Osteoarthritis

What is osteoarthritis?

Osteoarthritis is a common condition that affects joints of the body. It causes structural changes within a joint or multiple joints, resulting in pain and loss of function. Osteoarthritis is associated with a number of factors, including genetic, mechanical, hormonal and inflammatory factors. It is not just a disease of aging or an ‘older persons’ disease.

There is a high variability in the level of pain that an individual with osteoarthritis experiences, and it does not often correlate with the degree of change in the joints, such as those seen on x-rays.

Symptoms of osteoarthritis

The symptoms of osteoarthritis can vary from one person to the next and change within the same person over time. Some of the common symptoms include:

• stiffness
• pain associated with movement
• joint swelling
• muscle weakness
• joint instability
• reduced range of movement
• sounds within the joints.

Joints affected by osteoarthritis

Any joint in the body can be affected by osteoarthritis. Most commonly, it is the larger weight-bearing joints, such as knees and hips, that are most affected.

Risk factors for osteoarthritis

Evidence suggests that risk factors for osteoarthritis include:

• being overweight or obese
• a previous significant injury to the joint
• increasing age
• repetitive movements associated with an occupation
• genetics – the genes you inherit can play a role in the development of osteoarthritis
• gender – women are more likely than men to develop osteoarthritis

Diagnosis of osteoarthritis

If you are experiencing joint pain, it is important to see your health professional for a diagnosis and development of a management plan. Many different conditions can cause joint pain and they require different treatments.

Plain x-rays are sometimes used to confirm the diagnosis of osteoarthritis or to assist with planning interventions, such as surgery. A magnetic resonance imaging (MRI) is rarely required.

Management of osteoarthritis

If you have osteoarthritis it is important that your condition is monitored by a health professional, and that they create an osteoarthritis management plan for you. In most cases a management plan that focuses on non-surgical and non-pharmacological care is best. It is critical that the management plan supports you to take an active role.

It is also important that you have an understanding of osteoarthritis and how to manage it appropriately. This involves being informed about:

• your condition – including information about interventions that have been shown not to work and those for which there is no clear evidence for effectiveness
• living with and managing osteoarthritis
• managing pain
• pain-relieving medication
• how to adopt a healthy lifestyle – it is important that you maintain general fitness levels, reduce sedentary life style habits, manage stress, and eat healthily
• the importance of managing your weight – people who are overweight or obese are strongly encouraged to lose weight, and should be supported in doing so
• exercises or physical activity that will be of specific help to you.

Managing osteoarthritis pain

If you have osteoarthritis it is important to know about how to manage your pain, including how to pace and plan your daily activities.

Some people may have a specific pain management plan created for them, or they may be referred to a pain management clinic.

Talk to your health care professional about pain-relieving medication, including the benefits and potential risks. There are different medications that are available depending on your symptoms and other medical conditions.

Use of pain-relieving medication to manage osteoarthritis focuses on improving symptoms, not changing the disease process itself.

It is important to note that pain associated with osteoarthritis may change over time, which will influence what medication is required. Opiate-based medications are generally not recommended in the management of osteoarthritis.

Exercise for osteoarthritis

Exercise is an important and effective part of any osteoarthritis management plan. It can help to reduce your pain and increase your level of mobility.

A health professional such as an exercise physiologist or physiotherapist can provide you with an individualised exercise program that is tailored to your needs.

Appropriate exercise for osteoarthritis includes strength training, stretching, aerobic and balance programs. Such programs can be undertaken at home or as part of a group, and depending upon your preference you can do them on land or in water.

If any exercises feel uncomfortable, talk to the healthcare professional who is managing your program to make sure you are doing them properly and that they are appropriate for you. The aim is to start with what is achievable for you, and build up your program slowly over time.

Surgery for osteoarthritis

In most cases of osteoarthritis surgery is not required. However, if you have tried all non-surgical treatments options without success, and you are still experiencing significant pain and loss of function, then surgery may be an option.

The most common surgery for osteoarthritis is a total joint replacement. When considering surgery you should be informed about what it involves, the rehabilitation process, its likely benefits and any potential risks. Arthroscopy is not recommended for people with osteoarthritis.

Where to get help

• Your GP (doctor)
• Physiotherapist, or other allied health professional
• Musculoskeletal Health Australia National Helpline Tel. 1800 263 265 or email helpline@muscha.org.