You have many joints in your body; your bones help you move about by joining together at places called joint capsules. If we were to unwrap the joint capsule like a present, the first outermost layer would be the strong, protective fibrous layer. It protects the joint fluid inside which keeps your joints mobile. Your bones don’t quite touch when they move about – this fluid keeps them apart along with the smooth, ‘articular’ (joint) cartilage that forms a lining over the edges of bone.
What is osteoarthritis?
Osteoarthritis is a medical term to describe what happens when this smooth ‘articular’ cartilage lining begins to slowly decrease in quality. When you get older, your hair goes grey, you get wrinkles, and your joints tend to have these changes of their own.
This condition particularly occurs in the hands, spinal joints and especially in the lower half of the body including the hips, knees, and ankles. This is due to the repetitive forces that go through these joints day in and day out for your entire life – your joints don’t get any annual leave!
What tends to happen is you first notice some discomfort before, during or after activity, and this may progress to during minor movements or when you’re at rest.
Osteoarthritis is a term that 1 in 5 Australians (22%) over the age of 45 know very well (Australian Institute of Health and Welfare, 2022). It may increase with factors such as being female or having a high body mass index (BMI).
Imaging: X-rays, MRIs, Ultrasounds
The joint space narrowing or ‘osteophytes’ seen on your x-ray indicating osteoarthritis do not necessarily tell us everything we need to know. If every Australian over the age of 40 were to go and have your x-ray done today, many of them will have evidence of some changes associated with osteoarthritis, whether they have pain or not. About 80% of people 55 and older have X-ray evidence of osteoarthritis and approximately 60% develop symptoms (Cleveland Clinic, 2019). Very minor changes to the cartilage may result in a patient in exorbitant pain while someone else could have extreme changes with no symptoms.
Treatment options for osteoarthritis
There is no magic cure for osteoarthritis, but there are many effective treatment options that help 9.2% of Australians continue with everyday activities with slightly to completely minimised pain.
Treatment options for osteoarthritis include:
- physical activity
- weight management
- pain medication
- joint replacement surgery – usually only recommended by surgeons after everything has already been tried and hasn’t been effective.
- cortisone injections – may be recommended as a short-term management strategy, however evidence shows there is no long-term benefit and it must be in conjunction with other treatment methods (Zeng et al., 2019).
Physical activity, though it may sound counterintuitive, is extremely important in managing osteoarthritis and preventing it in other joints. When it hurts to move, individuals may be reluctant to move their joints which can make the joint stiff and decrease the strength of the muscles surrounding the joint.
Final thoughts about osteoarthritis
In conjunction with your osteopath or physiotherapist, you can create a management plan to increase your joint movement and strength to support the joint to do your everyday activities, which over time is designed to decrease your pain.
For more information, please feel free to peruse the following:
Krych AJ, Griffith TB, Hudgens JL, Kuzma SA, Sierra RJ, Levy BA. Limited therapeutic benefits of intra-articular cortisone injection for patients with femoro-acetabular impingement and labral tear. Knee Surg Sports Traumatol Arthrosc. 2014; 22(4): 750-755.
Zeng, C., Lane, N. E., Hunter, D. J., Wei, J., Choi, H. K., McAlindon, T. E., … & Zhang, Y. (2019). Intra-articular corticosteroids and the risk of knee osteoarthritis progression: results from the Osteoarthritis Initiative. Osteoarthritis and cartilage, 27(6), 855-862.