Osteoarthritis

Symptoms

The main symptoms of osteoarthritis are pain and stiffness in your joints, which can make it difficult to move the affected joints and do certain activities.

The symptoms may come and go in episodes, which can be related to your activity levels and even the weather. In more severe cases, the symptoms can be continuous.

You should see your GP if you have persistent symptoms of osteoarthritis so they can confirm the diagnosis and prescribe any necessary treatment.

Other symptoms you or your doctor may notice include:

• joint tenderness
• increased pain and stiffness when you have not moved your joints for a while
• joints appearing slightly larger or more "knobbly" than usual
• a grating or crackling sound or sensation in your joints
• limited range of movement in your joints
• weakness and muscle wasting (loss of muscle bulk)

Osteoarthritis can affect any joint in the body, but the most common areas affected are the knees, hips and small joints in the hands. Often, you'll only experience symptoms in 1 joint, or a few joints at any 1 time.

Osteoarthritis of the knee

If you have osteoarthritis in your knees, both your knees will usually be affected over time, unless it occurred as the result of an injury or another condition affecting only 1 knee.

Your knees may be most painful when you walk, particularly when walking up or down hills or stairs.

Sometimes, your knees may "give way" beneath you or make it difficult to straighten your legs. You may also hear a soft, grating sound when you move the affected joint.

Osteoarthritis of the hip

Osteoarthritis in your hips often causes difficulty moving your hip joints. For example, you may find it difficult to put your shoes and socks on or to get in and out of a car.

You'll also usually have pain in the groin or outside the hip. This is often worse when you move the hip joints, although it can also affect you when you're resting or sleeping.

Osteoarthritis of the hand

Osteoarthritis often affects three main areas of your hand:

• the base of your thumb
• the joints closest to your fingertips
• the middle joints of your fingers

Your fingers may become stiff, painful and swollen and you may develop bumps on your finger joints. Over time, the pain may decrease and eventually disappear altogether, although the bumps and swelling can remain.

Your fingers may bend sideways slightly at your affected joints or you may develop painful cysts (fluid-filled lumps) on the backs of your fingers.

In some cases, you may also develop a bump at the base of your thumb where it joins your wrist. This can be painful and you may find it difficult to perform some manual tasks, such as writing, opening jars or turning keys.

Causes

As part of normal life, your joints are exposed to a constant low level of damage. In most cases, your body repairs the damage itself and you do not experience any symptoms.

But in osteoarthritis, the protective cartilage on the ends of your bones breaks down, causing pain, swelling and problems moving the joint. Bony growths can develop, and the area can become swollen and red. (Redness can be harder to see on brown and black skin.)

Risk Factors

The exact cause is not known, but several things are thought to increase your risk of developing osteoarthritis, including:

• joint injury – overusing your joint when it has not had enough time to heal after an injury or operation
• other conditions (secondary arthritis) – osteoarthritis can happen in joints severely damaged by a previous or existing condition, such as rheumatoid arthritis or gout
• age – your risk of developing the condition increases as you get older
• family history – osteoarthritis may run in families, although studies have not identified a single gene responsible
• obesity – being obese puts excess strain on your joints, particularly those that bear most of your weight, such as your knees and hips

• being a woman – osteoarthritis is more common in women than men

Diagnosis

To help determine whether you have osteoarthritis, a GP will first ask you about your symptoms and examine your joints.

A GP may suspect osteoarthritis if:

• you're aged 45 or older
• you have joint pain that gets worse the more you use your joints
• the stiffness in your joints is not there in the mornings, or lasts less than 30 minutes

If your symptoms are slightly different, this may indicate another joint condition. For example, prolonged joint stiffness in the morning can be a sign of rheumatoid arthritis.

Further tests – such as X-rays or blood tests – are not usually necessary, but may be used to rule out other possible causes, such as rheumatoid arthritis or a fractured bone.

Treatment Options

Osteoarthritis is a long-term condition and cannot be cured, but it doesn't necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are also available to reduce the symptoms.

Mild symptoms can sometimes be managed with simple measures, including:

• regular exercise
• losing weight if you're overweight
• wearing suitable footwear
• using special devices to reduce the strain on your joints during your everyday activities

If your symptoms are more severe, you may need additional treatments such as painkillers and a structured exercise plan with a physiotherapist.

In a small number of cases, where these treatments haven't helped or the damage to the joints is particularly severe, surgery may be done to repair, strengthen or replace a damaged joint.

Prevention Tips

It's not possible to prevent osteoarthritis altogether. However, you may be able to minimise your risk of developing the condition by avoiding injury and living a healthy lifestyle.

Exercise

Exercise or a job that puts frequent strain on your joints and forces them to bear an excessive load can increase your risk of osteoarthritis.

Try to do at least 150 minutes of moderate aerobic activity (such as cycling or fast walking) every week, plus strength exercises on 2 or more days each week that work the major muscle groups, to keep yourself generally healthy.

Posture

It can also help to maintain good posture at all times and avoid staying in the same position for too long.

If you work at a desk, make sure your chair is at the correct height, and take regular breaks to move around.

Losing weight

Being overweight or obese increases the strain on your joints and your risk of developing osteoarthritis. If you're overweight, losing weight may help lower your chances of developing the condition.

Use the BMI healthy weight calculator to find out whether you're overweight or obese.

When To See A Doctor

You should see your GP if you have persistent symptoms of osteoarthritis.