Osteoarthritis

Osteoarthritis is the most common joint disease in Canada. It affects 1 out of 10 Canadian adults, and its prevalence increases with age. Find out how to prevent or limit wear and tear on your joints and ease the joint pain of osteoarthritis.

What is osteoarthritis?

Osteoarthritis refers to the gradual and permanent destruction of the cartilage that protects a joint. A joint is the point where two bones meet. The end of each bone is covered with cartilage, a flexible material that keeps the bones from rubbing against one another when the joint is in motion. The more the cartilage deteriorates, the more the joint becomes painful. Osteoarthritis can also lead to bone deterioration.

Osteoarthritis most often occurs in weight-bearing joints, such as the knees, hips and spine. The neck and the joints of the hands (including the finger joints) and big toes are also often affected. Osteoarthritis is generally limited to the affected joints and does not spread to the rest of the body.

The different types of osteoarthritis are named for the affected joint, e.g., cervical osteoarthritis (osteoarthritis of the neck), knee osteoarthritis, shoulder osteoarthritis.

What is the difference between arthritis and osteoarthritis?

The word arthritis means “joint inflammation.” This is an umbrella term for about one hundred joint problems. Contrary to popular belief, arthritis doesn’t just affect seniors but can strike people of all ages. It is estimated that 1 out of 6 Canadians aged 15 or over has  some type of arthritis.

Osteoarthritis is the most common type of arthritis and affects 1 out of 10 Canadian adults. Another common form of arthritis is rheumatoid arthritis.

What causes osteoarthritis?

We still don’t know the exact cause of osteoarthritis, but we do know some of the factors related to its development:

• Overweight, which exerts greater pressure on the joints and causes wear and tear on the cartilage.
• Damage to the joints from an injury or physical strain.
• A family history of osteoarthritis.
• Being female, as women get this condition more often than men.
• Age and normal wear and tear on the joints.

Osteoarthritis symptoms

Pain in the affected joint is the main symptom of osteoarthritis. This usually occurs during movement and disappears when the joint is at rest. The pain is caused by friction between bone surfaces. As osteoarthritis progresses, the pain may get more frequent and occur with less effort.

People with osteoarthritis may also feel stiffness and sensitivity in the affected joint. The typical stiffness of osteoarthritis usually occurs in the morning upon waking and lasts no more than 30 minutes. You can also feel stiffness after resting for a while.

You may hear cracking and get swelling in the joint.

Osteoarthritis treatment

Osteoarthritis can’t be cured, but treatment can alleviate pain and improve mobility in the joint to help you stay independent and maintain your quality of life. Starting treatment as quickly as possible after diagnosis is essential to maintain joint health as much as possible.

Lifestyle

• Achieving and maintaining a healthy weight prevents overtaxing and causing excess wear and tear on the joints. If you are overweight, losing a few kilos will help decrease the load on your joints and may ease your pain.
• Getting regular physical activity strengthens the muscles around the weakened joint and helps control pain. While convincing yourself to get moving when you're in pain may be hard, the benefits will no doubt motivate you to continue. Avoid overtaxing your joints. A health care professional (doctor, occupational therapist, physiotherapist or kinesiologist) can help create an activity program that is best for you.
• Eating a healthy and balanced diet will give your body the nutrients it needs to function. In combination with physical activity, a good diet will help you achieve and maintain a healthy weight.

Heat  and cold therapies

Applying hot or cold compresses to your painful joint can help decrease pain, swelling and stiffness. This treatment is safe and can be applied on a regular basis. Consult your pharmacist or your doctor to find out which types of compresses you should apply on your joint. To avoid chilblains, never put a cold compress directly on the skin.

Oral pain medications

Painkillers are the first choice for relieving osteoarthritis pain. Acetaminophen (Tylenol^TM) is the safest and most common type. You must follow the recommended dosage and not exceed the maximum daily dose. Ask your pharmacist for advice.

If acetaminophen no longer eases your pain, then you may want to consider taking anti-inflammatory drugs. There are 2 types: nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors (or coxibs) (Celebrex^TM). In addition to relieving pain, these drugs reduce inflammation. They must be taken with food because they are irritating to the stomach. However, they aren’t recommended for everyone. Consult your pharmacist or doctor to find out if you should try an anti-inflammatory and to choose the one that is best for you.

If NSAIDs or coxibs no longer relieve your pain, your doctor may then prescribe more powerful painkillers called opioids.

Topical medications

Capsaicin is a topical over-the-counter product that can be used when just a few joints are affected. It is applied locally on the painful joint. Topical diclofenac (Voltaren Emulgel^TM or Pennsaid^TM) can also be used topically on joints. Pennsaid^TM is only available with a prescription. Voltaren Emulgel^TM doesn’t require a prescription, but this medication must be listed in your record to ensure it doesn’t interact with any other medications you may be taking.

Natural health products

Glucosamine may help relieve the pain associated with osteoarthritis for some people. If you want to try this product, talk to your pharmacist or doctor first. You’ll need to use glucosamine for at least 3 months to see whether it’s effective. If you don't see any improvement after this time, you should stop taking this product.

Injections

Viscosifying agent (hyaluronan) injections in the joint are meant to replace destroyed cartilage, decrease pain, and increase joint mobility. Cortisone injections in the joint are also possible to try and reduce inflammation and pain.

Surgery

If your osteoarthritis is so severe that it leaves you debilitated, you may consider surgery to replace the weakened joint. According to The Arthritis Society, 8 out of 10 people who have had a hip replacement and 9 out of 10 people who have had a knee replacement are overweight. This is why it’s so important to achieve or maintain a healthy weight to avoid these invasive procedures.

Pain from osteoarthritis won’t kill you, but you do need to talk to your pharmacist or doctor right away about your different treatment options so that you don't suffer needlessly.

Resource:
The Arthritis Society