Arthritis means inflammation of joints. Osteoarthritis is the most common form of arthritis.¹ The underlying problem in osteoarthritis is the gradual breakdown of the tough, rubbery tissue (cartilage) that covers the area of the bones where they meet at the joints. There may also be problems with outgrowths of bone forming around the edges of affected joints, making them knobbly and swollen. This means that the normal, smooth gliding of bones against each other at the joints is disrupted, resulting in joint pain and stiffness, and reduced mobility.

Osteoarthritis affects people of all ages, but generally is more common in older people. Osteoarthritis (OA) is by far the most common form of arthritis in the Irish population with women 2-3 times more likely to be affected than men.²

Osteoarthritis is caused by mechanical stress to the joints. Various factors can increase the risk of osteoarthritis, and cause it to occur earlier in life:

• Obesity — people who are overweight are more likely to develop arthritis because of the extra load that strains the joints and causes damage.³
• Injury or over-use — over-use or a serious injury to a joint, such as a fracture or infection, can cause damage to tissue, and increase the possibility for further wear and tear to the joint.³
• Lack of activity — under-use of joints can be almost as damaging as too much activity. Inactivity can cause a joint to become stiff and painful. Lack of activity can reduce flexibility in joints and weaken the muscles that support them, increasing the risk of injury.
• Osteoarthritis can run in families - making it more likely to occur in someone whose parents or other close relatives have suffered the problem.⁴

Osteoarthritis symptoms include pain, stiffness and, occasionally, loss of function of the affected joint. The main initial symptom is pain in the affected joint, made worse by movement and eased by rest. Stiffness may be present after inactivity, but morning stiffness (on getting up out of bed) is usually not a symptom.⁵ As the affected joint deteriorates with loss of joint movement, the pain becomes more pronounced and often persists at rest and during the night.⁵ Osteoarthritic joints may also become enlarged and distorted by bony outgrowths, which cause the gnarled appearance often seen in hands affected by the condition.

Osteoarthritis is usually diagnosed from the patient's symptoms and from a physical examination of the affected joints, which will reveal tenderness, swelling and pain on movement. An X-ray can confirm loss of cartilage in the affected joint and formation of bony outgrowths. It can also enable assessment of the extent of the joint damage and degeneration

While there is no cure for osteoarthritis, apart from the surgical replacement of severely affected joints, management is directed at reducing stress on osteoarthritic joints, activity and exercise, treatment of the pain and inflammation caused by the osteoarthritis.

Medication which helps relieve patients' symptoms, such as, painkillers (analgesics), and anti-inflammatory medications including both non-steroidal anti-inflammatory drugs (NSAIDS) (traditional and cox-selective) and corticosteroids (Cortisone).⁶

Treatment should be tailored to the individual, if side effects occur, it is important to discuss these with your doctor who can look at changing the dose or switching to an alternative therapy.

• Exercise such as stretching, strengthening, and postural exercises can help to maintain healthy cartilage, increase a joint's range of motion, and strengthen surrounding muscles so that they absorb shock better.³
• Avoid soft chairs, recliners, mattresses, and car seats that may worsen symptoms.³
• Use straight-backed chairs, firm mattresses, and bed boards.³
• Heat treatment can be useful.³
• Splints and supports can protect specific joints during painful activities.³

 References 

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