Osteoarthritis: The Ultimate Guide

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Osteoarthritis: The Ultimate Guide

for the newly diagnosed

This Ultimate Guide to Osteoarthritis has been developed for the newly diagnosed and their family and loved ones, to help better understand the implications for, and the future of, a person diagnosed with this chronic disease.

Table of Contents

What is Osteoarthritis (OA) ?

Osteoarthritis (OA) is often described as a “wear and tear” condition, however it is now considered to be more likely the result of a joint working super hard to repair itself. It is now referred to as a chronic disease. It is the  most common type of arthritis. The condition affects the whole joint including bone, cartilage, ligaments and muscles. When the smooth cushion between bones (cartilage) breaks down, joints can get painful, swollen and hard to move. OA can affect any joint, but is most commonly found in the:

    • knees, 
    • hips, 
    • hands and finger joints 
    • big toe
    • lower back
    • neck

OA may include:

    1. inflammation of the tissue around a joint
    2. damage to joint cartilage 
    3. bony spurs (exostosis)  growing around the edge of a joint 
    4. deterioration of ligaments (the tough bands that hold your joint together) and tendons (cords that attach muscles to bones).
Osteoarthritis joints

OA can affect any joint. It can develop at any age but tends to be more common in people aged over 40 years or those who have had joint injuries.

Videos about OA

What are the symptoms?

OA Symptoms compressed

The symptoms of OA are unique to each and every individual. Symptoms will depend upon which joints are affected. OA symptoms tends to devleop slowly, over months and even years. Some people, however, can remain asymptomatic for years and then get sudden onset of symptoms, often triggered by some kind of injury or repeated overuse of the affected joint.

The most common symptoms are pain and stiffness of the joints. These sensations are usually worse with activity initially, but can be more constant in later disease. 

These symptoms may affect your ability to do normal daily activities, such as walking, climbing stairs and opening jars. Other symptoms may include clicking noises, grating sensations, or a loss of flexibility in a joint.

Symptoms can include:

    • Pain or aching in the joint during activity, after long activity, or at the end of the day.
    • Joint stiffness usually occurs first thing in the morning or after resting.
    • Limited range of motion that may go away after movement.
    • Clicking or cracking sound when a joint bends.
    • Swelling around a joint.
    • Muscle weakness around the joint.
    • Joint instability or buckling  (knee gives out).
" My personal experience: In hindsight, I had been experiencing some stiffness in my knees in the mornings getting out of bed, but it was a mild discomfort only and I blamed it more on my back than specifically my knees. I was two weeks into a new job as a Teacher Librarian. I had worked in the role previously for over 15 years, but had taken a 7 year break where I had been predominantly in a sedentary office-type of role.

I had begun to notice that my knees were sore during the evenings after work and I put it down to the fact that I had been kneeling a lot and doing multiple squats to the floor, plus also moving from sitting to standing and vice versa. One morning as I drove my manual car to work, I experienced excruciating pain in my left knee as I went to change my gear at traffic lights. After 3 more gear changes, I could not cope with another one and had to pull my car to the side of the road and abandon the driving. 

What followed was 7 months of GP, Specialist, Physio, Work Cover and Work Rehabilitation appointments before finally learning that the ‘work injury’ that I thought I had, and that I would eventually recover from, was in fact Osteoarthritis of both knees. OA is a progressively, degenerative disease, that has no cure "

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Creaky Me
Living with Osteoarthritis

How OA affects different parts of the body

    • Hips. Pain is felt in the groin area or buttocks and sometimes on the inside of the knee or thigh.
    • Knees. A “grating” or “scraping” feeling when moving the knee. 
    • Fingers. Bony growths (spurs) at the edge of joints can cause fingers to become swollen, tender and red. There may be pain at the base of the thumb.
    • Feet. The big toe feels painful and tender. Ankles or toes may swell.

As OA gets worse, cartilage may get uneven edges and cracks. Bones may harden, change shape and get bumpy. Once cartilage breaks down, it doesn’t grow back on its own.

What causes it?

Risk Factors for OA

Osteoarthritis can develop at any age but tends to be more common in people aged over 50 years or those who have had joint injuries.It affects women more than men. Some people never develop OA.

