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Osteoarthritis

Published by Bupa's health information team, November 2009.

This factsheet is for people with osteoarthritis, or who would like information about it.

Osteoarthritis is the most common type of arthritis, affecting 8.5 million people in the UK. It develops gradually over time, causing joints to become stiff and painful. It can affect any joint but commonly affects the hands, knees, hips, feet and spine.

About osteoarthritis

Osteoarthritis is more common among women and people aged over 40. It's a major cause of disability and reduction in quality of life in the UK. Many people think that osteoarthritis keeps on getting worse, causing increasing permanent pain and disability, but this often isn't the case. Instead, it's likely that your osteoarthritis will settle down over time as your body repairs itself. However, sometimes the damage is too severe to repair and leads to stiffness and pain, especially in the hip and the knee.

Although there isn't a cure, there are many treatments and self-help measures that can ease your symptoms.

You can think of osteoarthritis as a 'wear and tear' disease. It causes the cartilage on the end of your bones to get rougher and thinner. The bone underneath makes up for this by thickening and growing outwards, creating outgrowths (osteophytes) that can make your joint appear knobbly. The capsule around the joint also thickens and becomes inflamed.

Illustration showing how the knee is affected by osteoarthritis
How the knee is affected by osteoarthritis

Symptoms of osteoarthritis

If you have osteoarthritis, your joints will be stiff and painful, and may be swollen. The pain may be worse after exercise. You may find you can't move the joint as much or as easily as before. It may make creaking sounds called crepitations. As osteoarthritis progresses your joints may become misshapen and look knobbly. They may also be unstable.

You will probably notice that there are times when your symptoms are worse. There may be no particular cause, although they may be affected by changes in the weather or how active you are.

Sometimes pain and stiffness can be more severe in the early stages, especially in women who develop osteoarthritis around the time of the menopause. It tends to settle down over the next few years.

If you have severe or advanced osteoarthritis, it's possible that you will feel pain all the time, even at night and when you're resting.

More specific symptoms for different joints include the following.

Causes of osteoarthritis

The exact reasons why you develop osteoarthritis aren't fully understood. However, certain things that may increase your risk include:

Diagnosis of osteoarthritis

There's no single test that can check for osteoarthritis, so your GP will ask about your symptoms and examine you. He or she may also ask about your medical history. Your GP will look for bony outgrowths, swelling, creaking, instability and reduced movement of your joint, and ask if the joint is stiff for longer than half an hour in the morning.

Treatment of osteoarthritis

Self-help

Although you may not feel like it, it's very important to take regular exercise to strengthen your muscles around the affected joint and give it more support. Your GP is likely to advise you to take regular aerobic exercise, such as walking or swimming, and do strengthening exercises whatever your age or disability.

Regular exercise combined with a healthy, balanced diet will also help you to lose any excess weight. This will reduce the strain on your knee joints. It's a good idea to exercise little and often. Stop doing exercise or activities that cause you pain because you will continue to damage the joint.

A physiotherapist or occupational therapist can give you specific exercises for the affected joint.

Other self-help treatments include:

If your osteoarthritis stops you from carrying out daily activities, such as turning on taps, your GP may refer you to an occupational therapist.

Lots of claims are made about certain foods affecting osteoarthritis but there is little evidence to support them. The only certainty is that if you're overweight, eating a balanced diet that is low in sugar and fat will help you to lose excess weight and ease your symptoms.

Glucosamine sulphate and chondroitin supplements may provide you with some pain relief, although there is limited evidence that they are effective. Glucosamine usually comes from shellfish so don't take it if you have a shellfish allergy. However, vegetarian versions are available and these may be suitable if you're allergic to shellfish.

There is only limited evidence that cod liver oil is helpful if you have osteoarthritis.

Medicines

Medicines can't cure osteoarthritis but they can relieve your symptoms. Pain may be relieved by over-the-counter painkillers such as paracetamol, ibuprofen or aspirin. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

You may wish to use non-steroidal anti-inflammatory drugs (NSAIDs) in the form of creams and gels that you rub into your affected joints. These are less likely to have side-effects than NSAIDs taken as tablets, but this means you may notice only limited benefit as less of the medicine gets to the affected area. If these don't help, your GP may prescribe NSAIDs to take as tablets to reduce the inflammation, pain, and stiffness, but it's important to balance any benefits these may offer with possible negative side-effects.

Your GP will only prescribe stronger painkillers if your pain is severe. He or she may also suggest steroid injections given directly into the affected area.

Non-surgical treatments

You may be prescribed capsaicin cream or gel, made from an extract of chilli peppers, to help relieve pain. Your GP may prescribe it as an additional treatment for osteoarthritis of the hand or knee.

Surgery

If you have severe osteoarthritis, there are a number of different types of surgery that you may be able to have. These include the following.

Complementary therapies

There is good evidence to suggest that acupuncture is effective in relieving symptoms of osteoarthritis.

There is little evidence for other therapies although you may find they make you feel more relaxed, which helps you better manage your osteoarthritis. Speak to your GP before trying complementary therapy or herbal remedies.

Related topics

Related Bupa products and services

For osteoarthritis sufferers, Bupa offers APOS Treatment. APOS is a new breakthrough treatment to help reduce pain and improve function for people suffering from knee, lower back, hip and ankle pain.

Further information

Arthritis Care
0808 800 4050
www.arthritiscare.org.uk

Arthritis Research Campaign
0870 850 5000
www.arc.org.uk

Sources

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: November 2009