| Osteoarthritis is the leading cause of physical disability | | | | and depression are not uncommon in arthritics and this |
| in people over the age of 65. Sufferers find that | | | | can amplify pain, leading to a vicious circle which can |
| everyday tasks become challenging or impossible, and | | | | be very difficult to escape from. |
| many of the activities they used to enjoy gradually drift | | | | Sometimes arthritic individuals don't experience very |
| away from them. How does this happen, and what | | | | much pain. In which case, they present to their doctor |
| can be done to help them? | | | | because of functional impairment. Restriction of |
| There are many factors which contribute to the | | | | movement can be caused by fibrosis of the joint |
| development of osteoarthritis, and these can be | | | | capsule or development of bony outgrowths which get |
| summarized by two main disease pathways: either | | | | in the way of the joint, blocking its movement. |
| abnormal mechanical stresses damage what was a | | | | Deformity of the joint is common, particularly in the |
| previously healthy joint; or an abnormal, unhealthy joint | | | | hands, and causes significant functional limitation. |
| will be injured by normal mechanical forces. The end | | | | Muscle weakness and wasting mean gripping or |
| result of both is that there is structural failure of the | | | | walking become very difficult. |
| cartilage, ligaments and bones of the joint and damage | | | | Osteoarthritis treatment is predominantly directed at |
| is sustained to the joint housing, the 'synovial capsule'. It | | | | relieving symptoms, maintaining and improving joint |
| is usually the hip, knee and hand joints which suffer the | | | | function and minimizing the disability. The |
| greatest disability in osteoarthritis. | | | | non-pharmacological measures which can be taken |
| The first symptom to be noticed is usually pain in the | | | | are dependent on the sites of the arthritis, i.e. knee |
| joint. This pain appears gradually and may be | | | | braces or special footwear. Most people with |
| intermittent at first. It will be aching in character and is | | | | osteoarthritis will benefit from physiotherapy or other |
| initially provoked by movement of the joint and relieved | | | | muscle-strengthening activities. Pharmacological |
| by rest. As the disease progresses bouts of pain will | | | | treatment begins with pain-killers and continues with |
| become more prolonged and the individual may start | | | | other drugs such as steroid injections to help halt |
| waking at night because of it. Morning stiffness or | | | | disease progression. The last resort for patients with |
| stiffness after inactivity is transient and will only last a | | | | hip or knee arthritis that is not responding to treatment |
| few minutes. Because of the pain and disability, anxiety | | | | is joint replacement surgery. |