that is affected by osteoarthritis, while ‘support braces’ offer more generalised support for the entire knee.

Clinician fitting an Unloader One knee brace to a middle aged man

Surgery for osteoarthritis

The last resort for sufferers of osteoarthritis is surgery. There are three different types of surgery available for patients: athroscopy, osteotomy and arthroplasty. Athroscopy is a surgery performed using an athroscope via small incisions around the affected area. This is the least invasive of the surgical options and is ideal for younger patients.

Osteotomy is where the surgeon changes the shape of the bones in order to improve the joint alignment, while arthroplasty is a knee replacement, where the joint is removed and replaced with an artificial joint. This is reserved for older people with severe osteoarthritis.

Self-help for osteoarthritis sufferers

Although osteoarthritis is incurable, there are plenty of ways in which you can improve symptoms and prevent further degeneration of the joint. The first thing to do is to be aware of the way you stand and walk and do what you can to prevent undue strain. For example, wear low-heeled or flat shoes with thick, soft soles to give adequate shock absorption. You could also use a walking cane to help take some of the weight, or lose weight if you are overweight.

Other ways in which to reduce pain and prevent your condition worsening include avoiding sitting in the same position with knees bent for too long, always use the handrail when climbing stairs and put weight on chair arms when standing up from a seat or sitting down. Heat or ice packs can also be useful for sore joints. Wearing a support bandage around your knee will also help to support it.

Another area of your lifestyle to look at is your diet. Our diet affects our health in so many ways and there are many foods that are proven to help the joints. Fatty acids are important for cartilage health, so ensure that you include oily fish in your diet a couple of times a week or take supplements with fish oil included. Avocado contains lots of mono-saturated fats which are excellent for joint health, while nuts and nut oils contain active ingredients that can reduce pain through improved natural lubrication.

Other supplements to consider to combat osteoarthritis include glucosamine, which is naturally found in cartilage and can be bought as a supplement from health food shops. This compound has been studied and found to be potentially effective if taken each day, as it can reduce joint space around the knee and provide some pain relief. Chondroitin is a similar chemical also found in joint cartilage and taking a supplement of this may also help to improve your symptoms.

Lifestyle changes

Osteoarthritis can affect daily life considerably as sufferers find their movement restricted and even basic actions such as climbing stairs become a battle. Sleep can become difficult as sufferers can find themselves in pain as they lie in bed due to the limited movement at rest which can cause increased stiffness. Activities that were once enjoyable become difficult to perform and daily life can be restricted and less enjoyable, often leading to a reduced social life and intermittent or even constant pain.

By taking care to overhaul your diet, in addition to making sensible changes to your lifestyle, it is possible to reduce the symptoms of osteoarthritis so that the condition is manageable. If your arthritis is more severe then treatment may be necessary and your doctor will be able to offer advice on the best course of action, whether that is physiotherapy, braces, drugs or surgery.