Osteoarthritis (OA) is the most common type of arthritis and causes joints to feel stiff and painful. It is more common in older people but can also affect younger people especially if there has been an injury to a joint. Sometimes OA causes the joints to become swollen and change shape, especially the finger joints, and sometimes the joints make creaking or cracking noises. The symptoms of osteoarthritis can vary a lot. Sometimes there is no pain and sometimes the joints can be very painful and moving them is difficult. There can be loss of muscle around the joints and this can make them feel weaker. Almost all joints can develop osteoarthritis but the most common places are the fingers, thumbs, knees and hips as well as the low back and neck.
What causes osteoarthritis?
Osteoarthritis used to be called “wear and tear” arthritis because it was thought that the joints gradually wore out with use and that this was inevitable as we get older. It is now known that osteoarthritis is much more complicated than this and that inside the affected joints there is quite a lot of healing and repair going on including the formation of new bone which can contribute to some of the pain and stiffness. Although the risk of osteoarthritis increases as we get older, osteoarthritis is not inevitable.
Inside a joint with osteoarthritis there is loss of cartilage which acts as a shock absorber and the formation of new bone which can cause the joints to look lumpy or become bent.
No-one knows exactly what causes osteoarthritis but it may be due to repeated small injuries that happen as part of daily life and which don’t heal completely. Osteoarthritis can also run in families and injuries such as a broken bone or sporting injury can lead to osteoarthritis later in life. Being overweight puts extra strain on the weight-bearing joints, especially the knees and hips and this can lead to more severe osteoarthritis.
Is osteoarthritis caused by too much exercise?
Osteoarthritis is not caused by too much exercise. Marathon runners are not more prone to osteoarthritis of the knees for example and if anything, exercise may help protect against osteoarthritis because strong muscles help to support the joints and people who exercise may be slimmer than those who don’t and keeping to a healthy weight can also help protect the joints from osteoarthritis.
What joints are affected by osteoarthritis?
Osteoarthritis is most common in the ends of the fingers, the thumbs, the hips, knees, neck and low back.
What are the symptoms of osteoarthritis?
Sometimes osteoarthritis causes no pain at all but the most common symptoms are:
Joint stiffness, especially in the morning and lasting for less than 30 minutes
- Joint pain, especially on movement and after exercise, for example knee pain when walking upstairs, thumb or wrist pain after gardening
- Joint tenderness
- Loss of movement in the joint
- Bony swelling around the edges of the joints, especially in the fingers
- A creaking or grating noise coming from the joints
- Loss of muscle around the joint and a feeling of weakness for example difficulty gripping
Most people with osteoarthritis find that they have good days and bad days and sometimes the pain goes away completely.
How is osteoarthritis diagnosed?
Osteoarthritis is likely if:
- You are over 45
- You have pain and stiffness in one or more of the joints commonly affected by osteoarthritis
- The stiffness in the morning lasts for no more than 30 minutes
- The stiffness and pain are worse with exercise or using the joints
Often no special tests are needed to diagnose osteoarthritis, but sometimes blood tests may be taken to make sure that nothing else is wrong and sometimes X-rays can help confirm the diagnosis. Sometimes MRI scans are used but these are usually not necessary. X-rays of the neck and low back are not very useful in osteoarthritis because they often show changes with age and many people with these changes have no pain.
What can I do to help myself?
There is nothing that you can do to completely prevent osteoarthritis but there are lots of things that you can do to reduce your risk of developing osteoarthritis and to reduce pain and improve function if you already have osteoarthritis.
- Try to keep to a healthy weight – For every pound that you are above a healthy weight, an extra 4 or 5 pounds of weight goes through your hips knees and feet and this can increase the pain. Reducing weight can help a lot with pain.
- Keep your muscles strong and do some exercise – Exercise that increases muscle strength can really help support the joints and reduce the pain of osteoarthritis. Exercise can also help your joints because it can help with weight loss, improve posture and flexibility and reduce stress. You should try to balance active (aerobic) exercise with increasing strength (resistance) exercise plus work on flexibility (stretching) to get the best results.
- Keep to a healthy diet – Eating healthily can help maintain muscle and bone strength and help you keep to a healthy weight.
- Self-management – Self-management is about taking control of your symptoms and lifestyle in order to live a better life with less pain and improved function.