Osteoarthritis: changes in the joints

Osteoarthritis: changes in the joints

Osteoarthritis, What is it?

Osteoarthritis is the most common rheumatic disorder. The chance of the condition increases with age. Incidentally, osteoarthritis does not involve wear, but a change in the joints. How this change comes about is not entirely clear. A number of factors that influence each other probably play a role. In particular, the construction, heredity and (over) strain of the joint seem to play a role. Other names for osteoarthritis are ‘osteoarthritis’, ‘degenerative joint disease’, ‘wear and tear erosion’ and ‘artrosis deformans’.

Symptoms osteoarthritis

Osteoarthritis is most common on the hands, hips and knees. It is twice as common in women than in men. Knee osteoarthritis is the most common. Osteoarthritis can be present in one or more joints. Incidentally, changes in the joints may be present without there being any complaints. The following complaints can occur:
  • pain
  • stiffness
  • changing joints
  • other symptoms.
Pain Osteoarthritis often starts with slight pain in the joint that may gradually get worse. The pain is usually in the joint itself, sometimes the pain can radiate to the area around the joint. The pain is often the most severe after a period of rest, for example after getting up in the morning or after sitting down for a long time. This is called starting pain and this usually disappears after a few minutes of exercise. With advanced osteoarthritis, the pain can also remain present during the night.
Stiffness In osteoarthritis, the joints can be particularly stiff in the morning. This is called morning stiffness. The stiffness disappears after a few minutes of exercise.
Changing joints Osteoarthritis often leads to a visible change in the joints. The joint may become wider, deform, change position, or (painless) protrusions may develop. Especially with osteoarthritis in the fingers, these protrusions may occur. These are called the ‘nodules of Heberden’.
Other symptoms In people with osteoarthritis, the joints can crack during movement. An inflammation of the joint may also occur. The joint then becomes thicker, redder, warmer, more painful and the function temporarily diminishes. When a piece of bone breaks off, it roams through the joint. As a result, the joint can sometimes be ‘locked’.

How does osteoarthritis occur?

A joint is a hinge between two or more bones. The hinge is kept in shape by muscles and connective tissues. The ends of the bones that form the hinge are covered with a layer of cartilage. The bone ends are surrounded by this and are thus protected against rubbing, forces and shocks. The joint moves more smoothly due to the cartilage. With osteoarthritis the amount and quality of this cartilage decreases. The bone ends are no longer sufficiently protected and this leads to pain. The joint runs less smoothly, resulting in stiffness. The bone ends are stimulated by the damage and can deform. Sometimes pieces, the so-called ‘mice’, break off.
Osteoarthritis is no wear and tear, it is a change. How this change comes about is not entirely clear. A number of factors that influence each other probably play a role. In particular, the construction, heredity and (over) strain of the joint seem to play a role. Elderly people, women, top athletes, people with occupations that burden the joints, people who are overweight and people who have ever had an injury or injury to a joint have a greater chance of getting osteoarthritis.
When the osteoarthritis is the result of an injury, injury or abnormality, this is referred to as ‘secondary osteoarthritis’. In the other cases it is referred to as ‘primary osteoarthritis’.

Is it serious and what can you expect?

Osteoarthritis is often diagnosed by the doctor. The complaints are usually so clear that additional examination, such as an X-ray, is usually unnecessary. There are no treatments or medicines that can cure osteoarthritis. Your doctor can propose a treatment. The purpose of this will be to help reduce symptoms that you may have due to osteoarthritis. At the end of this article you can read what you can do about it yourself to reduce your symptoms and prevent worsening. The treatment depends on the complaints, the situation and the health and can therefore differ per patient. Possible treatments are:
  • pain relief
  • practice
  • prevent overload
  • operation
Pain relief Paracetamol is often prescribed for mild to moderate pain. If you sometimes have symptoms, you can take paracetamol at times when it is necessary. If you almost always have pain, you can use one of these as a maintenance dose. This means that you take paracetamol at set times of the day. If you have severe pain or if paracetamol does not help, the doctor may prescribe stronger painkillers such as ibuprofen and diclofenac. These are pain killers that also have an anti-inflammatory effect. If you are sensitive to it, these painkillers can cause stomach upset. Therefore always consult your doctor before you start using these medicines. Occasionally your doctor will prescribe a cream that makes the skin somewhat numb and reduces the pain; in some cases your doctor injects anti-inflammatory substances directly into the joint. In general, it is not advisable to use painkillers in large quantities. Excessive use can be harmful. Therefore always consult your doctor first.
Exercise Complaints can be greatly reduced by training the joint correctly. The physical or remedial therapist can teach you exercises that you can perform at home. With the help of an occupational therapist you can learn how to best perform your daily activities such as work, hobbies and household tasks with your osteoarthritis. Heat has a positive effect on the complaints. Moving in warm water is therefore ideal.
Prevent overload Try to prevent overload. The osteoarthritis continues to worsen if any overload persists. If you suffer from osteoarthritis in your hip or knee, your doctor will recommend a walking stick. Obesity also leads to overloading your joints. If you are overweight, it is very wise to lose weight.
Operation In some cases, surgery is performed. The joint is then corrected, fixed or replaced with a prosthesis. When to the doctor? If you suspect that you have osteoarthritis, it is advisable to make an appointment with your doctor. Your doctor can check whether your symptoms are indeed caused by osteoarthritis and which form of treatment is most suitable for you.

When to the doctor?

If you suspect that you have osteoarthritis, it is advisable to make an appointment with your doctor. Your doctor can check whether your symptoms are indeed caused by osteoarthritis and which form of treatment is most suitable for you.

What can you do about it yourself?

You cannot do anything yourself to cure the osteoarthritis. You can, however, do a lot to reduce your symptoms and prevent aggravation (see ‘General advice and precautions’).

General advice and precautions

You can do the following to reduce your symptoms and prevent aggravation:
  • Ensure a good, healthy body weight. Overweight leads to overloading your joints.
  • Keep moving If you have temporary severe symptoms, it is best to relieve the joint. But try to move again as quickly as possible. Do this in a responsible manner so that you do not overload your joints. If necessary, consult with a physiotherapist or remedial therapist how you can rebuild your activities in a sensible way.
  • Keep your joints warm Heat can reduce the symptoms that can occur as a result of osteoarthritis. Make sure that it is not too cold in your area. Try to swim regularly in warm water. You can contact the regional rheumatism fund in your area or your swimming pool about the possibilities for this.
  • Avoid overloading Use a walking stick when walking. Try to minimize stressful movements such as climbing stairs and kneeling. You often notice yourself which movements overload your joints, because you subsequently get complaints.

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