Aug
14
Category: Orthopedics & Musculoskeletal | Medical Specialist: Orthopedic surgeon; rheumatologist; physiatrist; physiotherapist depending on condition | References: American Academy of Orthopaedic Surgeons (AAOS); American College of Rheumatology (ACR); WHO Introduction: When Everyday Movement Starts to Hurt A staircase you once climbed without thinking can suddenly feel like a challenge. Getting out of a chair may take an extra moment. Even opening a jar or taking a morning walk can become uncomfortable. These seemingly small changes can be signs of Osteoarthritis, the most common form of arthritis. Osteoarthritis is often described as a condition caused by “wear and tear.” But that description is misleading. The disease is more complex: it involves changes to cartilage, bone, the joint lining, ligaments, tendons, and surrounding muscles. And it is remarkably common. The World Health Organization estimates that about 528 million people worldwide were living with Osteoarthritis in 2019. The knee is the most frequently affected joint, followed by the hip and hand. The encouraging part? Osteoarthritis does not automatically mean giving up an active life. With the right combination of exercise, weight management, pain control, rehabilitation, and—when necessary—surgery, many people can maintain meaningful mobility and independence. What Is Osteoarthritis? Osteoarthritis is a long-term joint condition in which the tissues forming and supporting a joint gradually change. Healthy cartilage provides a smooth, resilient surface that helps bones move against one another. With Osteoarthritis, cartilage can deteriorate, while the underlying bone and other joint tissues may also undergo structural changes. Bone spurs, known as osteophytes, can develop around the joint. Commonly affected areas include: Importantly, Osteoarthritis is not simply an inevitable part of getting older. Age increases risk, but younger adults can also develop it, particularly after joint injuries, repetitive stress, or because of inherited joint abnormalities. Osteoarthritis vs Other Types of Arthritis Not all arthritis behaves the same way. Understanding the difference can help explain why treatment varies from person to person. Feature Osteoarthritis Rheumatoid Arthritis Main mechanism Structural changes and breakdown of joint tissues Autoimmune inflammation Typical pattern Often affects knees, hips, hands and spine Often affects multiple joints symmetrically Morning stiffness Usually brief, often under 30 minutes Frequently longer-lasting Common symptoms Pain with activity, stiffness, reduced movement Pain, swelling, stiffness and systemic symptoms Treatment focus Exercise, rehabilitation, weight management, symptom control Disease-modifying medicines and inflammation control This distinction matters because persistent joint pain should not automatically be labelled as Osteoarthritis. Conditions such as rheumatoid arthritis, gout, infection, or injuries can produce similar symptoms and may require very different treatment. What Causes Osteoarthritis? There is rarely one single cause. Instead, Osteoarthritis develops through an interaction between factors affecting the joint itself and factors affecting the body as a whole. 1. Age The risk increases with age because joints undergo biological and structural changes over time. However, ageing alone does not guarantee Osteoarthritis. 2. Previous Joint Injury A fracture, ligament injury, meniscus injury, or significant trauma can increase the likelihood of developing Osteoarthritis in that joint later. This is one reason that an apparently “old” injury can remain relevant years after recovery. 3. Excess Body Weight Weight can increase mechanical stress on weight-bearing joints such as the knees and hips. But the relationship is more complicated than simple pressure: metabolic and inflammatory processes associated with excess body weight may also contribute. 4. Repetitive Joint Stress Certain occupations and sporting activities can expose particular joints to repetitive loads. The risk depends on the joint, intensity, duration, biomechanics, and individual susceptibility. 5. Genetics Some people inherit characteristics that make their joints more vulnerable to Osteoarthritis. 6. Abnormal Joint Structure A joint that develops differently from normal may experience unusual mechanical forces, increasing the risk of later damage. Symptoms of Osteoarthritis Osteoarthritis often develops gradually, so the earliest warning signs can be easy to dismiss. Common symptoms include: Morning stiffness is typically relatively brief. In contrast, prolonged morning stiffness can point toward other forms of arthritis and deserves medical assessment. Symptoms Depend on the Joint Knee Osteoarthritis:Pain may appear when climbing stairs, walking, standing for long periods, or getting up from a chair. Some people experience grinding or a feeling that the knee may buckle. Hip Osteoarthritis:Pain can occur in the groin, thigh, buttock, or sometimes the knee. Hip movement may gradually become restricted. Hand Osteoarthritis:Finger joints may become painful, stiff, enlarged, or visibly changed. Grip-intensive activities can become difficult. Spinal Osteoarthritis:Neck or lower-back stiffness and pain may develop. In some people, degenerative changes around the spine can contribute to nerve-related symptoms. How Is Osteoarthritis Diagnosed? There is no single blood test that confirms Osteoarthritis. Diagnosis generally involves a combination of: X-rays may show joint-space narrowing, bone changes, or bone spurs. MRI can provide more detailed information about soft tissues and may be useful in selected situations. Blood tests or joint-fluid analysis may be used when another diagnosis, such as gout or infection, needs to be considered. Interestingly, X-ray severity and pain severity do not always match. Someone can have significant-looking changes on an image but relatively little pain, while another person can experience substantial pain with less dramatic imaging findings. That is why treatment should focus on the person and their function, not simply the scan. Treatment: What Actually Helps? There is no single treatment that works for everyone. The best approach is usually a combination of strategies tailored to the affected joint, symptoms, lifestyle, and overall health. 1. Therapeutic Exercise Exercise is one of the cornerstones of Osteoarthritis management. It can improve: Options may include walking, cycling, swimming, water exercise, strength training, stretching, and other low-impact activities. One of the biggest misconceptions is that painful joints need prolonged rest. In reality, avoiding movement for too long can weaken supporting muscles and make daily activities harder. The goal is not to “push through” severe pain but to gradually build a sustainable level of activity. 2. Weight Management For people with excess weight, even modest weight reduction can improve function and reduce symptoms, particularly with knee and hip Osteoarthritis. NICE recommends combining weight management with therapeutic exercise