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Osteoarthritis

Key points

  • Osteoarthritis can affect your joints and make them stiff and painful.
  • The exact reasons why you may develop osteoarthritis aren’t fully understood at present.
  • Osteoarthritis affects people differently – it may get worse over time or, on the other hand, it may ease.
  • There are many treatments and self-help measures that can ease your symptoms even though there isn't a cure for osteoarthritis.

Osteoarthritis is a condition that affects your joints, and makes them stiff and painful. It's sometimes called 'wear and tear’ arthritis. Osteoarthritis most often affects the joints in your body that carry weight, for example, your knees, hips, feet and spine. However, it can also affect your fingers, the base of your thumbs, elbows and shoulders, or potentially any other joint in your body.

Osteoarthritis is sometimes confused with osteoporosis (thinning of the bones) because the names are similar. However, they are different conditions.

About osteoarthritis

Osteoarthritis causes the cartilage on the end of your bones to get rougher and thinner. The bone underneath thickens and grows outwards, creating growths called osteophytes that can make your joint look knobbly. The capsule around the joint also thickens and tightens. Sometimes fluid builds up and your joint can look and feel swollen.

Illustration showing how the knee is affected by osteoarthritis

 

These changes to your joints can cause pain and stiffness and make it more difficult for you to get around, or do everyday tasks. Osteoarthritis can affect people in different ways. It may get worse over a short period of time and cause a lot of damage to your joints. This can have a significant impact on your day-to-day life. Or, you may find that your condition develops slowly over many years, causing small changes to your joints that don’t get any worse. They may even ease over time.

There are many treatments and self-help measures that can ease your symptoms even though there isn't a cure for osteoarthritis.

Osteoarthritis is the most common type of arthritis in the UK; it causes joint pain in around eight and a half million people. It’s more common over the age of 50, although it can develop in younger people too.

Symptoms of osteoarthritis

When osteoarthritis first develops, you may have some stiffness and pain in your joint. This might get worse when you move or put weight on it.

As your condition develops you may notice other symptoms. The main ones are listed below.

  • A deep, aching joint pain. Depending on which of your joints is affected, you may find this pain spreads. For example, if you have osteoarthritis in your hip, you may have pain down the side or front of your thigh and into your buttock. This is called radiated pain.
  • A reduction in your range of movement in the joint. This means you won’t be able to move your joint into the positions you did before, or move them as far.
  • A crunching and grinding sensation and noise in your joints when you move them. This is called crepitus.
  • A change in the shape of your joint, with hard bony growths and soft swelling caused by extra fluid.
  • Your joint may give way when you put weight on it. This can happen because your muscles have weakened or because your joint is less stable.

There may be times when your symptoms get worse. For example, when the weather is damp or when you have been more active than usual.

If you have any of these symptoms, see your GP.

Causes of osteoarthritis

The exact reasons why you may develop osteoarthritis aren’t fully understood at present. However, certain factors may increase your risk of developing the condition. You’re more likely to develop osteoarthritis if:

  • one of your parents has the condition
  • you’re over 50
  • you’re overweight or obese
  • you have previously injured or had an infection in your joint
  • you have another arthritic condition, such as rheumatoid arthritis or gout

Diagnosis of osteoarthritis

Your GP will ask about your symptoms and will ask to examine you. He or she may also ask you about your medical history.

There is no single test for osteoarthritis and an examination is often all that is needed to diagnose the condition. Your GP may look to see if you have any bony growths and swelling and any creaking in your joint. He or she might also check how well your joint moves and how stable it is.

Your GP may suggest you have an X-ray of your affected joint. An X-ray can help to show if the normal space in your joint is reduced because you have lost protective cartilage. It can also show if you have any extra bone growth around your joint or any roughening or thickening of the surface of your joint. Sometimes calcification of the cartilage can be seen on X-ray images. This is when calcium builds up in a joint, usually your knee. It’s more likely in older people who have osteoarthritis.

Treatment options for osteoarthritis

There are a number of treatments that can help you to manage osteoarthritis and control your symptoms. However, there is no cure for the condition.

Which treatments you’re offered will depend on your personal circumstances. Your doctor will discuss these with you to help you make a decision that’s right for you. Your decision will be based on your doctor’s expert opinion and your own personal values and preferences.

Self-help

There are many things you can do to reduce the pain and stiffness in your joints, and to make day-to-day life easier. Self-help measures can help to reduce the stress on your joints and reduce the severity of your condition. Some of the main ones are listed below.

