Osteoarthritis

What is Osteoarthritis?

Osteoarthritis is the word used to describe ‘wear and tear’ of joint surfaces. These changes are a normal part of aging and can be seen on scans in all of us at some point in our lives, some earlier or more severely than others. While as many as 30% of all those over the age of 50 show some signs of ‘wear and tear’ on scans, only a small portion of those actually have any symptoms at all, and so it is more common to NOT show any signs or symptoms. However, when you do have pain associated with your osteoarthritis, it can be a major cause of disability, pain, impaired mobility and decreased quality of life.

Signs of pain associated with arthritis are joint pains that are made worse by prolonged positions or activity more than the joint is used to. Your joints also may feel hot and stiff and you may see some swelling.

What Causes Osteoarthritis to Become Painful?

Osteoarthritis can become painful following physical trauma (such as a road traffic collision or accident at work), however, the likelihood of developing symptoms and the severity of symptoms depends on a combination of risk factors including

• Prolonged positions or activities that put excessive or repeated strain on your joints – such as through poor manual handling techniques at home or work, or long periods of inactivity.
• Individual factors – being female increases the likelihood of developing pain while increasing age increases the likelihood of ‘wear and tear’ of the joint surfaces.
• Physical wellbeing factors – smoking, obesity, poor general fitness and previous joint injuries all increase the likelihood of developing pain and the length of time it takes to recover.
• Psychological wellbeing factors – stress, depression and anxiety all increase the likelihood of developing pain and even increase the severity of pain and the length of time it takes to recover.

How can I help myself?

Unfortunately, there is no ‘cure’ for osteoarthritis, as the joint surfaces will never return to their youthful state. However, the good news is two-fold: 1. You cannot worsen or speed up the degeneration of the joint surfaces, and 2. You can work to minimise the factors that have made your osteoarthritis become painful and minimise those risk factors, thereby potentially making the pain reduce to a manageable level or even go altogether! Therefore, your attitude and the actions you take are the most important factors in keeping your joints healthy and happy. The most effective way to manage symptoms of osteoarthritis are to

1. Identify your individual risk factors and try to minimise these where possible.
2. Avoid static positions for long periods of time and keep active. Low impact exercise such as yoga, Pilates and swimming can be a good starting point, but ‘little and often’ stretch breaks are also important. Exercise is vital for long term joint health. You may not be able to manage much to start with, either limited by pain or lack of fitness, but the more you do, the easier it will become as you get fitter.
3. Talk to your GP or pharmacist about what pain relief may be right for you. If your pain is controlled (for example, with paracetamol), you will be able to maintain more movement, while anti-inflammatory medication (such as ibuprofen), can help reduce inflammation within the joints.
4. Apply gentle heat (such as a hot water bottle or microwaveable wheatbag) to reduce stiffness, or ice (wrapped in a towel) to reduce pain and inflammation if your joints are feeling hot or swollen after activity.
5. Ensure you are following all manual handling techniques correctly at home and work – keep the load close to your waist, use your legs to lift, lower or push loads as these are the most powerful muscles in the body, and work within your capability.

When should I seek further help?

If symptoms are worsening despite using the above strategies, or if your symptoms are preventing you from participating in your normal activities, contact your GP surgery for further assistance. They may refer you to a physiotherapist who can

1. Assess your symptoms,
2. Help you understand your condition
3. Help identify the factors that may be have caused or be aggravating your symptoms and providing advice on how to minimise these,
4. Develop symptom management strategies so you always feel in control
5. Provide an individualised exercise program to improve mobility and strength in order to address symptoms but also to prevent future episodes.
6. Determine whether onward referral may be appropriate.