Osteoarthritis

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 also builds up and your joint can look and feel swollen.

These changes to your joints can cause pain and stiffness and make it more difficult for you to get around, or to do everyday tasks. Osteoarthritis can affect people in different ways. You may find that your osteoarthritis gets worse over a short period of time and causes a lot of damage to your joints, which significantly impacts 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, or even ease over time.

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

Osteoarthritis is the most common type of arthritis in the UK and may affect as many as eight out of 10 people over the age of 50. It’s more common in people over the age of 50, although it can develop in younger people.

Symptoms of osteoarthritis

When osteoarthritis first develops, you may have some stiffness and pain in your joint, which can get worse when you exercise or at the end of the day.

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 through 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 changes and becomes damp, or when you have been more active than usual.

Causes of osteoarthritis

The exact cause of osteoarthritis isn’t known. However, certain factors may increase your risk of developing the condition. You’re more likely to develop osteoarthritis if: 

  • you’re getting older – osteoarthritis is more common in people aged over 50
  • you’re overweight or obese
  • one of your parents has the condition
  • you have previously injured the joint
  • you have rheumatoid arthritis or gout

Diagnosis of osteoarthritis

There is no single test that can check for osteoarthritis. Your GP will ask about your symptoms and examine you. He or she may also ask about your medical history.

During the examination your GP will look for bony growths and swelling and any creaking in your joint. He or she will also check how well your joint moves and how stable it is.

Occasionally your GP may also arrange for you to have an X-ray of the affected joint. An X-ray can help to show whether the normal joint space is reduced because of a loss of the protective cartilage. It can also show if you have any extra bone growth around your joint or any roughening or thickening of the joint surface. Sometimes calcification of the cartilage can be seen (this is when calcium builds up in the joint). It can be a sign of a type of osteoarthritis that can quickly become severe and cause more severe pain from time to time.

Treatment of osteoarthritis

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

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 weight if you’re overweight because it puts more stress on your joints and can make osteoarthritis worse.
  • Exercise regularly and keep moving. Exercise can help to keep your joints working well but it’s important to rest your joints as well. Doing a little exercise regularly may be helpful.
  • 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. This will help to reduce any jarring.
  • Massage the muscles around your joints affected by osteoarthritis to help ease pain.
  • Use a heat pad or an ice pack to help ease pain. Don’t put either of these directly onto your skin as they may cause burns – 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 (a health professional who can give practical assistance to help you manage with everyday tasks and increase your independence).
  • Use braces or supports for your joints to keep your joint stable and provide support. Ask your GP about these.

Medicines

Painkillers can help to ease 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 (NSAIDs) creams and gels, such as ibuprofen and diclofenac. You can put these directly onto the joint affected by osteoarthritis. 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 taking NSAIDs as tablets rather than as a cream or gel. He or she may also suggest a stronger type of painkiller called opioids. If you’re taking NSAID tablets regularly, your GP may suggest taking a medicine called a proton pump inhibitor as well. This medicine protects your stomach and reduces the risk of side-effects from NSAIDs. Using NSAIDs for long periods has been linked with heart, kidney and stomach problems.

Capsaicin cream is made from pepper plants and is an effective painkiller, particularly if you have hand or knee osteoarthritis. It’s only available with a prescription.

If you have a particularly painful, swollen joint, your GP may suggest a steroid injection directly into the 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 or a week or so, and can last for weeks or months.

Non-surgical treatments

Transcutaneous electrical nerve stimulation (TENS) 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 can 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 may be able to loan one from your physiotherapist to try, before you decide to buy one.

Surgery

If you have osteoarthritis that causes severe pain, or which has a significant impact on your day to day life, your doctor may suggest an operation to replace the affected joint with an artificial one.

Complementary therapies

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

Fish oils, such as cod liver oil, may be helpful in easing pain and stiffness. You need to take fish oils for between three and six months to see any benefit.

Glucosamine and chondroitin are two of the most commonly used supplements. 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 get benefit from taking them. If you decide to take glucosamine or chondroitin you will need to take them for 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, they may make you feel more relaxed, which may help you to manage your osteoarthritis. Speak to your GP before trying complementary therapies or herbal remedies.

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 might be done to help you. You may also find it helpful to contact support groups and talk to other people living with osteoarthritis.

