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Osteoarthritis 101: Symptoms, Causes, Stages, Diagnosis & Treatment

Mar 26, 2022

How common is Osteoarthritis in Singapore?

Osteoarthritis affects about 10% of the adult population and 20% of the elderly population in Singapore. It is a common condition that can affect everyday activities, limit movement and cause mental and emotional distress. There is no cure for Osteoarthritis but it can be managed. With proper education on what Osteoarthritis is and the proper management of this condition, those who are at a high risk of developing Osteoarthritis or already experiencing symptoms of it will be able to implement healthy lifestyle changes that can greatly improve their quality of life.  

What is Osteoarthritis?

Osteoarthritis (OA) is the most common form of arthritis. It is known by other names, such as wear and tear arthritis, degenerative arthritis and degenerative joint disease.

Osteoarthritis is caused by the breakdown of cartilage that connects bones. Over time, the cartilage wears down at the joints and this causes the bones to rub against each other. Osteoarthritis affects everyday function and movement and often causes pain, stiffness and swelling.

Osteoarthritis Symptoms

Joint pain can happen at any part of your body but it normally occurs in your hands, fingers, shoulders, spine, hips or knees. Symptoms vary case by case. For some, symptoms only flare up for a short amount of time and then disappear. While for others, it is consistent, continuous symptoms that may impair their performance to do basic tasks such as standing or moving. The following are common symptoms of Osteoarthritis.

Pain and Stiffness

Joint pain and joint stiffness may occur when you wake up or when you have been inactive for a considerable amount of time. It may also occur after you exercise or put pressure on weight-bearing joints.

Tenderness and Swelling

Tenderness and swelling commonly occur on or around the affected joints.

Limited Range of Motion

Osteoarthritis can limit the range of motion as well as flexibility.

Crepitus or Cracking or Popping Sound

For those who have osteoarthritis, a grating sensation, popping or a cracking sound may occur in the affected joint.

 

Osteoarthritis Causes

Although the exact causes of Osteoarthritis remain unclear, it is known however that Osteoarthritis occurs when the cartilage which acts as the connective tissue between two bones deteriorates. This causes friction between two bones during movement and eventually, it causes a change to the bones as well as inflammation of the joint lining.

 

Osteoarthritis Risk Factors

Age

Osteoarthritis is the so-called ‘wear and tear arthritis because the more damage and stress on cartilage and joints, the more likely you are to develop OA. As such, the risk factors of developing OA increase with age and signs and symptoms show up in individuals over the age of 50.

Weight

Excess weight such as obesity adds stress and pressure on joints, increasing the likelihood of developing OA.

Injuries

Young people can develop OA too especially if they have had a prior joint injury such as a torn ACL or vehicular accident. Even after recovery, they are still vulnerable to developing Osteoarthritis and injuries may develop osteoarthritis quicker, typically just within a period of a few years.

Overworked joints

Those who have jobs that require lifting, kneeling, walking or climbing stairs may over time lead to overworking their joints and this increases the risk of developing OA.

Family History

Those with a family member or relative who has Osteoarthritis have increased risks of developing Osteoarthritis themselves.

Certain Medical Conditions

Conditions such as haemophilia which is a bleeding disorder in the joints as well as other types of arthritis can develop similar symptoms to Osteoarthritis.  

 

Types of Osteoarthritis

Primary Osteoarthritis

Primary OA is the more common type of osteoarthritis and it can develop due to age. Often it develops at the hip joint and knee joint as well as the big toe, thumb and fingers.

Secondary Osteoarthritis

Secondary OA can happen to younger people and occurs to changes in the cartilage that happen due to non-age-related risk factors such as injuries, obesity, medical history, overworked joins and other medical conditions.

 

4 stages of osteoarthritis

Stage 0

Also considered as the Pre-Osteoarthritis. At this stage, the joint may still be healthy and normal, or it may already begin to show cellular damage that has yet to develop symptoms. There may be changes to joint lining due to an injury or overuse that may result in problems later on.

 

Stage 1

This is considered as the early or doubtful stage. There may be signs that there is cartilage loss at joints or development of bone spurs. Some may not yet experience symptoms at this early stage while others may start to experience mild joint pain.

 

Stage 2

This is the mild or minimal stage wherein the bone spurs have grown and have come painfully. Enzymes begin to break down the cartilage as such the spaces between joins begin to narrow. Some discomfort or pain can be at this stage, particularly after an activity, or when bending or straightening joints.

 

Stage 3

This is the moderate stage of OA and the cartilage between bones begin to show signs of wear and tear. Space between bones are narrower and there is an increased development of bones spurs that may, at this point, be enlarged. At this stage, there may be visible swelling and pain is common during movement that uses the joints. Prolonged sitting or inactivity may cause stiffness too.

 

Stage 4

Stage 4 is the severe stage of Osteoarthritis. Cartilage in the affected joints may have deteriorated considerably or may be completely gone. There is less space between bones and less fluid to lubricate bones making movement painful or impossible. Bone spurs are also much large. It is common to feel severe stiffness, swelling and inflammation.

 

Osteoarthritis Diagnosis

In diagnosing osteoarthritis the doctor will conduct a health interview as well as a physical check-up to look for signs of stiffness, pain and swelling. For those unable to go to a physical check-up, this can be done online or you can have an Orthopedist Singapore make a house call.

