Updated on 6 May 2008

The following information on Osteoarthritis is provided by the Central Health Board (CHB) of The Africa Federation:

What is Osteoarthritis?
Osteoarthritis is the most common type of arthritis presently affecting our community members. CHB has tracked significant number of chronic cases, some requiring Knee Replacement Surgery. Osteoarthritis is a joint disease that attacks the cartilage (a slippery tissue found on the end of the bone that cushions the joint), resulting in degeneration and stiffness of joints, swelling, loss of motion, and extreme pain.

What Causes It?
Several factors seem to increase the likelihood of getting the disease:

• Age - Osteoarthritis is uncommon before the age of 40
• Gender - Women are more prone to osteoarthritis than men
• Weight - Overweight (obese) people are at greater risk of developing osteoarthritis, especially of the knees
• Injury - An early injury, disease, operation, or repeated strain on the joints may lead to osteoarthritis later in life

Diagnosis
In its early stages, people hardly notice they are developing osteoarthritis, although some may experience frequent stiffness of joints when getting out of bed or sitting for a long time, swelling of the joints, and frequent crunching sound of the bones. A warm sensation over the joints is also experienced by some individuals.  Pain is the most common symptom of early osteoarthritis.

Normal Joint                                                    Diseased Joint 

NB: Both the synovial membrane and tendon in diseased joint may be affected and inflamed in osteoarthritis
                                             
An orthopedist, using X-rays, MRI, clinical evaluation, physical examination and other relevant tests could determine a more accurate and confirmed diagnosis of osteoarthritis. Osteoarthritis is more of a clinical diagnosis than laboratory.

Managing Osteoarthritis
A number of management and treatment options are available that are tailored according to a patient’s needs, lifestyle and general health.

For mild osteoarthritis and slight pain, doctors normally recommend the following options:

• Rest and Joint Care - Patients learn and adapt to signals that illicit pain and take frequent rest between periods of activities. This reduces excessive stress on the joints and decreases intensity of pain.
• Natural Pain Relievers - Water therapies such as hot showers, giving warm water baths around the affected areas as well as using heat pads are ideal for pain management in osteoarthritis patients. Wearing specially designed leg straps and cushioned shoes are also effective in reducing joint pains of ankles, knees and hips.
• Weight Control - Being overweight or obese can increase stress on a person’s weight bearing joints. Reducing some amount of weight can significantly decrease pressure on such joints as well as reduce pain.
• Exercise - Gentle exercise such as walking and swimming can increase endurance and strengthen muscles around the joints which makes them more stable.

Individuals suffering from moderate to severe osteoarthritis should resort to the following steps (in addition to the above options), for effective treatment and management of this disease:

a) Medications - Prescribed medications reduce or eliminate pain as well as improve the patient’s mobility and functioning in order to carry out daily tasks with ease and comfort. The most common type of medications used are NSAIDS: e.g. Ibuprofen, Diclofenac, and Meloxicam.

b) Intra Artecular Depot Injections – Steroids - Short lasting effect, Hyaluronic Acid - Long lasting effect

c) Surgery - This treatment option is generally reserved for severe cases of osteoarthritis. It should be considered if daily tasks become extremely difficult to carry out.  Surgical treatments include:

     Patient Undergoing Arthroscopy                               An Actual Knee Prostheses

1. Joint Replacement (Arthroplasty) - This procedure involves the removal of damaged joint surfaces, which are then replaced with plastic or metal implants (prostheses). Hip and Knee joints are most commonly replaced joints.
   
2. Removal of Loose Bone Pieces (Debridement) – In certain cases, loose pieces of cartilage and bone are removed from around the joint areas to relieve pain, usually through key - hole surgery (arthroscopy).
   
3. Bone Resurfacing - This option is available in some patients who cannot undergo joint replacement surgery.

Thanks to advancement in medical technology, this treatment option has proven quite effective in alleviating joint disorder pains, although it does carry a hefty cost, unaffordable by majority of individuals. Thankfully, other treatment and pain management options are available in managing osteoarthritis.