The most common joint disease Osteoarthritis

By Ranali Perera-2017-08-28

Osteoarthritis is the most common joint disorder affecting people. It is a chronic disease affecting mainly the weight-bearing joints such as the knees, hips and the spine. In osteoarthritis, the cartilage within the joints get destroyed over time leading to pain and stiffness of joints.

Osteoarthritis is mainly seen in older people. However, it can occur in younger individuals who have had joint injuries, have a history of joint overuse, or have other disease conditions affecting the joint cartilage. It affects women more than men, especially after the age of 50.

While the most common joints affected are the ones mentioned above, the joints in the hands and fingers and the big toe can be affected too.

Osteoarthritis is a debilitating condition that affects the day to day activities of those affected.
How is Osteoarthritis caused?

Earlier, osteoarthritis was considered as a degenerative condition which occurs as one ages due to increased wear and tear of joints. However, now, an inflammatory basis has been identified behind the development of osteoarthritis.

A joint is a junction between two bony structures. The bones are covered by a cartilage which facilitate friction-free smooth movement of the bones and help in shock absorption. In synovial joints, the joints are further bathed in a fluid, called the synovial fluid.

When the cartilage is damaged and slowly destroyed, over time, the two bony structures come into contact with each other. This loss of cartilage, and apposition of the bones, leads to all the symptoms associated with osteoarthritis.

What risk factors can lead to Osteoarthritis?

=Age is one of the biggest risk factors for osteoarthritis.
= Female gender (especially after menopause).
= Certain genes have been found to be associated with this condition.

= Obesity and being overweight can lead to an increased risk of getting osteoarthritis as there is an increased burden on the joint, leading to faster erosion of the cartilage. Increased fat content also renders the body more susceptible to inflammation.

= Joint injuries that would damage the cartilage and precipitate osteoarthritis.
= Disease conditions like diabetes mellitus, hormonal abnormalities (Growth hormone increase), rheumatoid arthritis, gout (increased deposition of uric acid crystals within joints) and a condition called haemochromatosis (where the body has an excess of iron, leading to increased deposition of iron within joints).

= Disease conditions affecting proper synthesis of cartilage or other joint abnormalities present since birth or childhood that would increase the likelihood of getting. osteoarthritis later on in life.
= Occupations that involve the overuse of joints, heavy lifting etc.
= Weakness of thigh muscles, leading to altered movement of joints.

What are the associated symptoms?

= Joint pain which increases towards the end of the day or with increased use of the joint.

= Joint stiffness early morning (lasting less than half an hour) or after prolonged periods of inactivity.
= Swelling of the joint.

= Limited range of motion of the joint.

= Cracking sound with movement of the joint.

What are the treatment options available?

The treatment is based on alleviation of symptoms and improvement of the joint function.
This condition does not have a cure, and the damage cannot be reversed. However, with proper treatment, the symptoms can be reduced and the debilitating effects minimized.

Physical activity and exercise:

Every adult is recommended to do at least 30 minutes of moderate intensity activities daily. These include walking, swimming and cycling amongst others. Stretching exercises are also recommended to prevent joint stiffness (eg: doing yoga is helpful in this context). Strengthening the muscles surrounding the affected joints would reduce the burden on that joint during movement.

= Weight reduction:

Reducing the weight helps to reduce the burden on weight-bearing joints like the knee, hip and spine.
= Physical and occupational therapy:

These include the use of assistive devices like canes and clutches, orthotics, use of heat or cold therapy to prevent joint stiffness and to reduce joint pain and the use of custom-made devices to cater to each individual and the affected joint.

= Alternative medicine:

Use of complementary medicines such as acupuncture, homeopathy, nutritional supplements and hydrotherapy (water therapy)

= Pharmacological treatment:

Paracetamol and other pain relieving drugs and NSAIDs (non-steroidal anti-inflammatory drugs such as ibuprofen, aspirin) for the treatment of pain, corticosteroids taken orally or injected into the joint for the treatment of inflammation and hyaluronic acid injections into the joint to replace the loss of fluid within a joint are the common treatment options. Glycosaminoglycans are taken by some to alleviate the symptoms but their efficacy with regard to this condition is not sufficiently proven yet.
= Surgery:

If the other treatment modalities alone do not reduce the pain or if the joint function is significantly impaired, surgery can be performed. Joint replacement can be done in the knee and hip successfully. Another surgical option is joint fusion.

How can we prevent Osteoarthritis?

Prevention is largely based on reducing the number of risk factors for the condition. Ensuring one leads a good lifestyle, with proper exercise and diet to maintain an ideal body weight can decrease the risk for this condition by many folds and prevent its onset or at least delay it.

What is the difference between Rheumatoid arthritis and Osteoarthritis?

Rheumatoid arthritis is an autoimmune condition whereas osteoarthritis is considered a degenerative one resulting due to wear and tear or excessive use.

Autoimmune conditions are disorders where the body's immune system attacks the healthy tissue of the body. Therefore, in rheumatoid arthritis, other organs are affected as well, whereas in osteoarthritis the condition is limited to the joints. Fatigue and fever are symptoms seen in rheumatoid arthritis.


In rheumatoid arthritis, the disease condition presents itself with the involvement of small joints (in the hands and feet) and typically in a symmetrical manner, affecting both limbs. In osteoarthritis, the condition affects weight bearing joints like the knees and hips and a symmetric picture is not evident. Osteoarthritis also affects the small joints of the hand, but the most common sites are the knees and hips.