Are your joints so painfully stiff and weak that they can barely support you?
Osteoarthritis is the most common type of arthritis, it develops gradually over time, causing joints to become stiff and painful. It can affect any joint but commonly affects the hands, knees, hips, feet and spine.
Osteoarthritis is more common among women and people aged over 40. It’s a major cause of disability and reduction in quality of life in Singapore. Many people think that osteoarthritis keeps on getting worse, causing increasing permanent pain and disability, but this often isn’t the case. Instead, it’s likely that your osteoarthritis will settle down over time as your body repairs itself. However, sometimes the damage is too severe to repair and leads to stiffness and pain, especially in the hip and the knee.
There are many treatments and self-help measures that can ease your symptoms.
You can think of osteoarthritis as a ‘wear and tear’ disease. It causes the cartilage on the end of your bones to get rougher and thinner. The bone underneath makes up for this by thickening and growing outwards, creating outgrowths (osteophytes) that can make your joint appear knobbly. The capsule around the joint also thickens and becomes inflamed.
Symptoms of osteoarthritis
If you have osteoarthritis, your joints will be stiff and painful, and may be swollen. The pain may be worse after exercise. You may find you can’t move the joint as much or as easily as before. It may make creaking sounds called crepitations.
Sometimes pain and stiffness can be more severe in the early stages, especially in women who develop osteoarthritis around the time of the menopause. It tends to settle down over the next few years.
If you have severe or advanced osteoarthritis, it’s possible that you will feel pain all the time, even at night and when you’re resting.
More specific symptoms for different joints include the following.
- Hand – the base of your thumb and the joints at the end of your fingers are affected, resulting in firm, knobbly swellings on the back of these joints known as Heberden’s nodes.
- Neck and back (spondylosis) – the discs of cartilage between the bones in your back (vertebrae) become thinner, causing the spaces to narrow. Outgrowths form at the edges of your vertebrae and joints, causing pain and numbness to travel down your arm.
- Feet – osteoarthritis generally affects the joint at the base of your big toe making it stiff – leading to difficulty walking – or bent, which may cause painful bunions.
- Knee – you will probably have pain at the front and sides of your knee. If your osteoarthritis is severe, your knees may become bent and bowed.
- Hip – you’re likely to have pain mainly in the front of your groin, but sometimes around the side and front of your thigh, buttock or down to your knee. If it’s severe, your affected leg may become shorter.
Causes of osteoarthritis
The exact reasons why you develop osteoarthritis aren’t fully understood. However, certain things that may increase your risk include:
- being over 40
- being a woman
- being overweight or obese
- someone else in your family having the condition
- playing sport professionally and injuring your joints
- having an injury or an operation on a joint for any other reason
- having rheumatoid arthritis – you may develop secondary osteoarthritis
Diagnosis of osteoarthritis
There’s no single test that can check for osteoarthritis, so our doctor will ask about your symptoms and examine you. He may also ask about your medical history. Our doctor will look for bony outgrowths, swelling, creaking, instability and reduced movement of your joint, and ask if the joint is stiff for longer than half an hour in the morning.
Treatment of osteoarthritis
Conservative treatment for osteoarthritis:
- Oral Medication
- Lubricant injection given directly into the affected area
- Anti-inflammatory injection
- Platelet Rich Plasma injection
If you have severe osteoarthritis, there are a number of different types of surgery that you may be able to have. These include the following.
- Microfracture surgery uses a drill or pick to make holes in the bone surfaces to encourage new cartilage to grow.
- If your knee locks or gives way, a knee arthroscopy can clear away debris in it that causes this. The operation is done using keyhole surgery.
- Hip resurfacing replaces the damaged surfaces in your hip joint with artificial ones.
- Hip or knee replacements have high rates of success in improving mobility and reducing pain.
- Realignment or osteotomy changes the position of the bones in your knee joint.
- Trapeziectomy is thumb surgery to remove a small bone and create more space so the bone surfaces don’t rub together.
- Foot surgery can correct the positions of these joints.
- Wrist surgery includes stiffening or fusion, and less commonly joint replacement.
- Chondrocyte or cartilage transplants involve growing new, healthy cartilage cells and transplanting them into people who have osteoarthritis. However, this technique is only in the early stages of being developed.