Risk Factors for Osteoarthritis: 

    • age: The risk of developing OA increases as someone gets older because bones, muscles and joints are also aging . 
    • joint injury: A break or tear, can lead to OA after years.
    • overuse: Using the same joints over and over in a job or sport can result in OA.
    • obesity: Extra weight puts more stress on a joint and fats cells promote inflammation.
    • weak muscles: Joints can get out of the right position when there’s not enough support.
    • genes: People with family members who have OA are more likely to develop OA.
    • sex: Women are more likely to develop OA than men

Factors that put you at more risk of developing OA in certain joints, include:

    • knees: being overweight; having a previous knee injury; jobs involving kneeling; climbing and squatting
    • hips: being overweight; having a previous hip injury; jobs involving lifting heavy loads (including farming); a family history of OA
    • hands: a family history of OA; repetitive use or previous injuries to the hands; being overweight.

Is OA an acute or a chronic condition?

Osteoarthritis can have acute symptoms but is generally considered a chronic condition.

In medicine, a chronic condition can be distinguished from one that is acute . An acute condition typically affects one portion of the body and responds to treatment. A chronic condition on the other hand usually affects multiple areas of the body, is not fully responsive to treatment, and persists for an extended period of time

Acute Chronic

Is OA a chronic disease or illness?

Osteoarthritis is classified as a chronic disease.

This means that it is a disease that persists for a long time: lasting 3 months or more. A chronic disease has persistent effects. OA cannot be prevented by vaccines or cured by medication, nor will it just disappear. Chronic diseases such as Osteoarthritis are a leading cause of disability, and have major impacts on health and welfare services.  Once present, Osteoarthritis, although manageable will persist throughout life. 

How is it diagnosed and is there a cure?

Your doctor will diagnose OA from your symptoms and a physical examination. An x-ray may show the narrowing and changes in the shape of your joint. However x-rays do not necessarily indicate what level of symptoms you may experience. An x-ray that shows joint damage does not always mean you will have a lot of pain or problems. On the other hand your joint may be very painful despite x-rays being normal. Blood tests are only helpful to rule out other types of arthritis.

Currently, there is no cure for OA. There are treatments that can effectively control symptoms and you can learn to self manage these too. Your proactive management, combined with your specialist team will work on this together.  There’s no cure for osteoarthritis, but there is a lot you can do to slow its progression, reduce pain, and maintain or improve function. Treatment for OA focuses on managing your symptoms. The disease cannot be reversed. 

While prescription medication, physical therapy, exercise, and complementary approaches like acupuncture can help relieve pain and other osteoarthritis symptoms, these treatments cannot stop or slow the disease itself.

Effectively managing milder symptoms of OA has been key for myself. I use the RICE technique shown below. 

Rest Ice Compress Elevate

How Much Pain is Too Much Pain during exercise

You will hear, over and over again that it is vital to keep your joints moving to help alleviate the pain levels of Osteoarthritis. When exercise itself can cause pain – this seems counter-productive. Read my article “How Much Pain Is Too Much Pain?” to help you become more confident with exercising with discomfort.

https://creakyme.com/how-much-pain-is-too-much-pain/ 

Four Stages of Osteoarthritis

Osteoarthritis disease starts gradually and worsens over time. The severity of the OA affecting your joints  will be assessed according to which one of 4 stages your joints reflect. The stages below show how these stages are shown in osteoarthritis of the knee.

What will happen to me?

The impact of OA on your normal activities and lifestyle depends on which joints are affected. However the outlook for most people with OA is very positive. For many people OA will be mild and not cause major problems. OA of the hip and knee can sometimes cause severe disability and surgery to replace joints may be necessary. Joint surgery is usually only an option if less invasive treatments, such as weight loss, exercise, and medicines, have failed to control your symptoms.

OA Complications & Disability

Osteoarthritis can be debilitating. If it’s not treated, your movement may become limited over time.

Complications of osteoarthritis can vary depending on the severity of the condition and the joint involved.

Potential complications include:

    1. Long-term pain (chronic) 
    2. Difficulty performing daily activities, such as household chores, cooking, and maintaining personal hygiene, potentially leading to the loss of independent living
    3. Loss of employment due to the inability to work
    4. Joint deformities — hard or bony nodules that form where two bones come together, often giving the joint a knobby or knotted appearance 
    5. Muscle weakness, which often occurs when a joint becomes too painful to use, especially with knee osteoarthritis
    6. Impaired balance
    7. Increased risk of falling 

Pain from osteoarthritis can make it difficult to enjoy — or even execute — everyday activities, such as running errands, cleaning house, exercising, or getting good rest.  Some research suggests that osteoarthritis symptoms and restlessness from a lack of activity can interfere with sleep.

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