Creaky Joints - All about Osteoarthritis
Osteoarthritis is the most common arthritis in the UK and is often called "wear and tear". Generally symptoms appear after the age of 45 and are more likely to occur in women. Symptoms can vary a lot between people and even between the different joints in the body. Neck pain and back pain can be a result of OA in the spine, but any joint can be affected. OA occurs most commonly in the joints of the hands, knees and hips.
Osteoarthritis (OA for short) is a condition that causes joint pain, stiffness and swelling. Sometimes movement of the affected joint makes a grinding cracking sound. Muscles around the affected joint are used less so they demand less blood supply, get inflamed and may become weaker and smaller.
Osteoarthritis is the degeneration or break down of the cartilage that coats the bones inside of a joint capsule and the inflammatory response of the body to attempt repair. Without a nice plump layer of protective cartilage, movement of a joint can become painful, and feel swollen and stiff. In an attempt to stabilise and protect itself, the bone may develop bony growths, causing further irritation and pain to the joint. As the symptoms of pain and stiffness are partly caused by the inflammatory response, it is more accurate to call OA "wear, tear and repair"
We do not know the precise cause of cartilage break-down, but there are some known risk factors, including particular lifestyle choices or events that contribute to the development of this degeneration of cartilage and the resulting inflammation as the body tries to overcompensate in its repair.
The known risk factors include:
Injuring a joint – a sprained or fractured joint in youth can be prone to osteoarthritis as we age. Overusing a joint before it has healed from a surgical procedure or infection can precede osteoarthritis.
Age – as we age the likelihood of developing osteoarthritis increases.
Family history – no single gene has been identified but we do know that osteoarthritis runs in families.
Weight – being overweight strains your entire body including your joints. Excess weight puts excess strain on your joints.
Gender – women are more likely to develop osteoarthritis than men.
How to best live with OA?
An arthritic joint does not always look painful and the creaks and crackling you can hear are usually only loud enough for you to hear. Without an external “wound” to show, some may feel isolated and lonely in their experience. Others may be glad of this as it enables them to maintain their strong persona. Regardless of where you may feel you fit on that spectrum ranging from stiff upper lip “soldier” through to the sensitive “sharer” you may want some tips on how to incorporate some lifestyle changes to improve symptom management.
Aviva Osteopathy's three top tips to living with Osteoarthritis:
Stay active and maintain a healthy weight! This may seem obvious, but it is overlooked by many. While this will not directly treat OA, it will slow the onset and put you in the best place physically and mentally to deal with any symptoms.
Educate yourself. Read up on Osteoarthritis, read about other people’s experience of the condition. Ask your osteopath and other healthcare providers questions, no matter how silly or embarrassing they seem. The more you know about the condition the less you will fear it, thus reducing pain by regaining control through knowledge.
See your osteopath – OA flares up now and again and the stiffness and pain may prevent you from moving the affected joint, which causes the surrounding muscles to stiffen and become even more painful! Your osteopath will work through these muscles and gently mobilise the sore joint to allow the inflammation a better chance to drain away into your lymphatic system. A joint with OA loses the space between the bones. This approximation of the bones is one of the sources of pain. Osteopaths are excellent at very gently pulling the bones away from each other (traction), providing a lovely feeling of relief. Your osteopath can also give you good advice on the most appropriate exercise to keep you, your muscles and your joints healthy.
Should you seek medication and other interventions?
On the topic of medical intervention, there are some commonly prescribed and over-the-counter medications: NSAIDs, paracetamol, voltarol are the common choices. It is always best to talk to your pharmacist or GP first if you feel that you may benefit from medication. In my experience, if it is safe, effective, and the benefits outweigh the risks, then give it a go!
Invasive treatments that some rheumatologists will suggest include joint injections of either hyaluronic acid or steroids (WD40 anyone?!) and finally joint replacement surgery can in some cases be relevant. When considering a more invasive intervention always make sure that the procedure, its side effects, limitations, and possible complications have been explained to you. Do the benefits outweigh the risks? Get a second opinion if you aren’t confident. Your body, your choice.
Any questions? Did I miss something that you really want to know about Osteoarthritis / “wear and tear”? Get in touch, I am always happy to chat.