Osteoarthritis

Osteoarthritis is a common ailment in the elderly. It is a degenerative joint disease that is the most prevalent form of arthritis affecting the joint cartilage. It causes stiffness and pain, worsening as the level of activity progresses through the day. Osteoarthritis can be described as a disorder of cartilage metabolism, where patients are more prone to cartilage degradation. This is accelerated if they have previous joint injury, joint inflammation or increased weight loading if they are obese. In advanced cases, one can think of the condition as “joint failure” as in any other organ failure.

Who gets it?

It also typically affects overweight people; the excess weight increases stress on weight-bearing joints such as the knees, hips and lower back. It doesn’t mean that osteoarthritis is exclusive to the elderly and overweight though; there are also variants such as primary or generalised osteoarthritis that are familial and start in the hand joints. In these patients, weight loading does not seem to be a major factor.

How is it diagnosis?

There are no definitive tests to diagnose osteoarthritis. It usually begins with a physical examination and medical history, after which the following tests may be ordered to confirm the initial diagnosis:

X-Ray/MRI: Both methods will be able to show the extent of damage to the cartilage, with the latter being able to point out early abnormalities.

Joint aspiration: Fluids are drawn from the affected areas, and tested for signs of joint degeneration. This helps to rule out other forms of arthritis.

How can it be treated?

Where pharmacological therapy is concerned, there are three groups of treatments:

Painkillers

The most appropriate medication for pain relief in a patient with osteoarthritis is paracetamol.

Viscosupplementation 

This involves direct injection of hyaluronic acid compounds to increase the viscosity of the cartilage. This works better in patients with milder osteoarthritis, and there is symptom relief for up to a year. It is best reserved for patients who need daily symptom relieving drugs. These patients may do well with other measures too, such as weight management and exercise.

Surgery

More severely affected patients (such as those with badly swollen joints that significantly affect movement) may require surgery.

How can osteoarthritis be prevented?

• Weight management is important when the weight bearing joints are affected
• Exercise: While exertion triggers pain in osteoarthritis, simple exercises can alleviate the symptoms. Light activities such as stretching help to maintain, improve joint flexibility, strengthens the muscles around the affected joints, and are very useful in improving joint function.
• Use of appropriate footwear and walking aids when exercising can also make a difference.