Osteoarthritis explained

Posted on 17 April 2014

Osteoarthritis (OA) is commonly called ‘arthritis’ and is found across the world in hands, knees, hips and spines – though it can affect most joints in humans.

What causes arthritis?
The gradual degeneration of ‘joint’ cartilage results in changes to the underlying bone, which can ultimately lead to joint failure.

Who gets arthritis?
Dr Gareth Tarr, a rheumatologist and specialist physician at Winelands Rheumatology Centre in Stellenbosch says: ‘OA occurs in 40% of adults over 70 years old. It’s a degenerative disorder and is therefore age-related and a leading cause of physical disability in the elderly.’ Genetics, obesity and joint trauma can all cause progressive joint damage and OA.

What are the symptoms?
Pain, stiffness and difficulty moving the joint easily are the most common symptoms.

What is the difference between rheumatoid arthritis and osteoarthritis?
OA primarily affects joint cartilage, whereas rheumatoid arthritis (RA) is an inflammatory disease of the soft tissues around the joint.

How is arthritis treated?
Dr Tarr says treatment is tailored to the individual depending on the joint involved, and aims to reduce symptoms, improve mobility and prevent progression of the disease. However, that is not always possible.

Treatment options include medication and surgery. Professor Helmuth Reuter, head of the Winelands Rheumatology Centre says that ‘non-pharmacological therapies are usually more effective than pharmacological treatments in treating pain symptoms.’ He adds that education is also vital to any treatment plan. ‘Patients who understand their disease and are well informed will do better, and participate more in treatment programs.’

Dr Tarr adds that while cartilage is composed of glucosamine and chondroitin, despite well-designed studies with supplementation of these substances there has been mixed results. However, some patients with moderately severe osteoarthritis may benefit from their use and decrease their pain symptoms.

The symptoms experienced by OA are generally exacerbated by activity and often a period of rest is needed. However, as with other types of arthritis, exercise plays a significant role in weight control, cardiovascular benefits, mood, and helps to improve joint mobility, muscle strength and alleviate pain. Thermotherapy (hot and cold packs), acupuncture, and a TENS (transcutaneous electrical nerve stimulation) machine, which is much like acupuncture without needles, are also used in pain treatment.

Does diet influence symptoms?
‘There has been no diet showing an absolute benefit in OA,’ says Dr Tarr.  ‘Vitamins have been studied and their role is uncertain. However, high dietary Vitamin C was associated with less progression of OA.’

What medical treatment is available?
A major aim for OA treatment is pain control, as there is no cure for the condition. Patients start treatment with analgesics, such as paracetamol. If this is ineffective, the doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. Oral cortisone is ineffective as a treatment, while joint surgery is a last resort.

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