  • Try to maintain a healthy weight for your height. This may mean losing excess weight because this can put more stress on your joints and make osteoarthritis worse.
  • Exercise regularly and keep moving. Exercise can help to keep your joints working well.
  • Pace yourself. For example, spread out any chores that need doing, rather than trying to do them all at once.
  • Use a walking stick to ease any stress on your knee or hip joint.
  • Wear shoes with a soft, thick, cushioned sole or use an insole. This will help to reduce any jarring.
  • Massage the muscles around your joint to help ease pain.
  • Use a heat pad or an ice pack to help relieve pain. Don’t put either of these directly onto your skin as they may damage it or even give you a burn. Wrap them in a towel or dishcloth first.
  • Think about making changes to your car, home or workplace to ease any stress on your joints. You may be able to get help from an occupational therapist. This is a health professional who can give practical assistance to help you manage with everyday tasks and increase your independence.
  • Use braces or supports to keep your joint stable and provide support. Ask your GP about these.

Exercise

Researchers have been looking into whether exercise classes supervised by a physiotherapist and information sessions have benefits for people with osteoarthritis in their hip. They compared this with people who just went to the information sessions. Their results showed that people who did the exercise sessions had less pain from their osteoarthritis than those who only received information. The people who did exercise were also able to move around more easily, and their condition progressed more slowly. This meant that they were less likely to need a hip replacement operation.

Ask your GP if there are exercise programmes in your area. They may be able to refer you or give you information about physiotherapists who are running them.

Medicines

Painkillers may help to ease your pain and stiffness, but they can’t make your condition better. Paracetamol may help for mild pain. You can also try non-steroidal anti-inflammatory (NSAID) creams and gels, such as ibuprofen and diclofenac. You can rub these directly onto your joint. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

If these medicines don’t work, your GP may suggest you take NSAIDs as tablets rather than as a cream or gel. He or she may also suggest a stronger type of painkiller called an opioid. If you’re taking NSAID tablets regularly, your GP may offer you a medicine called a proton pump inhibitor as well. This will protect your stomach and reduce the risk of side-effects from NSAIDs. Using NSAIDs for long periods is usually safe but it has been linked with heart, kidney and stomach problems.

Your GP may offer you a medicine called capsaicin cream to help ease your pain. Capsaicin cream is made from pepper plants and is an effective painkiller, particularly if you have hand or knee osteoarthritis. Side-effects are uncommon but can include a slight burning or itching sensation where you apply the cream.

If you have a particularly painful, swollen joint, your GP may suggest you have a steroid injection directly into your joint. This can only be done a few times each year, but can help to reduce inflammation and ease pain. The injection usually works within a few days, and can last for weeks or months. Although side-effects are unlikely, steroid injections may cause a temporary ‘flare up’ of your symptoms.

Non-surgical treatments

You may decide to try a type of pain relief called transcutaneous electrical nerve stimulation (TENS). This is an electronic device that sends pulses through your skin to your nerve endings. It interferes with the messages being sent to your brain and may help to relieve your pain. Some people with osteoarthritis find it useful, although it doesn’t work for everyone.

You can buy a TENS machine from your pharmacy. You could ask your physiotherapist if you can borrow one to trial before you decide to buy one.

Surgery

If you have severe pain from osteoarthritis or it has a significant impact on your life, your doctor may suggest you have surgery. Which type of surgery you’re offered will depend on your personal circumstances. This could be keyhole surgery or an operation to replace part, or the whole, of your affected joint with an artificial one. Your doctor will discuss these options with you to help you make a decision that’s right for you.

Surgery may help to ease your pain if other treatments haven’t been effective for you. As with every procedure, there are some risks associated with having surgery for osteoarthritis. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

Complementary therapies

Many people with osteoarthritis take supplements or use complementary medicines to ease their symptoms.

You might find that fish oils, such as cod liver oil, help to ease pain and stiffness. However, there is no strong evidence that they work for osteoarthritis.

Glucosamine and chondroitin are two of the most commonly used supplements for osteoarthritis. Current research suggests that they don’t work to reduce joint pain and they aren’t recommended as treatments for osteoarthritis. However, some people with osteoarthritis do see a benefit from taking them. If you decide to take glucosamine or chondroitin, it may take up to two months before you will know if they work for you.

There is little evidence that other therapies, such as acupuncture, are effective at treating osteoarthritis. However, acupuncture may help if you have osteoarthritis in your knee. Speak to your GP before you try a complementary therapy or herbal remedy.

Living with osteoarthritis

Living with osteoarthritis can be difficult and the more severe your condition is, the bigger the impact it’s likely to have on your life.

As with many long-term conditions that cause pain and discomfort, having osteoarthritis can affect your emotions and your relationships with those around you. It can also have an impact on your sleep, which may affect other areas of your life, or lead to depression. Talk to your GP about the impact the condition has on your day-to-day life and what can be done to help you. You may also find it helpful to contact support groups and talk to other people living with osteoarthritis.


Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, January 2014.

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For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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  • Publication date: January 2014

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