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Osteoarthritis (Degenerative Joint Disease)

Osteoarthritis (Degenerative Joint Disease) - What is it for

Initially it affects the joint cartilage, causing pain in the joints. The pain and stiffness in the joint can ultimately restrict movement. The pain tends to get worse towards the end of the day and with activity.

The primary cause of osteoarthritis is increased age and “wear and tear” of the joints. However, there is increasing research evidence that osteoarthritis may be more than just “wear and tear”.

Osteoarthritis can also arise as a side effect of other problems that put abnormal stress on the joints, such as obesity (from the joints having to carry that extra weight), abnormally shaped hips and knees (added stress is placed on these joints when a person moves), a previous fracture or injury involving the joint, or in the case of some sportsmen, repeated stress to the joint.

This conditions affects both men and women; where women have a higher rate of it. The rates increase sharply after one turns 50.

While osteoarthritis can affect any joint, it occurs more commonly at the knees, hips, spine, and hands. 

What does osteoarthritis do to the joints?

Our joints are normally covered with cartilage so that they can glide over each other smoothly. In Osteoarthritis, the joint cartilage steadily softens and disintegrates over time.

With the loss of this protective material, the exposed bones of the joint begin to grind against each other more easily and wear each other out, creating a painful sensation when weight is put on them, such as during walking or standing up. As the condition progresses, cysts, bony lumps and excess fluid may develop in the affected joint, giving rise to a swollen joint.

Osteoarthritis (Degenerative Joint Disease) - Symptoms

The first symptom of Osteoarthritis is a recurring pain in the affected joint(s) or muscles around the joint after a period of prolonged or strenuous use, such as after a long walk or exercise. The pain increases with continued use of the joint, but usually subsides after sufficient rest.

Mild stiffness usually sets in when the joints have been rested (“gelling”). Therefore, if you’ve been sitting still for some time, your hips and knees may feel stiff upon standing again.

In advanced Osteoarthritis where much of the cartilage or “protective lining” around the joints has disintegrated, it may cause an increased secretion of joint fluid, which tends to accumulate around the joint area leading to mild swelling of the joint.

Osteoarthritis (Degenerative Joint Disease) - How to prevent?

One cannot prevent ageing. One can however reduce the risk of developing osteoarthritis by maintaining a healthy weight, engaging in moderate exercise and eating a healthy and nutritious diet. Early diagnosis and treatment can
prevent further joint damage and deformity.

Osteoarthritis (Degenerative Joint Disease) - Causes and Risk Factors

Osteoarthritis is linked to age, obesity, sports injuries, hereditary (especially osteoarthritis of the hands) and may be associated with other forms of arthritis like rheumatoid arthritis and gout.

Osteoarthritis (Degenerative Joint Disease) - Diagnosis

If a patient exhibits symptoms of Osteoarthritis, the doctor can confirm the diagnosis by doing a physical examination and X-rays. The degenerative effects of Osteoarthritis on the bones of the joint will show up
clearly on the X-ray.

Sometimes, the patient may need to undergo additional tests:
  • Magnetic resonance imaging (MRI): may be used to get a better picture of the condition of the joint
  • Joint aspiration: may be carried out to obtain a sample of the fluid in the joint
  • Arthroscopy: a procedure in which the interior of the joint is visualised by using a special instrument

Osteoarthritis (Degenerative Joint Disease) - Treatments

As of today, osteoarthritis does not have a known cure. Research is still ongoing.

That being said, treatment at osteoarthritis centres aim to alleviate its symptoms, help patients regain lost muscle strength, or replace the affected areas.

a. Medication

Most medications treat only the symptoms of Osteoarthritis. Paracetamol (Panadol) can be prescribed for low level pain, while stronger drugs like non-steroidal anti-inflammatory drugs (NSAID) and COX-2 inhibitors may be
necessary for more severe pain. The effect of glucosamine and chondroitin is variable. Speak to your doctor first before you try these supplements. 

If movement becomes significantly affected, steroids or hyaluronic acid
preparation may be injected directly into the joint. The effect is usually temporary and cannot be used in the long-term as they can cause adverse side effects.

b. Physiotherapy

Physiotherapy is needed to build up the strength in the surrounding muscles so that they can hold up the joint better, lessening the stress and strain that is exerted on the joint. Exercises such as walking (with an aid, if necessary), swimming or cycling are recommended for most forms of arthritis.

c. Surgery

In advanced cases, surgery may be required to remove bone fragments, realign the joints, or even replace the joint with an artificial part. One example of such a treatment is total knee replacement surgery which treats osteoarthritis at the knee.

Osteoarthritis (Degenerative Joint Disease) - Preparing for surgery

Osteoarthritis (Degenerative Joint Disease) - Post-surgery care