As the more common form of arthritis, Osteoarthritis (or OA) is a degenerative disease of the joints that is more prevalent in older people and worsens with age. In patients of osteoarthritis, cartilage begins to breakdown, causing pain, swelling and hindering with joint mobility. Joints most commonly affected are those in the:
Cartilage is a firm, rubbery tissue that encapsulates the end of bones, facilitating a gliding motion where bones meet to form a joint. Cartilage not only acts as cushioning buffer, it also absorbs the jarring impact that occurs when bones rub against each other during movement. As cartilage starts to wear down, bones start to rub against each other, resulting in pain, inflammation, and loss of motion of the joint. Over a period of time, this friction between bones causes bones to lose their natural shape, as small pieces of cartilage and bone break off and get entrapped within joint space or synovial sac, causing further damage.
The reason osteoarthritis is also sometimes called as ‘wear and tear’ arthritis is because it’s more common in the elderly, as cartilage naturally wears out with age. However, obesity, injury and joint overuse can also exacerbate symptoms of osteoarthritis.
The symptoms of osteoarthritis will vary depending on the affected joints and severity of the disease. Also, this is a slow progressing disease that worsens with time and age, so it’s important to be able to identify the early signs.
If you have recurrent joint pain, especially after you have not moved the joint for a while, this is one of the early signs of osteoarthritis. Many people notice that they experience pain first thing in the morning because the joint has been resting all through the night, or after they get up post sitting at their work desk for extended hours.
For some, especially those with a high pain threshold, the first sign of osteoarthritis comes in the form of joint tenderness. You may feel that your joint is sore after hours of rest, or may experience discomfort when the joint is pressed. Tenderness and pain become more common during advanced stages of osteoarthritis when swelling of the joint becomes evident.
While it’s normal to wake up with stiff joints or experience a bit of stiffness after you’ve been sitting in the same position for a long period of time, it becomes more common as well as exaggerated in those who suffer from osteoarthritis. Warm up your joints with some basic stretching exercises to relax them and see if the stiffness returns.
As cartilage starts to wear down, bones start to rub against each other causing friction and a grating sensation. This can be felt in a variety of abnormal, jarring sensations in the affected joints and you may actually feel bones rub against each other.
Also, when the bones rub against each other because there’s a lack of cartilage in between them to provide adequate cushioning and absorb shock, you may hear a crackling sound when the joint is in motion. We are all aware of the cracking sound of the neck when we quickly turn the head, or the snapping sound of the knee when we suddenly stand up after sitting for hours, and the popping sound of the ankle while rotating. They are common, and nothing to worry about. But if these are accompanied with pain, tenderness and discomfort, you may be showing early signs of osteoarthritis.
For those who are displaying the early signs of osteoarthritis, reduced joint mobility becomes a common concern. An aching and stiff joint can become less flexible, reducing range of motion in that joint. For example, you may notice that your knees hurt a lot when you bend them to climb stairs, your hip may hurt when you step out of the car or put on your shoes, or you may not be able to move your fingers easily. While loss of joint flexibility is a gradual process, you should see a doctor if you notice any changes in normal range of motion for a joint.
For many patients in early stages of OA, affected joints can seem particularly painful and tender after physical activity or by the end of the day. This is because movement causes further wear and tear of the joint, ensuing worsened pain and soreness.
During the early stages of osteoarthritis, cartilage is breaking down and wearing out, resulting in inflammation. As bones start to grate against each other, the swelling worsens, accompanied by pain and irritation. Swelling may also be a result of fluid build-up in the joint and hardened cartilage.
With increased swelling around the joint, it’s not uncommon for OA patients to notice changes in the shape of their joints. Osteoarthritis can cause joints in the fingers to enlarge and knee joint to thicken.
As cartilage wears down, bony spurs or growths starts to appear around the edge of bones to repair the loss of cushioning. These feel like hard lumps and further distort the shape of joints. They also worsen joint damage and contribute towards pain and swelling.
Some elderly patients with early stages of OA may notice that their leg gives away as they suddenly try to stand up. Even without any visible signs of the joint being unstable, muscle wasting around the joint can result in muscle weakness. This is especially seen in patients with hip osteoporosis, particularly those who lead a sedentary lifestyle. When muscles weaken due to inactivity, this poses extra stress on surrounding joints, which makes them wear out faster.
During early stages of osteoarthritis, symptoms will often vary and you may have good days and bad days. For some, cold damp weather will exacerbate symptoms. While osteoarthritis cannot be cured, it can be managed. With the right osteoarthritis treatment plan and a healthy, non-inflammatory diet, it is possible to maintain a happy, pain-free, healthy, independent and active lifestyle despite osteoarthritis. We also highly recommend Chondroitin Sulfate and Glucosamine Sulfate supplements as an alternative treatment to deal with the pain that accompanies this degenerative joint disease.
Handout on Health: Osteoarthritis – https://www.niams.nih.gov/Health_Info/Osteoarthritis/default.asp
Muscle weakness in hip osteoarthritis: A systematic review – http://onlinelibrary.wiley.com/doi/10.1002/acr.21806/abstract