Be as detailed as possible when answering questions regarding symptoms as this information is necessary for your doctor to make the right diagnosis. Your doctor will likely suspect you have Osteoarthritis if you fall under the following criteria:

–        Aged 45 and above

–        Pain increases as you use your joints

–        Morning stiffness last for 30 minutes or less

–         

Imaging Tests

X-Ray and MRI are imaging tests your doctor may advise you to undergo to be able to examine the condition of your joints. An X-Ray will focus on the cartilage loss in your joints while MRI can show the condition of your joints and may shed light on joint damage. It can also provide insight into the condition of your surrounding tissues, bones and cartilage.

Laboratory Tests

Blood tests and Joint Fluid Analysis are tests your doctor may ask you to take. Blood tests can help rule out rheumatoid arthritis, a type of autoimmune and inflammatory disease that may have similar symptoms to OA. On the other hand, Joint Fluid Analysis can show signs of inflammation in your joints as well as rule out infections.

 

 Osteoarthritis Complications

Osteoarthritis, as a degenerative disease, gets worse over time. Pain and swelling may increase in severity which can lead to limited physical activities, troubles with sleep and even depression.

 

Osteoarthritis Treatment

Although the doctor cannot prescribe a cure for Osteoarthritis as there is no known cure for this degenerative joint disorder, your doctor can create a personalized treatment plan that can help control your symptoms and prevent further deterioration.

Medications

Before taking any medication, it is important to consult with your doctors to know which are the right ones to take.

–        Oral Pain Relievers such as non-steroidal anti-inflammatory drugs (NSAIDs) and over the counter acetaminophen are often prescribed to patients with osteoarthritis.

–        Duloxetine, more often used to treat depression, may also use as chronic pain relief for those who have osteoarthritis.

–        Injection of steroids is a short term treatment and may relieve pain from Osteoarthritis.

 

Rehabilitation Therapy (Services in Singapore),

Physiotherapy and Occupational Therapy can also be prescribed by your doctor to help manage osteoarthritis. Retire Genie provides work with the best physiotherapy Singapore to provide you with a personalized care plan that seeks to meet your every care need.

Physiotherapy provides exercises that can help manage or eliminate pain related to arthritis. These exercises are also designed to engage and strengthen the muscles to improve flexibility.

Occupational Therapy, on the other hand, can help you regain independence in doing simple daily activities like chores in such a way that you can avoid arthritis pain. They can also help choose and give instructions in using assistive devices that can be your helpful tool to move more freely and independently in your day to day life.  

 

Surgery (and Singapore Orthopedic Hospitals)

Surgery is the last resort in the Osteoarthritis treatment plans. Procedures may entail realigning joints or replacing damaged bones. For damaged joints, your doctor may recommend joint replacement surgery. This entails removing damaged portions of the joint and replacing them with plastic or metal parts.

 

Living with Osteoarthritis

Exercises for Osteoarthritis

Staying active may be hard when you have Osteoarthritis by choosing the right kinds of exercises can help improve your symptoms. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, there are many benefits to exercising for people who have osteoarthritis. exercising does not only reduce joint pain but also improves muscle strength, flexibility and reduces endurance. It recommends starting slow and speaking to a health professional about a safe and well-rounded exercise program. So long as you know your limits and commit to a routine, you can make the most out of the benefits of working out.

The following are examples of exercises you can do:

–        Water sports such as swimming

–        Walking

–        Cycling

–        Low-impact strength training

Hot and Cold Packs

Hot and cold therapy helps reduce pain and swelling in affected joints. This can be in the form of compresses or baths and will help ease your joint pain.

Be Mindful of Your Weight

Maintaining a healthy weight will also benefit your joints as obesity or excess weight puts too much stress on weight-bearing joints such as your knees.

A healthy weight can be managed by an active lifestyle but ultimately, it depends on the food you eat. The Arthritis Foundation debunks food myths that some believe to be exacerbating Osteoarthritis symptoms but may be beneficial. One example is Citrus fruits which are blamed to be inflammatory due to their acidity. However, these food are rich in Vitamin C which has antioxidant and anti-inflammatory benefits. While it also debunks total avoidance of dairy (for non-lactose intolerant people) and claims that an alkaline diet and raw food (mainly fruits and vegetable diet) have no scientific basis for curing osteoarthritis, it does promote that a well-balanced diet is a key to a healthy lifestyle.

Take Care of Your Emotions

Osteoarthritis is a degenerative disease that may gradually limit the things you can do. It may disallow you to do things you previously could. This often leads to anxiety, sadness or frustration. Therefore it is important to manage both physical and emotional well being when dealing with OA. Keep up with other passions and leisurely activities such as enjoying a good book, listening to music or perhaps even visiting art galleries and museums. It is also important to talk to your doctor about your mental and emotional health so they can advise on how best to manage it.

Build a Support Network

Having a good support network of family or caregivers who can help you perform everyday tasks is beneficial, especially if you start experiencing discomfort or pain when performing them. Don’t hesitate to ask for help when you need it and don’t let OA keep you at home and isolated. Stay social and go out to meet new people and make new relationships. OA is no reason to stop enriching your life with new experiences, passions and relationships. Your support network is there to help you.

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