Do you have questions or concerns about osteoarthritis?
We spoke to Consultant Rheumatologist Dr Wendy Holden from Arthritis Action, a charity which offers practical, hands on advice to help people manage the pain of arthritis, to get expert insights into what osteoarthritis is and how you can manage it.
Osteoarthritis is the most common form of arthritis and roughly 8.75 million people in the UK have pain associated with it.¹ This form of arthritis tends to affect people over the age of 45 and is quite rare in younger people.
At least 50% of people over the age of 65 have evidence of osteoarthritis.² Osteoarthritis can affect both men and women, but women are more likely to develop it. ³
What do osteo and arthritis actually mean?
“Osteoarthritis comes from ‘osteo’, which refers to the bones, and arthritis, which refers to any inflammation in the joints. Osteoarthritis, therefore, is a type of joint disease which results from breakdown of joint cartilage around our bones,” says Dr. Wendy.
What causes osteoarthritis?
Your joints are the parts of your body where two or more bones meet. The joint enables your bones to move around without slipping too far away from each other. Osteoarthritis can occur when the cartilage starts to thin or roughen.
Osteoarthritis (OA) used to be called ‘wear and tear’ because people thought joints would inevitably wear out as you got older. “It is now known that the process of osteoarthritis is much more complicated,” says Wendy.
“Inside the affected joints there is quite a lot of healing and repair going on, also called inflammation,” Dr.Wendy explains, “this healing and repairing process can include the formation of new bone, which can contribute to some of the pain and stiffness.”
While the risk of osteoarthritis increases with age, it is not inevitable. “The other good news is that the pain of osteoarthritis can come and go and will not inevitably get worse,” Dr.Wendy adds.
“No-one knows exactly what causes osteoarthritis but it may be due to repeated small injuries that happen as part of daily life that don’t heal completely. Osteoarthritis can also run in families and injuries such as a broken bone or sporting injury can lead to osteoarthritis later in life,” she adds.
What is cartilage and how does it become worn?
“Cartilage is a flexible tissue found around the joints between bones. Inside a joint with osteoarthritis, there is loss of cartilage which surrounds the ends of the bones and acts as a shock absorber,” Dr Wendy says.
“Despite its flexibility and strength, cartilage can be damaged. Problems can arise due to general wear and tear over time, a specific injury, or other diseases. When cartilage is damaged, the bones may rub and grind against one another at the joint, which can be very painful,” she continues.
What are the symptoms of osteoarthritis?
“The symptoms of osteoarthritis can vary a lot from person to person,” Dr. Wendy explains, “sometimes OA causes the joints to swell and change shape, especially the finger joints, and sometimes the joints make creaking or cracking noises.”
While arthritis can occur in any joint, it is most commonly found in fingers, thumbs, hips, knees, the lower back and neck.
Osteoarthritis can be present without symptoms. While 70% of people over 70 years of age have x-ray evidence of osteoarthritis, only half of the people with x-ray evidence develop symptoms. ⁴
How does osteoarthritis impact a person?
The symptoms of osteoarthritis are very varied. “Sometimes a person will feel no pain at all, while for others the pain can be severe and make moving their joints difficult,” says Dr.Wendy, “there can frequently be loss of muscle around the joints and this can make them feel weaker.”
Osteoarthritis can sometimes affect your mobility and the pain can sometimes affect people’s work, home and social life, but pain relief medication and an exercise plan can lessen its impact.
Is surgery the only option for osteoarthritis?
“Surgery is one option for people living with osteoarthritis, however there are many effective ways at managing their symptoms,” says Dr.Wendy.
“Arthritis Action promotes the self-management of arthritis. Put simply, this means managing your condition yourself using a variety of approaches and techniques to address both the physical and mental impact of arthritis,” she continues.
Different things will work for different people, so it’s important to create a self management plan which is right for you.
Is osteoarthritis genetic or can anyone get it?
“Genetic factors can sometimes make someone more likely to develop arthritis, but anyone can get osteoarthritis,” Dr Wendy.
There isn’t a gene which is responsible for arthritis, as far as we are aware. Your age, weight and lifestyle are more likely to play a part.
Does a person’s weight impact the likelihood of osteoarthritis?
“Body weight plays a key part to arthritis, especially the three common types (osteoarthritis, rheumatoid arthritis and gout),” says Dr.Wendy, “excess weight places additional pressure on weight-bearing joints. A landmark study has found one lb of weight-loss lessens four lbs of pressure on the knees, per step,” she continues.
Eating a healthy diet and incorporating an enjoyable activity - whether that be walking, gardening or zumba - into your daily life can help you maintain a healthy weight.
Why is exercise important for those with osteoarthritis?
While exercise may be the last thing you want to do when you’re in pain, it actually has a lot of benefits. “Exercise may help protect against osteoarthritis because strong muscles help to support the joints and people who exercise may be slimmer than those who don’t and keeping to a healthy weight can also help protect the joints from osteoarthritis,” says Dr. Wendy.
“The latest research suggests that exercise can actually increase the level of anti-inflammatory chemicals inside the joints and these can protect against cartilage loss and joint damage,” she adds.
Tips for self-managing arthritis by Dr. Wendy Holden
- Try to keep to a healthy weight
For every pound that you are above a healthy weight, an extra 4 or 5 pounds of weight goes through your hips knees and feet and this can increase the pain.
- Keep your muscles strong and do some exercise
Exercise that increases muscle strength can really help support the joints and reduce the pain of osteoarthritis.
- Maintain a healthy diet
Eating healthily can help maintain muscle and bone strength and help you keep to a healthy weight.
- Try to relax to help manage the pain better
Distraction, meditation, reducing stress and trying to help your sleep can all help reduce pain.
- Painkillers and anti-inflammatory medicines do a job
They are often prescribed to help with the pain and stiffness of osteoarthritis and can be taken when needed or before activities you know tend to trigger pain.
- NSAIDs are effective but come with an asterisk
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help pain and stiffness but they should be used in the lowest possible dose for the shortest possible time as they can increase the risk of irritation of the stomach including ulcers as well as cardiovascular disease such as heart attack and stroke
- Try physiotherapy, osteopathy and chiropractic treatment
Expert-led physical therapies can help you manage your pain and improve your function.
- Corticosteroid and local anaesthetics can provide lengthy relief
Joint injections can help individual joints that are especially painful and the benefits can last for many months or even longer