Understanding osteoarthritis

Joint pain and osteoarthritis

Most people are likely to experience joint pain at some point in their lives. Playing sports or engaging in other strenuous activities can contribute to acute pain and inflammation from overuse of the joint.

While serious injuries are relatively uncommon, chronic joint pain may progress into a more severe hindrance over time.

What is osteoarthritis (OA)?

A common cause of joint pain, such as knee pain or hip pain, is osteoarthritis (OA). OA is a degenerative disease, also described as “wear and tear,” which leads to loss of cartilage.

OA is a chronic joint condition, and as it progresses, cartilage protecting the ends of the bones gradually breaks down, joint fluid loses its shock-absorbing qualities and bones may begin to rub against each other. This can cause pain, swelling and problems moving the joint.

Sometimes knee or hip pain caused by bursitis is confused with OA. There are some differentiators to be on the lookout for. Bursitis pain increases when pressure is put on the joint and can start sharply to gradually change to a dull ache. Osteoarthritis pain comes on gradually and gets worse over time. However, people with OA may also get a bursitis.

What causes osteoarthritis?

There are several factors that can increase the risk of developing osteoarthritis and impact the rate at which OA progresses over time.

Overuse

The most general cause of joint osteoarthritis is "wear and tear", categorized by overuse of the joint, leading to increased load, or pressure, which further breaks down vital cartilage. However, this doesn't mean, that you should avoid any unnecessary movement. Moderate activity is important for OA patients, as it strengthens the muscles, stabilizes the joints and supports the nutrition of the cartilage.

Body weight

Extra weight can add increased pressure on joints and often accelerates the degenerative process of cartilage breakdown, causing osteoarthritis. Maintaining a healthy body weight is the primary way to reduce your risk of developing OA.

Age

Age is a contributing factor in the development of osteoarthritis because the natural ability of cartilage to heal decreases as you get older.

Family history

Having a family history of arthritis may increase your likelihood of developing OA.

Past joint injury

Injuring your knee or hip, and specifically damaging crucial ligaments, can cause cartilage degeneration to start much earlier or progress more rapidly. Those who have torn their anterior cruciate ligament (ACL), or sustained other ligament injuries, are at an increased risk of developing OA within the next ten years.

What symptoms are associated with osteoarthritis?

Listed below are the symptoms commonly reported by people who have been diagnosed with osteoarthritis (OA). If you are experiencing any of these symptoms, especially if you have previously injured your knee or hip, it is important that you talk to your doctor about OA.

Pain or discomfort in your joints that may reduce mobility, making it difficult to get up and out of chairs, use the stairs, or walk long distances. The pain may be deferred, or even appear in other areas of your body, such as back pain, which could be caused by osteoarthritis.

Joint swelling may also be an indicator of OA, as the inflammation could lead to effusions (excess fluid) in the joint. These are often related to acute worsening of the overall osteoarthritic condition.

Stiffness, usually due to inflammation, may be common, especially in the morning or after sitting for a long period of time.

Creaking, crackly and popping sounds when the joints move has also been reported by people suffering from OA.

How are stages of OA classified?

OA stages can be classified from x-ray evaluation in the Kellgren Lawrence grades KL 0 - KL 4:

• KL 0: No radiographic features of osteoarthritis
• KL 1: Possible joint space narrowing and osteophyte formation
• KL 2: Definite osteophyte formation with possible joint space narrowing
• KL 3: Multiple osteophytes, definite joint space narrowing, sclerosis and possible bony deformity
• KL 4: Large osteophytes, marked joint space narrowing, severe sclerosis and definite bony deformity

A more common description of the stages of osteoarthritis are mild, moderate and severe OA (stages 2 - 4).

1. Mild Osteoarthritis
At this stage, the surface of the joint cartilage is beginning to breakdown and x-rays or MRIs of joints may show small bone spurs, cracks or indentations forming. Patients with mild OA may experience pain or discomfort after a long day of walking. Wearing an ultra-lightweight brace like Unloader One Lite or Unloader Hip could help prevent further breakdown while easing mild joint pain.

2. Moderate Osteoarthritis
At this stage, the joint cartilage has broken down to the point that the bones are more frequently rubbing together. People with moderate OA may experience pain while walking, running, bending or using the stairs. Joint stiffness is commonly experienced after long periods of sitting or lying down. Inflammation of the joints is also reported following more strenuous activities.

Wearing a brace, such as Unloader One or Unloader Hip, could help delay the need for total joint replacement surgery.

3. Severe Osteoarthritis
Severe OA is characterized by great pain and discomfort during everyday activities. By this stage, the joint space between bones is significantly reduced because the cartilage is nearly gone, causing the bones to rub and grate against each other. The synovial fluid, which provides lubrication for joints, has decreased drastically and no longer reduces friction during movement.

Joint Replacement surgery is often the only viable treatment option for people who are diagnosed with severe osteoarthritis. However, it is important to maintain a healthy weight and lifestyle in order to avoid complications during surgery. Wearing an Unloader One knee brace can help you to maintain a healthy lifestyle and manage your weight, making yourself a better surgical candidate.

How is OA diagnosed?

Only a trained medical professional can accurately and effectively diagnose osteoarthritis. If you are experiencing chronic knee or hip pain and think it may be due to osteoarthritis, it is best to speak with your doctor as soon as possible.

Your doctor may ask you questions regarding the symptoms you are experiencing, such as knee or hip pain, and their impact on your daily function. Your doctor may also perform a physical examination of the affected joint(s), or even take X-Rays to help verify the diagnosis. This process may be repeated over time to better monitor the progression of the disease. Additional diagnostics could include further ultrasound, CT and MRI scans.

An ultrasound is helpful to view a joint effusion and injuries to ligaments and muscles, without radiation exposure.

Computer tomography (CT) illustrates bony structures very well for your physician, and can be used to show even small fractures. For osteoarthritis, CT scans help evaluate bony alterations that may not show clearly on x-rays.

Magnetic resonance imaging (MRI) also works without radiation. MRI's show detailed sectional images of tissue, which is especially useful for ligament and meniscal injuries or injuries/ changes of the joint cartilage.

If you do receive a diagnosis of OA, do not lose hope! There are a number of options available to treat your condition, including our Unloader knee braces, clinically proven to relieve OA pain, and the Unloader Hip brace, proven to improve activities of daily living.

How is OA treated?

With the right treatment, you can relieve your symptoms and improve your quality of life, despite osteoarthritis being a chronic (non-curable) condition. Managing OA symptoms is vital as it can slow the progression of the disease down considerably.

The main goals of OA therapy are pain relief, improvement of mobility and preservation of joint function. As osteoarthritis may present different symptoms in each individual, it is necessary to work with your doctor to develop tailored osteoarthritis management plans.

However, there are many things you can do yourself or at home to improve your osteoarthritis pain:

• Stay active and exercise on a regular basis. This will strengthen your muscles, stabilize your joints and keep the cartilage hydrated.
• Eat well. Healthy nutrition is a big contributor to our overall well-being and has a positive effect on inflammations in our joints.
• Get the support you need for your joints early and don't suffer through the pain. Speak to your doctor or try an Unloader brace at an orthotist or practitioner near you.