04 Nov Osteoarthritis- What is it and busting the myths
What is Osteoarthritis?
Osteoarthritis (OA) is a disease which affects the entire joint. It can occur in any joint but most commonly affects the knees, hips and hands. OA is the most common chronic condition of the joints and is the leading cause of physical inactivity in those over 65 years of age.
In healthy joints, the ends of our bones are covered in cartilage which provides a smooth gliding surface and a ‘cushion’ between the joints. In OA, the cartilage can change structure due to numerous factors, and if it’s not doing its job it can lead to pain, swelling and stiffness.
Is osteoarthritis a ‘wear and tear’ disease?
NO. Although this has commonly been used to describe OA, this is in fact a myth. Yes some structural changes do include thinning of cartilage and bone growths (described as spurs or osteophytes), however OA also occurs without this. In more cases than not, OA does not show visible progression on imaging.
What are the symptoms?
Common symptoms include:
- Pain when moving or loading the joint -which can occur at rest or at night
- Joint stiffness
- Heat and swelling
- Muscle tightness
- Difficulty moving around
- Noise (crepitus) during joint movement (e.g. grating, cracking, crunching, or popping)
What causes osteoarthritis?
Our bodies are continually changing and adapting to what we do. All our soft tissues (cartilage, muscles, tendons, bones etc.) have cells which when stimulated are breaking down and then regenerating (growing) new tissue depending on the daily demands of our body. This process is called metabolic turnover.
OA occurs when there is more breakdown than regeneration of cartilage. Common risk factors that lead to this:
- Sex (females >males)
- Physical inactivity
- Increased weight
- Muscle weakness
- Sports related joint injury
- Work or leisure related joint injury
This leads to altered cartilage structure.
This importantly highlights that both doing too much or doing too little is not ideal for our joints. Pain and symptoms associated with OA are also influenced by many factors including: fatigue, poor sleep, stress/depression, fear, avoidance and lack of confidence.
Although we cannot control some risk factors (age, sex, genetics), we can definitely affect the other risk factors associated with OA.
How do I know if I have osteoarthritis?
Diagnosis should always be confirmed by a health professional. They will determine this based on symptoms, history and objective testing. Important signs and symptoms which help diagnose include:
- Location and severity of pain and other symptoms
- When and how pain or other symptoms began
- If symptoms limit everyday activities
- Joint crepitus
- Restricted movement
- Bony enlargement
Do I need imaging (e.g. X-ray) to diagnose osteoarthritis?
No. Often medical imaging findings are poorly related to pain (as seen above, pain is multifactorial) and commonly show age-related changes which can be misleading.
Imaging may be requested by your health professional to rule out other causes of pain which may change your management/rehab plan.
Does it only affect elderly people?
No. Although OA appears more often in older age groups, recent research has found that those under 40 years old can also experience arthritic changes – especially if they have injured their joint earlier in life. Approximately half of those who have ruptured their ACL (a major ligament in the knee) will develop arthritic change within the first 10 years after injury – regardless of if they had surgical repair.
For treatment options for OA read HERE.
Photo by Dominika Roseclay from Pexels