Everything you need to know about osteoarthritis

The word arthritis means inflammation of the joints, and there are more than 100 different forms of arthritis and related diseases. One of the most common types is osteoarthritis (OA), which is mainly associated with older people. It occurs throughout the world, and the disease affects people differently, with joint damage developing over years or in some cases more quickly.

8 Questions about OA answered

1. What exactly is OA?

OA is a degenerative form of arthritis that most often affects middle-age to elderly people. Younger people can, however, also get osteoarthritis, primarily from joint injuries.

OA is characterised by:

• breakdown of the cartilage (the tissue that cushions the ends of the bones between joints),
• bony changes of the joints,
• deterioration of tendons and ligaments, and
• various degrees of inflammation of the joint lining (called the synovium).

2. What are the different types of OA?

Osteoarthritis is quite varied. There are many different types, affecting different joints, including:

• Knees
• Hips
• Hands
• Spine
• Big toes

3. What are the differences between OA and other forms of arthritis such as rheumatoid arthritis (RA) and gout?

The main distinguishing features are the distribution of the joints affected and the nature of the pain. In OA the pain is typically made worse by activity, whereas in RA the pain is relieved by activity.

In OA, the hands are involved but it generally spares the wrist and elbows, whereas with RA the joint involvement is often more widespread and the associated morning stiffness is often more prolonged.

In gout the onset is characteristically more acute and isn’t an uncommon cause of a single, very painful and swollen joint.

4. What causes osteoarthritis?

OA has no specific cause and usually happens gradually over time. Some risk factors that might lead to the development of OA include:

• Being overweight
• Getting older 
• Joint injury
• Joints that aren’t properly formed
• A genetic defect in joint cartilage
• Stresses on the joints from certain jobs and playing sports

5. What are the warning signs and symptoms of OA?

OA can occur in any joint. It tends to creep up on you, gradually increasing over months or years. Stiff and painful joints are the most common symptoms, however other warning signs of OA are:

• Pain that’s worse after activity or toward the end of the day.
• Limited range of motion or stiffness that goes away after movement.
• Swelling or tenderness in 1 or more joints.
• A crunching feeling or the sound of bone rubbing on bone.

6. How is osteoarthritis diagnosed?

Rheumatologists are doctors who are experts in diagnosing and treating arthritis and other diseases of the joints, muscles and bones. Doctors detect OA based on the typical symptoms and on results of the physical exam.

In some cases, X-rays or other imaging tests may be useful to tell the extent of disease or to help rule out other joint problems.

7. What are the treatment options?

There’s no cure for osteoarthritis, but there are steps you can take to manage the disease. Treatment focuses on pain relief and giving the patient improved joint function. Some tips include:

• Properly position and support your neck and back while sitting or sleeping.
• Adjust furniture, such as raising a chair or toilet seat.
• Avoid repeated motions of the joint, especially frequent bending.
• Lose weight if you’re overweight or obese. This can reduce pain and slow progression of OA.
• Exercise every day.
• Use adaptive devices that will help you do daily activities.

8. When do I need to see a doctor?

Consult your doctor if:

• A joint is becoming increasingly painful and swollen.
• You experience sudden extreme pain or immobility in a joint.
• You’ve experienced pain and swelling in your knee(s) and it has started to give way with movement, particularly when going up and down stairs.
• You know that you’ve osteoarthritis of your weight-bearing joints, are overweight and would like some advice on weight loss and exercise.
• You’re no longer able to cope and suspect you need replacement surgery.

Osteoarthritis video

More information

• National Osteoporosis Foundation of South Africa - NOFSA
• South African Arthritis and Rheumatism Association