Osteoarthritis: Causes, Symptoms and Treatment


At a Glance:

  • Osteoarthritis is the most common form of arthritis
  • It is caused by wear and tear to the hyaline cartilage that cushions joints
  • As the cartilage wears away the bones in the joint rub against each other leading to pain, reduction in range of movement and inflammation, and often cysts and bone spurs
  • Any joint may be affected by osteoarthritis but the fingers, hips, knees and spine are the most commonly affected
  • Osteoarthritis is a progressive condition, meaning it gets worse over time
  • Anyone may be affected by osteoarthritis, but it is more common in people over 45, the obese and women
  • The damage caused by osteoarthritis is irreversible, but through treatment, including exercise, medication and sometimes surgery, the progress and symptoms of the condition may be managed

What is Osteoarthritis

Arthritis is an umbrella term used to describe conditions that cause pain, inflammation and stiffness in the joints. Osteoarthritis is the most common form of arthritis in Australia, with around one in 11 people (9.3%) living with the condition. Unlike many other forms of arthritis, the condition is not caused by autoimmune response or infection, but instead is the result of wear and tear on the cartilage that cushions the joints.

Osteoarthritis may affect any joint in the body but it is most commonly seen in the hands, knees, hips and spine. As the cartilage at the end of bones wears away, the bones themselves rub against each other, leading to degeneration of the joint, inflammation, pain and stiffness. It is a progressive condition, meaning that the symptoms become worse with time. 

As the condition progresses, the affected joint may grow bone spurs, leading to further pain and loss of motion, as well as the degeneration of ligaments around the affected joint. Although the damage from osteoarthritis cannot be repaired, the symptoms may be managed and the progress of degeneration slowed through lifestyle changes and exercise.

People of any age may have osteoarthritis but it is far more common in people over 45 than it is in younger people. The risk of developing osteoarthritis increases with age, with a large proportion of people living with osteoarthritis being 75 and older. Women are more likely to suffer osteoarthritis, with about three in five people living with osteoarthritis being female.

Symptoms of Osteoarthritis

The symptoms of osteoarthritis typically worsen over time, initially developing slowly but becoming more pronounced as the condition progresses. Common symptoms of osteoarthritis include:

  1. Pain - joints affected by osteoarthritis may hurt either during or after movement. Pain may range from mild to severe, in some cases being bad enough that function is affected and day to day activities become difficult
  2. Inflammation - the soft tissues around the affected joint may become swollen and inflamed
  3. Stiffness - joints affected by osteoarthritis may be stiff and harder to move than unaffected joints. This stiffness may be more noticeable after waking up in the morning or after long periods of inactivity. Stiffness in affected joints may become so pronounced that it makes daily tasks difficult
  4. Loss of Flexibility or Limited Movement - the affected joint may have a reduced range of motion. In the case of spinal osteoarthritis, the back or neck may have reduced flexibility
  5. Grating, Popping and Cracking - affected joints may make cracking or popping noises when moved. A grating sensation may also be noticeable in affected joints
  6. Bone Spurs - arthritic joints may develop bone spurs due to damage. These spurs may feel like bony knobs growing off the side of the joint and may further limit movement or cause pain
  7. Tenderness - affected joints may be painful to touch
  8. Muscle Weakness - people with osteoarthritis may experience muscle weakness in areas around the affected joint as the pain and inflammation from the joint, effectively switches the muscles off 
  9. Broken Sleep - due to the pain associated with osteoarthritis in some joints, especially the hips and spine, people living with the condition may experience poor or broken sleeping patterns
  10. Joint Deformity - typically seen in the hands. The cartilage in joints may wear away unevenly, leading joints to twist or angle away from true. Inflammation in the soft tissues around affected joints as well as degeneration of connecting ligaments in the fingers may also lead to deformation of the joints

Although not direct symptoms of osteoarthritis, severe cases may result in chronic pain, disability and an increased chance of developing depression.


Nobody should have to live with pain and reduced movement. If you’ve been diagnosed with osteoarthritis, make an appointment to see a physiotherapist to see how they can help manage your symptoms and increase your range of movement. 


What Causes Osteoarthritis?

