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OsteoarthritisPublished by Bupa's health information team, August 2007. This factsheet is for people with osteoarthritis, or who would like information about it. Osteoarthritis is the most common type of arthritis - every year about two million people in the UK see their GP about it. Osteoarthritis causes your joints to become stiff and painful. It's estimated that over eight million people in the UK are living with osteoarthritis. You are more likely to get it if you are over 40, although it can occur if you are younger. Women are more at risk than men. You can take measures to relieve the symptoms and medicines may also help.
What is osteoarthritis?Arthritis means inflammation of the joints. You can think of osteoarthritis as a "wear and tear" disease. It usually affects your knees or hips, but can occur in your hands, feet and spine. It causes the cartilage on the end of your bones to get rougher and thinner. The bone beneath compensates by thickening and growing outwards, creating outgrowths (osteophytes). These make your knees look knobbly. The capsule around the joint also thickens and becomes inflamed.
SymptomsIf you have osteoarthritis, your joints will be stiff and painful, and may be swollen. The pain may be worse after you have been exercising. You may find you can't move the joint as much or as easily as before. It may make creaking sounds called crepitations. As osteoarthritis progresses, your joints may become misshapen and look knobbly, and they may be unstable. You will probably notice times when your symptoms are worse than at others. There doesn't seem to be any particular cause for this, although you may find you are affected by changes in the weather or the amount of activity you do. Sometimes pain and stiffness can be more severe in the early stages, especially in women who develop osteoarthritis around the time of the menopause. It then tends to settle down over the next few years. If you have severe or advanced osteoarthritis, it's possible that you will feel pain all the time, even at night and when you are resting. CausesThe exact reasons why you may develop osteoarthritis aren't fully understood at present. However, certain things can make you more likely to get it.
DiagnosisThere is no single test that can check for osteoarthritis, so your GP will ask about your symptoms and examine you. He or she will look for bony outgrowths, swelling, creaking, instability and reduced movement of the joint. A blood test won't confirm osteoarthritis, but your GP may do one anyway to check that you don't have another type of arthritis. An X-ray image can show up any narrowing within your joint or outgrowths of bone. However, these can only give limited information and in the early stages of osteoarthritis they may look normal. The severity of arthritis isn't related to the degree of change on the X-ray image. TreatmentSelf-helpOsteoarthritis affects everyone differently, but it's likely that you will be able to carry on with life as usual. However, it's important to cut down the strain you put on your joints. You can do this by:
Although you may not feel like it, it's important to keep active and take regular exercise. This will help if you are trying to lose excess weight and will keep your muscles strong so they can support your joints. One of the most helpful activities you can do is swimming - this exercises and strengthens your muscles without putting strain on your joints. A physiotherapist can advise about the most suitable sort of exercise for you. MedicinesNo medicine can cure osteoarthritis but they can help to relieve symptoms. You may find over-the-counter painkillers such as paracetamol helpful. If the pain is more severe, your doctor may prescribe anti-inflammatory medicines known as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammation. These are helpful in reducing pain, swelling and stiffness. With all medicines, you should follow the instructions in the patient information leaflet that comes with your medicine and ask your pharmacist or doctor for advice. Complementary therapiesAlthough there is little evidence for the effectiveness of complementary therapies in treating osteoarthritis, 60 percent of people with all forms of arthritis have used or are using one type or another. If you have severe side-effects as a result of medication, you may find acupuncture or reflexology helpful in relieving pain. Complementary therapy may make you feel more relaxed, and this may help you to manage your osteoarthritis in everyday life. It's important to speak to your GP before stopping any regular prescription medicines or trying complementary therapy. Non-surgical treatmentsYour GP may prescribe creams called topical rubifacients as another method of pain relief. One that may be prescribed is capsaicin cream. NSAIDs are also available as creams and gels - you can rub these directly onto affected areas. These are less likely to have side-effects than NSAIDs taken as tablets, but this means you may notice only limited benefit as less of the drug gets to the affected area. If you have very painful osteoarthritis, your doctor may suggest that you have steroid injections. These are given directly into the affected area. If your knee joint is particularly painful, you may find it helpful to have an injection of a fluid called hyaluronan to help ease the friction caused by roughened joints. Food supplementsGlucosamine and chondroitin supplements may provide you with some pain relief, although there is only limited evidence that they are effective. These chemicals are found naturally in cartilage and it's thought that taking supplements may improve the condition of damaged cartilage. They may also slow down thinning of the cartilage. Glucosamine comes from shellfish so you shouldn't take it if you have a shellfish allergy. SurgeryThe surgical options available have advanced recently, particularly if you have only mild osteoarthritis. Some of these are listed below.
If you have a particularly painful joint, your doctor may recommend that you have an operation to replace it. This is most commonly done for the hip and knee joints and both of these have high rates of success in improving mobility and reducing pain. Living with osteoarthritisYou may find osteoarthritis upsetting and frustrating. It's important to tell your doctor about how it's affecting you so he or she can make sure you get the most suitable treatment. You may need to make changes to your daily life, but there are people such as physiotherapists and occupational therapists who can help to make this easier. Further information
Related topicsSources
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr S Bhalara MSc MD MRCP, consultant rheumatologist; Dr Daniel Fishman FRCP PhD, consultant rheumatologist, Luton and Dunstable NHS Foundation Trust; and Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: August 2007.
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