Osteoarthritis

Osteoarthritis is the most common chronic (long-lasting) joint condition. A joint is where two bones come together. A protective tissue (cartilage) covers the end of your bones to prevent the bone from wearing out. With osteoarthritis, this cartilage breaks down, causing the bones within the joint to rub together. As a result, this can cause pain, stiffness, bone reshaping and other symptoms.

The effects of this disease on joints cannot be reversed when the disease progresses, it is important to identify it early and begin treatment. Most patients who are treated with early disease have a higher chance of limiting bone changes.

Osteoarthritis symptoms often develop slowly and worsen over time. They include:

• Joints that are affected will be painful during and/or after movement.
• The inflammation process will also lead to swelling and tender joints. This leads to Stiffness, most noticeable immediately after waking or after sitting without movement for a while.
• You will hear some cracking or popping sounds when moving. Joints may also lose their flexibility and not be able to move as usual.
• The inflammation in the joints will form extra bits of bone that can be felt around the affected joint.
• Some patients may also have rounded finger ends that appear like clubs, commonly called clubbing of the fingers or nails. It is common in advanced disease and in the elderly.

Osteoarthritis occurs when the damage (wear and tear) in the cartilage that cushions the end of your bones break down faster than it is being repaired. This can be caused by ageing, infection, swelling and other conditions. The damage often extends to the bone ends themselves; they change shape and may break easily.

Factors that can increase your risk of osteoarthritis include:

• The risk of osteoarthritis increases with age but more significantly from the age of 50 years.
• More women than men are more likely to develop osteoarthritis.
• Being overweight can increase your likelihood of developing osteoarthritis and can worsen the outcome.
• Joint injuries from work or sports can worsen the pain and slow recovery from osteoarthritis.
• In people born with defective cartilage or those with connective tissue disorders, osteoarthritis can be more severe.
• Genes also play a role, as primary relatives of people with arthritis will likely develop it.
• People suffering from inflammatory diseases, like diabetes and a condition in which your body has too much iron (hemochromatosis), are at more risk than other patients.

If you have joint pain, swelling or stiffness that doesn't go away, make an appointment with your healthcare provider. An early diagnosis and treatment will usually produce the best outcomes.

You may be able to delay the condition by remaining physically active, losing excess weight and treating any underlying chronic condition. If you prevent knee injury, you may be able to delay knee osteoarthritis.

If an infection causes your condition, you will require treatment and support to move around to prevent injury to your bones.

While no treatment can reverse the damage by osteoarthritis, some can help relieve symptoms and maintain mobility in the affected joints.

Interventions include exercise, manual therapy, lifestyle modification, and medication.

Self-care tips

They include:

• Support your joints during exercise or work that impacts your knees a lot. You can wear athletic knee supports and shoes that reduce the impact on your knees.
• Ensuring that you remain within recommended weight for your age, sex or activity level can help.
• Eat a range of healthy foods, with a focus on fresh vegetables and fruits. These can help with micro-nutrients that reduce inflammation and improve joint support.
• Get enough rest. Give your body ample opportunities to rest and to sleep.

Treatment

• Most healthcare providers will recommend pain relievers that can be used long-term with little to no side effects (e.g. paracetamol). Stronger pain relievers may be used when there is a flare-up of pain, but you should not use them long-term due to side effects. Your healthcare provider may also include some medicines used as antidepressants to reduce how you perceive the pain (e.g. amitriptyline).
• Cortisone injections can be used to reduce inflammation but may also worsen knee cartilage. So injections are limited to less than four a year.
• Patients with severe movement limitations can receive joint replacements made of rubber, special metals, or ceramic. These surgical options are expensive but available in tertiary hospitals in Nigeria. Syrgery poses a risk of infection, blood clots and other side effects.

Depending on the most affected joints, you will be able to get some support to aid your movement. Simple supports like knee or elbow braces are available commercially or can be made from well-fitting cotton stockings. Also, walking aids like walking sticks, crutches, walkers are useful and affordable for low-income earners, especially since patients can easily change worn parts in most localities in Nigeria. Other suitable modifications can be done to homes, like accessible entrances for wheelchairs and low steps.

Most patients with chronic diseases like osteoarthritis may sometimes feel overwhelmed by the limitations of the disease. This often may lead to depression. Severe or long-term pain that affects your daily life and possibly disturbs your sleep can also affect your mood. If you’re feeling low, talk to your healthcare provider, who can recommend services to help you.