Video

See our videos about osteoarthritis, they include:

Should I exercise if I have arthritis?
What exercises can I do for arthritis in my hands, wrists and forearms?
What exercises can I do for arthritis in my shoulders?
What exercises can I do for arthritis in my back?
What exercises can I do for arthritis in my knees?
 

What can I do at home to make life easier?

Answer

Making changes to your home and car can help to protect your joints and reduce pain and stiffness. These include finding new ways to move or lift things and pacing yourself to reduce the stress on your joints.

Explanation

There are many things you can do at home and with your car, to make day to day tasks easier for you and reduce the stress on your joints. Making a few small changes can also help to protect your joints and prevent problems from becoming worse in the future. Some helpful tips are listed below.

  • Use labour saving gadgets and aids specially designed for people with arthritis. These include things like devices for turning on taps, kitchen utensils with padded handles and automatic can openers.
  • Rearrange your kitchen and other rooms to make sure the things you use most are easy to reach.
  • When you’re lifting things, try and reduce the weight of the item and spread the load across more than one joint, for example, lifting with two hands instead of one. If you can’t reduce the weight of an item, slide it rather than picking it up, for example slide heavy pans across the worktop.
  • Plan ahead and pace your day. Don’t do large jobs all at once. Instead split them into smaller jobs and do a little at a time. You may find it easier to leave larger jobs for the afternoons when you’re less stiff and sore.
  • Adapt your car to make driving easier. A padded steering wheel, extra side mirrors or a steering wheel knob may all help. If your osteoarthritis is more severe, consider an automatic rather than a manual car.

An occupational therapist can assess you in your home to see whether you may be eligible for financial help to make changes to your home. Your local social services department may also be able to help with equipment or with adapting your home. Some equipment may be available through the NHS but you may have to pay some costs yourself.

What type of exercise is best for osteoarthritis?

Answer

It's important to exercise regularly if you have osteoarthritis. Exercise can help to ease pain and stiffness and keeps your joints and muscles strong and flexible. You should follow a programme that includes exercises to strengthen your muscles and improve your range of movement, as well as aerobic exercise to improve your overall fitness.

Explanation

If you have osteoarthritis, exercise is very important. It helps to keep your muscles strong and your joints flexible and can help to ease pain and stiffness. Regular exercise won’t make your arthritis worse or damage your joints any further. Without regular exercise your muscles lose their strength and your joints will become stiffer, less flexible and more painful.

You can perform exercise at different intensities. Moderate means your breathing is faster, your heart rate is increased and you feel warmer. At this level of activity, your heart and lungs are being stimulated and this goes towards making you fitter. Vigorous intensity activity means that your breathing will be much stronger and your heart rate will increase rapidly. You will find it difficult to hold a conversation.

You should aim to do some physical activity every day. The recommended healthy level of physical activity is 150 minutes (two and a half hours) of moderate exercise over a week in bouts of 10 minutes or more. You can do this by carrying out 30 minutes on at least five days each week. Alternatively, you can do 75 minutes of vigorous intensity activity.

It’s important that you include at least two weekly activities to build up muscle strength, such as exercising with weights. Try to spend as little time as possible being inactive.

Swimming in a warm pool or using a hydrotherapy pool is particularly good for osteoarthritis. It can soothe your joints and ease stiffness. The water also supports your joints and muscles while you exercise.
Your physiotherapist can help you to create an individual exercise programme that works for you.

I have osteoarthritis in my hands. Will wearing splints help?

Answer

Wearing a splint on your hand, thumb or wrist can help to ease pain and stiffness and provides support for your joints. Resting splints can ease pain overnight and working splints can provide support and ease pain when you’re using your hands.

Explanation

Wearing a hand or wrist splint can help to reduce your pain and ease the strain on your joints. There are two main types of splint.

Resting splints can help if you have pain overnight, which is affecting your sleep. They support your hand, wrist and forearm. Resting splints are usually custom made to fit you. Your physiotherapist or occupational therapist can give you advice on how to get a splint made.

Working splints can help to reduce pain when you’re using your hands, for example when you’re driving or gardening. They are made of an elastic material, which provides you with more flexible support. Working splints come in a number of different types, for example those that specifically support your thumb or your wrist.

Compression gloves, sometimes called isotoner gloves, can also be helpful in reducing pain and swelling. Many people find these easier to wear than splints.

It’s important that you don’t wear your splint all the time as it can make your joints stiff. You also shouldn’t wear a working splint overnight unless your therapist has advised you to do this.