Your Health  -   A to Z of Common Medical Conditions

Arthritis (Osteoarthritis)

Description - Osteoarthritis is found, to some degree, in all humans, assuming they live long enough to develop it. It is the arthritis of "wear and tear". Between the bones of all moving joints are pads of gristle, the joint cartilages, which help the bones to move over each other smoothly. The joint itself is surrounded by a protective capsule lined with a synovial membrane which produces a lubricant fluid, synovial fluid. In osteoarthritis the cartilage gets worn, or begins to break down, either as a result of over-use, inappropriate use or injury. Sometimes the cartilage is damaged by infection or inflammation such as would occur in rheumatoid arthritis (see Arthritis Rheumatoid arthritis) or gout (see Gout). Once the cartilage has been compromised, the underlying bony surfaces become damaged and small outgrowths of bone (osteophytes) appear around the joints. The commonest joints to be affected by osteoarthritis are those that are weight bearing - hips and knees - and those joints used the most - thumbs. Any joint can be affected, particularly if previously injured, and osteoarthritis of the spine is common in this respect. Any stress on a joint can lead to osteoarthritis. Arthritis of the knees is more common in the obese than in the non-obese, and osteoarthritis, generally, tends to be more common in those who have spent their lives in a heavy labouring job than those who have not.
Osteoarthritis usually comes on in middle and later life. The affected joints become stiff and painful and sometimes there is swelling. It can be diagnosed by X rays in that there is a reduction of joint space i.e. the opposing surfaces of bone are closer together, or in actual contact, because there is less, or sometimes, no cartilage between them. Inflammatory disease of the joints such as rheumatoid arthritis, damage the joint, and even when treated leave a legacy of osteoarthritis.

Management - Everybody above a certain age will get some aches and pains from osteoarthritis for which mild painkillers, local rubs, warmth etc will help. In severe arthritis, particularly of the hips and knees, the sufferer can be crippled. It is in these individuals that joint replacement is now common place. Other joints in the body can be replaced but the damage in those is usually he result of inflammatory arthritis. Simple measures do sometimes suffice. In osteoarthritis of the knees, for example, the obese individual losing weight and the development of the muscles around the knees with quadriceps exercises can be most beneficial. In early arthritis of the hip a walking stick can help by transferring some of the body weight. Painkillers of the NSAID variety (non-steroidal anti-inflammatory drugs) are very often used to ease the pain. Physiotherapy, exercises, ultrasound, massage all help. Osteoarthritis of the spine can be very painful particularly if the arthritic spine or surrounding osteophytes impinge on the spinal nerves. In such circumstances surgery may be necessary.

 
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