What is osteoarthritis?

Osteoarthritis is a disease that affects joints in the body. It can involve any joint, but usually concerns hands and weight-bearing joints such as hips, knees, feet and spine. Cartilage is the tough elastic material that covers and protects the ends of bones. In healthy joints cartilage acts as a shock absorber when you put weight on the joint. The slippery surface of the cartilage allows the bones to move smoothly. When a joint develops osteoarthritis the cartilage gradually becomes rough and thin, and the bone underneath thickens. Osteoarthritis is classified as non-inflammatory arthritis. This suggests that there is no inflammation (swelling), but recent research shows that this is not true. Although there is usually no swelling in the early stage of the disease, as the arthritis progresses there can be inflammation. Bits of cartilage may break off and float around inside the joint. This disturbs other soft tissues inside the joint and can cause pain and swelling between bones. The result is you may have trouble moving the joint. Over time as the cartilage wear down, the bones may form bumps on their ends. These bumps are called spurs or the cartilage may wear away entirely, and your bones may rub together. OA may lead to other problems such as:

How prevalent is osteoarthritis?

What are the warning signs of osteoarthritis?

Symptoms of OA usually come on slowly, and involve the area around the joints. If you have joint pain, stiffness, or swelling for more than two weeks, see your doctor. Damage due to OA progresses slowly over time and may result in several problems. You may have pain, especially when moving a joint. Sometimes, you may hear a grating sound when the roughened cartilage on the surface of the bones rubs together. Bumps or swelling may appear, especially on the fingers and feet. A joint may feel sore and stiff, and the joint won't move as easily or as far as it once did. All these changes can make it hard to move around and to do everyday tasks, such as opening a jar or walking up stairs.

Joints Affected

OA commonly affects weight-bearing joints such as hips, knees, feet and spine. However, non-weight bearing joints such as finger joints and the joint at the base of the thumb may be affected as well. It usually does not affect other joints, except when they have been injured or been put under unusual stress.

What causes osteoarthritis?

No one knows for sure what causes OA, although scientists are well on their way to understanding the events that lead to the breakdown of cartilage. Researchers now think that there are several factors that may increase your risk for getting OA. Key risk factors include:

Wear and Tear?

Osteoarthritis used to be thought of as the inevitable result of "wear and tear" on the joints. Research now shows that normal wear does not actually cause "tear." Normal activity and exercise is good rather than bad for joints and does not cause osteoarthritis.

What can you do about osteoarthritis?

Establishing the correct diagnosis is very important, because something can be done to manage most forms of arthritis, and most therapies work best when started early in the disease. Your doctor may be able to diagnose OA based on your medical history and a physical examination. Sometimes, your doctor may order certain tests to help confirm the diagnosis, to determine how much joint damage exists, or to distinguish among different types of arthritis. These tests may include x-rays, blood tests or joint fluid tests. Although there is no cure for OA, a lot can be done to help manage the condition. A variety of treatments can help to lessen pain and stiffness and to make movement easier. Your active involvement in developing your prescribed treatment plan is essential.

A Word about medication Safety

All medications have potential side effects

It is important for patients to discuss the benefits and potential side effects of all their medications with their doctor.

Exercise

Exercise helps reduce pain and prevents further joint damage. It can also help you maintain a healthy weight, which puts less strain on your joints.

Not using a sore joint will cause the muscles around it to become weak, resulting in pain.

A physiotherapist can teach you correct exercises such as:

Muscles and the other tissues that hold joints together weaken when they aren't moved enough, so the joint loses its shape and function. Exercise helps lessen the symptoms of OA and can help make you feel better overall. Moderate stretching exercises will help relieve the pain and keep the muscles and tendons around the affected joint more flexible and strong. Low-impact exercises like swimming, walking, water acrobics and stationary bicycling can all reduce pain while maintaining strength and flexibility. While these measures won't stop the disease from progressing, they can help slow damage to your joints. Combined with good medical care, you can better manage your symptoms.

Protect Your Joints

Protecting your joints means using your joints in ways that avoid excess stress. Benefits include less pain and greater case in doing tasks.

Heat/Cold

Applying heat helps relax aching muscles, and reduces joint pain and soreness. For example, take a hot shower.

Applying cold helps to lessen the pain and swelling in a joint. For example, put an ice pack on the area that is sore.

Heat applied to an arthritic area can reduce pain, stiffness and muscle spasm. It promotes blood circulation, which nourishes and detoxifies muscle fibers. Having a hot shower before exercise may help you get ready for the workout. You should not apply heat to an inflamed joint. Cold applied to inflamed joints reduces pain and swelling by constricting blood flow.

Surgery

If one of your joints becomes badly damaged, or if the pain is too strong, your doctor may recommend surgery.

There are different kinds of surgery for OA. With some surgery, bits of cartilage are removed from the joint. Other kinds of surgery repair or rebuild parts of the bone, or replace a joint with an artificial or a man-made joint.

