Arthritis (arthr meaning ‘joint’ and -itis meaning ‘inflammation’) is a joint condition that affects around ten million people in the UK. Osteoarthritis (osteo meaning ‘bone’) is by far the most common type of arthritis, knowingly affecting around nine million people in the UK.
Osteoarthritis is caused by changes to the bony surfaces at joints, most commonly at the knees, hips, feet, spine and hands.
In a healthy joint, the surface of each bony is covered in a thin layer of cartilage. This cartilage is incredibly smooth and slippery, which allows for smooth and pain-free movement at that joint.
In an osteoarthritic joint, these layers of cartilage have, for a number of possible reasons, become thinned and rougher. Our wonderful human bodies try to repair this and sometimes the repairs work and sometimes they don’t, and sometimes they work a bit for a while and then they become less effective. The most common noticeable side effects of osteoarthritis are pain and stiffness, usually as a result of:
Possibly. The following are the main ‘risk factors’ for osteoarthritis:
AGE. Changes at joint surfaces are to a degree a natural side-effect of ageing. The older you are, the more likely you are to develop osteoarthritis somewhere in your body. Most of us will end up with it to a greater or lesser degree, though this degree and the effect that it has on our lives is not set in stone…
GENDER. It’s more common, and more severe, in women.
OBESITY. Carrying around excess load puts more strain on our joints and makes adverse changes at these joints more likely. A healthy argument for obtaining and maintaining a healthy weight.
INJURIES & ACTIVITY. A traumatic injury e.g. a broken bone can lead to osteoarthritis somewhere down the line. Normal, healthy levels of exercise and physical activity – including that involved in the jobs that we do – don’t cause arthritis (not even running!) But excessive, very hard/high impact and repetitive movements, be they in our sports or our work, can.
GENETIC FACTORS. These are less common than the above but can lead to changes at joints earlier than in those without predisposing genetic factors.
A verbal and physical assessment can determine whether or not you have arthritis. NHS-draining images are not needed.
You can feel pain before any changes to the bones are evident in a scan and conversely you can have evident bony changes without any pain. Everyone, and everyone’s pain experience, is different, because pain is very complicated! This point also lends further weight to the fact that scans aren’t necessary, as they may show changes that you don’t experience as pain.
Two enormous studies carried out in 2019 determined that exercise did not cause inflammatory (painful or damaging) responses in people with osteoarthritis, nor did it cause any further damage to joint surfaces. Furthermore, exercise has been shown to improve cartilage regeneration in people at high risk of developing osteoarthritis. Exercise is very much a way to prevent and manage osteoarthritis, therefore I will now throw out the myth that ‘running will ruin your joints’. Alongside this, exercise is an effective preventative and management tool for many other chronic diseases and conditions, many of which people with osteoarthritis are susceptible to.
Surgery should only be considered an option AFTER making significant efforts with non-surgical care, including exercise therapy, medication, weight management and learning about your osteoarthritis and how best to manage it. Current evidence suggests that knee arthroscopic surgery, also known as keyhole surgery, where surgeons attempt to ‘tidy up’ the joint, is no better than non-surgery options for people with mild-moderate osteoarthritis.
Once osteoarthritis becomes ‘severe’ – determined predominantly by pain levels and how badly your daily functioning and activities are affected – many people then find that joint replacement surgery, such as the now common hip or knee replacement, can offer significant pain relief. However, studies carried out in 2010 and 2011 showed that one in five people were not satisfied with the outcome of their new knee and 7% of people were dissatisfied with their new hip. They can be effective solutions but are not risk-free.
OK, so you can’t completely guarantee that you won’t get it. But you can definitely reduce your chance of developing osteoarthritis. You can also push further down the line the age at which you may develop it and, should you develop it, you can slow its progression and reduce its severity.
Traumatic injuries are unavoidable… but are they always? Injury prevention programmes run alongside sporting activities have been shown to reduce injury occurrence by up to two-thirds. Being as strong, mobile, flexible, fit and healthy as we can reduces our chance of injury – traumatic or otherwise – irrespective of whatever physical ‘thing’ we are doing.
Being a healthy body weight can both prevent osteoarthritis in the first place and can help manage and reduce the symptoms if you already have it.
And what of the unavoidable age, gender and genetic factors?
PHYSICAL ACTIVITY AND EXERCISE will have an osteoarthritis-reducing effect on these three remaining causes.
Being physically fit and active is the silver bullet. Exercise can help to reduce and/or slow some of the effects of ageing for both men and women. And if you have a genetic disposition towards developing osteoarthritis, being fit and healthy will help mitigate this fact.
I so often come back around to the same point. Being active is in our DNA, it is what we are designed to be. Yes it can be a drag, yes it can require large amounts of self-discipline and yes it is often contrived in this the 21st century where we don’t actually have to ever do any exercise if we don’t want to. But exercise can also be mood and confidence-boosting, sociable and fun. And by getting and staying aerobically fit, strong and supple and improving and keeping your balance and co-ordination as best you can, you can significantly offset the likelihood and the symptoms associated with this debilitating condition, many other debilitating conditions and the many other problems associated with osteoarthritis.
More information about the symptoms, diagnosis, treatment options and management of osteoarthritis are available on the NHS website.