Osteoarthritis is a degenerative joint disease characterised by progressive wear and tear of joint cartilage. All joints of the body may be affected. Osteoarthritis most commonly occurs in the knee, hip and shoulder joints (shoulder blade) and in the spine. Damage to the cartilage causes bones to directly rub together and manifests itself in painful joints and a restriction in mobility.
Osteoarthritis at a glance
Osteoarthritis is a degenerative joint disease caused by wear and tear on the cartilage. The affected joint becomes painful, stiff and limited in its mobility. Osteoarthritis can affect all joints, but most commonly the knees, hips, hands and spine.
Osteoarthritis (sometimes abbreviated to 'OA') is a form of arthritis whose main feature is wear and tear on the joint cartilage. Arthritis is a group of over 100 different diseases. They are characterised by inflammation in the joints. Examples are rheumatoid arthritis and psoriatic arthritis.
Distribution and forms of osteoarthritis
Gonarthrosis
Gonarthrosis, osteoarthritis of the knee joint, is particularly common in middle-aged and older people. Obesity and excessive use of the knee may increase the risk of gonarthrosis. When the joint is moved, the resultant pain may be dull or sharp, or somewhere in between, and the mobility of the knee may decrease significantly over time.
Rhizarthrosis
Rhizarthrosis affects the saddle joint at the base of the thumb. It causes pain in the thumb and wrist area and weakness when gripping or turning the wrist. Everyday activities such as opening containers or holding cutlery may be complicated by this form of osteoarthritis. Pain may be increased during fine motor activities, which can lead to a significant impairment of hand function.
Coxarthrosis
Coxarthrosis is osteoarthritis of the hip, which often causes pain in the groin, thighs or buttocks. The pain may increase when walking, or after sitting for a long time. This form of osteoarthritis can interfere with sleep, as pain makes it difficult to lie on the affected side. At an advanced stage, there may be a visible shortening of the affected leg, which further restricts mobility.
Spondyloarthritis
Spondyloarthritis is a form of osteoarthritis that affects the spine and can lead to chronic back pain and reduced mobility of the spine. The disease often affects the lower back. It can cause pain that extends to the hips or legs. The stiffness may be particularly pronounced in the mornings or after rest periods, and may interfere with everyday activities.
Causes and risk factors for osteoarthritis
The causes and risk factors for osteoarthritis are manifold and include genetic predisposition, obesity and previous joint injuries, as well as overuse for occupational reasons or due to sports. The higher incidence of osteoarthritis within some families suggests that genetic factors may play a role, as people with a family history of osteoarthritis are at higher risk of developing it themselves. Being overweight is another risk factor because it increases pressure and strain on weight-bearing joints such as the knee and hip, which in turn increases the risk of developing osteoarthritis in these areas.
Joint injuries can increase the risk of osteoarthritis, especially if they are not treated properly or lead to long-term changes in the joint. Certain occupations and sports may also increase the risk of osteoarthritis. This happens when they require repeated movements or place high loads on the joints.
Incidence and age
The incidence of osteoarthritis increases with age. Women are also more frequently affected than men. In Switzerland – in fact, throughout the world – osteoarthritis is one of the most common joint diseases, especially among the elderly. This underlines the importance of prevention and treatment strategies to improve the quality of life of those affected and to minimise disease-related limitations.
Symptoms: Detecting osteoarthritis
The main symptom of osteoarthritis is pain in the affected joint caused by damage to the cartilage layer. This pain can be mild to very severe. A common side effect of osteoarthritis is the development of inflammation in the joint. This is called activated osteoarthritis. Relieving postures, which are often adopted in response to the pain, can weaken the surrounding muscles and further destabilise the joint. Bones, ligaments, tendons and muscles may also be affected by changes over time.
Typical symptoms of osteoarthritis are:
- Pain after prolonged inactivity, occurring in the morning after getting up or after sitting for a long time
- Pain when moving the joints
- Joint stiffness
- Resting pain, especially with inflammation
- Restricted mobility in areas such as shoulder, arm, knee and back
Course of the disease
The course of osteoarthritis can vary greatly from individual to individual and depends on various factors such as age, the specific location of the osteoarthritis and the patient's general state of health. In many cases, the disease gradually worsens over a period of years.
Diagnosis
The diagnosis of osteoarthritis usually begins with a detailed medical history and a physical examination. The doctor asks about the symptoms and examines the affected joint for swelling, pain and restriction of movement.
Laboratory tests
In some cases, laboratory tests are useful, especially to distinguish osteoarthritis from other joint diseases such as rheumatoid arthritis. Possible results of these tests are the detection of inflammatory markers in the blood or the detection of specific antibodies.
In most cases, an accurate diagnosis of osteoarthritis is possible with a combination of the patient’s medical history, a physical examination and imaging techniques. Early detection and treatment are crucial to alleviating symptoms and improving the quality of life of those affected.
Conservative treatment
Targeted physiotherapy makes it possible to maintain mobility and positively influences the course of the disease. Chronic pain, however, often causes sufferers to avoid using their joints, which can paradoxically lead to a further restriction of mobility and an aggravation of their osteoarthritis. Weight loss also plays an important role. In overweight people, losing weight can significantly relieve the weight-bearing joints and thus reduce pain and improve mobility.
Medication
With the help of painkillers and anti-inflammatory drugs, acute symptoms can be alleviated, especially in the initial phase.
Surgical interventions
In cases of advanced osteoarthritis, and if conservative measures are not sufficient to maintain the sufferer's quality of life, surgical intervention may be an option. Arthroscopy, which is used for diagnosis and, in some cases, also for treatment, can remove or repair damaged tissue. Osteotomy, in which the bone is cut and realigned, is intended to allow better weight distribution in the joint, thus reducing wear and tear. In situations where pain and loss of movement severely restrict patients’ daily lives, the use of prostheses or artificial joints such as hip, knee or shoulder joints may be an effective solution to improve function and reduce pain.
Preventing osteoarthritis
Ways of preventing osteoarthritis include the use of aids and lifestyle changes. Activities that are gentle on the joints such as swimming, cycling or walking are important to prevent osteoarthritis, as they keep the joints moving without putting too much strain on them. Adjusting daily activities and using aids can also help to minimise joint strain and relieve pain. Regular medical check-ups also help doctors to diagnose and treat osteoarthritis at an early stage. This can have a positive effect on the course of the disease, as well as helping to control the symptoms effectively and to improve the quality of life of those affected.
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