Osteoarthritis is caused by wear and tear and while there is no definitive cause for the degeneration of cartilage in joints, it is typically caused by either injury to a joint or repetitive use of a joint. A number of risk factors may increase a person’s chance of developing osteoarthritis, including:

  1. Age - the chance of developing osteoarthritis increases with age due to the cartilage in the joints having more wear and tear
  2. Bone Deformities - people born with malformed bones, joints or cartilage are more prone to cartilage damage leading to osteoarthritis. These malformations include uneven limb length, bow legs (genu varum) and knock knees (genu valgum)   
  3. Diabetes - people with type 2 diabetes are at higher risk of developing osteoarthritis than those without. This may be due to obesity, one of the major risk factors for type 2 diabetes, rather than the diabetes itself
  4. Genetic Predisposition - some people have a genetic predisposition to developing osteoarthritis. It is understood that there is a strong genetic element in the development of osteoarthritis but at this moment the exact inheritance model is unknown 
  5. Haemochromatosis - haemochromatosis is a condition in which the body stores too much iron. This iron is deposited in joints and may accelerate the degeneration of cartilage
  6. Joint Injury - injury to a joint may increase your chance of developing osteoarthritis. Even previously healed injuries may contribute to the development of the condition over time.  For example, knee osteoarthritis will occur in an anterior cruciate ligament injured knee, whether the ligament is repaired with surgery or not
  7. Obesity - carrying extra body weight may contribute to the development of osteoarthritis in a number of ways. Weight may put extra pressure on weight-bearing joints such as the knees and hips. The greater the weight the greater the pressure. 

    Fatty tissues may also produce proteins that can lead to inflammation in and around the joints. Being obese may also restrict movement making it more difficult to perform exercises that may relieve that aim to slow the progression of osteoarthritis
  8. Repetitive Movement - repetitive joint movements, especially those related to weight bearing or joint loading, such as lifting objects, squatting and standing, etc may increase the risk of osteoarthritis in the knees. Repetitive movements, such as typing my increase the risk of developing osteoarthritis in the hands.  However, this does not mean that these exercises performed safely are not beneficial for your body
  9. Repetitive Stress - repeated stress to joints from sudden weight bearing, awkward positioning or sudden stops and starts,, such as those caused by playing sports or through ergonomic injury may increase your chance of damaging the cartilage in your joints and developing osteoarthritis
  10. Sex - women are more likely to develop osteoarthritis than men but as yet no readily identifiable reason has been discovered

Treatment for Osteoarthritis

The damage to joints caused by osteoarthritis is irreversible, but through treatment the symptoms may be reduced and the progress slowed allowing for greater quality of life and ease of movement. 

Exercise

A regular exercise plan put together by a physiotherapist or exercise physiologist has been shown to be one of the most effective ways of managing osteoarthritis, as it not only helps strengthen the muscles around the affected joints and improve flexibility, but it also reduces the risk of developing other health complaints that may result from inactivity.

The exact form of exercise may vary from person to person depending on the severity and location or severity of the osteoarthritis. 

Occupational Therapy

An occupational therapist may work with a person living with osteoarthritis to help discover ways of performing tasks in a manner that puts less stress on affected joints. An OT may also recommend specialised tools made to be easily used by people with limited movement, such as cutlery with large ergonomic handles that are easy to grip with little strength.

Pain Relief Medications

In some cases, pain relief medications may be recommended to help people manage their symptoms. Commonly prescribed or recommended medications include:

  • Acetaminophen (Paracetamol) - the over the counter pain reliever may offer some relief to people experiencing mild to moderate osteoarthritis pain. Paracetamol poisoning may cause liver damage and is the number one cause of pharmaceutical poisoning in Australia, so moderation is required
  • Duloxetine (Cymbalta) - this strong antidepressant has shown effectiveness in managing chronic osteoarthritis pain (especially in the knees). It is typically only used when acetaminophen and NSAIDs have prove ineffective
  • NSAIDs (Non Steroidal Anti-Inflammatory Drugs) - over the counter drugs such as ibuprofen and naproxen are commonly used to help manage osteoarthritis pain. Stronger prescription NSAIDs may also be recommended
  • Steroids - cortisone injections into affected joints may help relieve pain and inflammation. The number of injections per year should limited to two as repeated injection may actually accelerate the degeneration of the joint and can weaken and rupture the soft tissues around the joint including ligaments and tendons 

Surgery

If other forms of management have failed, surgery may become a treatment option.

  • Arthrodesis - the fusing of bones into position. While the fused joint loses all mobility, the procedure also significantly reduces if not eliminates related pain. The procedure is most commonly performed in the fingers and thumb, wrists, ankles and lower spine.  This can then lead to increased loading on adjacent joints, so is often a last resort option
  • Arthroplasty - the replacement of joints. During this procedure the joint is removed and replaced with one made of plastic, ceramic, metal or a combination thereof. Most joints affected by osteoarthritis, including vertebrae, may be replaced in this manner. Knees and hips are the most common joint replacement surgeries
  • Osteotomy - partial reconstruction of joints. This procedure is typically performed on the knee. Small pieces of bone are removed above and below the joint allowing it to be straightened or realigned

If you’re experiencing pain in your joints, schedule a consultation with a doctor to get a diagnosis. If it’s arthritis, the longer you wait the worse it may get. The fastest and easiest way to search for and book healthcare appointments online is with MyHealth1st

 

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