Osteoarthritis may progress to the point where surgery is necessary. Minor surgery can be performed to clean out cartilage debris from the joints, particularly the knee. This is called arthroscopic surgery. It is performed as outpatient surgery and does not usually require an overnight stay in hospital. Severely damaged joints can be reconstructed or surgically replaced with artificial ones. Joint replacement is major surgery, and is most often performed to replace hip and knee joints. Hip and Knee joints. Hip and knee replacements relieve pain and can restore your ability to move your joints and function normally. Artificial joints can last 10-20 years before they require replacement, which is why this type of surgery is delayed until it is clearly necessary.

Complementary Approaches

It's important to remember that non-conventional approaches to manage osteoarthritis aren't meant to replace your treatment plan, but rather act as a complement.

You should always discuss your selection of supplements and complementary therapies with your doctor.

Massage

Massage is widely used for pain relief, but its results are open to question. At best, massage may relieve muscle ache or tension by increasing blood flow, but benefit is relatively short-lived. Massage should be avoided when joints are especially tender or inflamed, since it can actually worsen your condition at such times. If you're having a massage done by a professional, make sure he or she understands that, because of your arthritis, you want only the gentlest procedure.

Exercise And Arthritis

Exercise is essential for people with arthritis. As for anyone, exercise:

Increase energy levels

Helps with weight control

Improves cardiovascular endurance

Increases bone and muscle strength

Decreases depression and fatigue

Serves to improve self-esteem and self-confidence

Improves sleep pattern

Moving the joints daily helps to keep them fully mobile. Added joint support is achieved by strengthening the surrounding muscles. Also, joint movement transports nutrients and waste products to and from the cartilage, the material which protects the ends of the bones.

Range-of-motion Exercises

Range-of-motion exercises are gentle stretching exercises which move each joint as far as possible in all directions. These exercises need to be done daily to help keep joints fully mobile and prevent stiffness and deformities. ROM (range-of-motion) exercises are especially important for arthritis patients, who because of intense inflammatory pain tend not to want to move painful joints. It is the notice of some people that normal daily activities take joints through their full range-of-motion but this is not the case. Normal daily activities, such as housework, dressing, bathing, and cooking, are not a substitute for ROM exercises.

Strengthening Exercises

Strengthening exercises help increase muscle strength. Strong muscles help to support the joints, making the joints more stable, and helping a person move more easily and with less pain. The two types of strengthening exercises are isometric and isotonic.

Isometric exercises involve tightening the muscles, without moving the joints. These exercises are especially useful when joint motion is impaired.

Isotonic exercises involve strengthening the muscles by moving the joints.

Endurance Exercises

Endurance exercises are physical activities that bring your heart rate up to your optimal target level for at least twenty to thirty minutes. The target heart rate is computed based on age and physical condition. These exercises, by raising the heart rate, improve cardiovascular fitness. These exercises should be performed at least three times a week to enhance effectiveness. Many arthritis patients who do endurance exercises:

Increase physical strength

Develop a better mental attitude

Improve arthritis symptoms

Not all arthritis patients are able to perform endurance exercises however. Endurance exercises for arthritis patients need to be chosen carefully to avoid joint injury.

Exercise Choices

People with arthritis should always discuss their exercise plans with a doctor. There may be many exercises that are off-limits for people with a particular type of arthritis of when joints are swollen and inflamed. The amount and form of exercise recommended for each individual will vary depending on:

Type of arthritis

Joints involved

Levels of inflammation

Stability of joints

Joint replacements

Other limitations

Exercise choices for people with arthritis may include:

Exercise Guidelines

To obtain the maximum benefit from an exercise program

Exercise should be performed daily. Sporadically done exercise do not reap any long term benefits.

The best exercise program is one which beings at a low intensity and builds up gradually as symptoms permit. Too much exercise, especially initially, can worsen symptoms.

The best time to exercise is when pain and stiffness are at a minimum. Some patients feel the best time is after morning stiffness subsides. Other patients dislike the afternoon because they are fatigued by that time of day.

Many strengthening and range-of-motion exercise programs suggest performing the exercises in sets of three to ten repetitions, with each set repeated one to four times.

No specific number works for everyone. The number of repetitions is dependent on how well the patient feels. Too much activity during a flare can aggravate or worsen symptoms.

A certain amount of discomfort during exercise is acceptable and expected especially for patients who have endured arthritis for a long time. If pain lasts two hours or more after exercise, the body is signaling that the exercise session was too strenuous.

If the joint feels hot, avoid exercise. Exercise can make a swollen, tender, and hot joint feel worse. Modify activity until arthritis is once again under control.

Excercising and breathing should be coordinated. Avoid bouncing or jerky motions which can add stress to joints. Exercise in a smooth, steady rhythm and relax between repetitions.

While activity is important in maintaining healthy joints, so is getting the appropriate amount of rest.

Therapeutic Excercises

Therapeutic excercises are exercises which are recommended by a doctor, physical therapist, or occupational therapist with a specific goal in mind. Health professionals can help you design a fitness program which meets your individual needs.