Osteoarthritis is a disease which affects joints (this includes bone, cartilage, ligaments and muscles)
It is caused by an imbalance between repair and damage to the joint. The process involves a cycle of damage, flare and then repair. This will eventually leave a pain-free but structurally altered joint. Sometimes, if there is overwhelming damage, the repair process is unable to compensate fully leading to tissue damage, loss of function and pain.
The main risk factors we can change are things like being overweight, weak muscles in the thighs, playing impact sports and avoiding knee injuries. Osteoarthritis can be associated with types of work and hip osteoarthritis is a recognised industrial disease in farmers.
For overweight patients, a 5% loss in body weight can reduce the chance of osteoarthritis developing three-fold over the following 6 years.
The most important interventions for patients with osteoarthritis are:
2. Information (how to exercise, how to lose weight, how effective are treatments)
3. Weight loss
Pain medication can be used to help support the core treatments of exercise and weight loss, although there are limitations as to the effectiveness of these and also potential side effects. Recommended medications are:
1. Paracetamol (7 people need to take this for 1 to benefit)
2. Anti-inflammatory gels (2 people need to take this for 1 to benefit)
3. Anti-inflammatory tablets (there are concerns about heart and kidney effects if these are used in certain people or for prolonged durations)
Other supportive treatments include cortisone injections (5-8 people need to try this treatment for 1 to benefit).
Joint replacement surgery can be considered if there is prolonged and established functional limitation and pain. Surgery has risks of failure, infection, anaesthetic and blood clots and requires careful consideration. Keyhole surgery to joints is no longer routinely recommended.
Some helpful links are included below:
This is an excellent patient information book that is free to download
Versus Arthritis produces good patient leaflets on exercises
Escape Pain also delivers self-management exercise programmes to patients with chronic pain conditions
The NHS fitness studio has lots of options for patients who want to exercise at home:
Information to support patients with pacing and grading activity