JOIN USGrowing old can be a pain in the knees. Osteoarthritis is one disease to watch out for, warns Dr Biren Nadkarni
A mother’s love is great medicine while comforting her children but when it comes to curing her pain, you may have to call a doctor. Does your mother often wince because of knee pain? If your answer is yes, then she might be suffering from arthritis. Arthritis is one of the major causes of knee pain in India. Figures shows that by 2015, patients suffering from arthritis will be more than that of diabetes. The Planning Commission’s recent report says that women are more affected by osteoarthritis than men after the age of 50.
Osteoarthritis, also known as degenerative arthritis degenerative joint disease, OA, or osteoarthrosis, is a form of arthritis caused by inflammation, breakdown, and the eventual loss of cartilage in the joints — when the cartilage wears down over time.
Osteoarthritis (OA)generally affects elderly women, but has also been found in a few above the age of 40. Younger people affected by osthearthritis, usually after an injury or as a result of another joint condition, will show three basic characteristics:
nBony growth development around the edge of joints.
nDamaged cartilage — cartilage is the part of the joint that cushions the ends of the bones and allows easy movement of joints.
nSynovitis — a mild inflammation of the tissues around the joints.
After menopause, the level of estrogen goes down drastically and due to this, the cartilage loses its elasticity. If the cartilage is stiff, it is becomes more susceptible to damage. The cartilage, which acts as a shock absorber, will gradually wear away in some areas. Eventually the bones may rub against each other causing severe pain.
The symptoms develop slowly and get worse with time. Searing pain in the joint, either during or after use, or after a period of inactivity is a clear symptom of arthritis. Over time, the same joint will become harder to use as it loses its flexibility. Some women experience a grating sensation when they use the joint. Hard lumps or bone spurs may appear around the joint. The most commonly-affected joints are in the hips, hands, foot thumbs, knees and spine.
In most cases, both knees are affected, unless the osteoarthritis is caused by an injury (or another condition). The patient will experience pain when walking, especially uphill or upstairs. Knees may lock into position, making it much harder to straighten the leg. The knee may make a soft, grating sound when used.
People with arthritis will often avoid moving the affected joint because of the pain. Typically, pain will be felt whilst walking but some may feel pain even when resting.
Osteoarthritis, which starts as a negligible ache, will soon start to show symptoms. As soon as its symptoms are noticed, it is best to see a doctor and get it fully diagnosed. Some say that osteoarthritis is an inevitable part of ageing. This is untrue. There are people well into their 90s who have no clinical or functional signs of the disease.
Identifying the disease
Arthritis affects people in many different ways. How long the patient is affected and how severe it is, depends on the type of arthritis. Arthritis sufferers will have their share of good and bad days. Most patients with arthritis will suffer from discomfort, pain, stiffness and/or fatigue.
Women will slowly lose their ability to grip things well or get around like they used to. It is important to remember that if you suffer from arthritis, this does not mean you have to give up having an active lifestyle. With some changes to your way of life, there is no reason why you cannot continue being active. Other signs and symptoms may include:
* Affected joints which are larger than usual
* Worsening pain and stiffness
* Warm joints
* Loss of muscle bulk
* Tenderness in the affected joint
* Limited range of movement
* Grating or crackling sound/sensation around the affected joint
* Pain spreading to other joints such as the hips and spine.
When to see a doctor
People who suffer from joint stiffness and swelling that persist for more than a couple of weeks, should see a doctor. Those already on osteoarthritis medications should contact a healthcare professional if they experience nausea, constipation, drowsiness, abdominal discomfort, or have black or tarry-coloured stool.
Cure
Physical therapy can be helpful for some types of arthritis. Exercises can improve one’s range of motion and strengthen the muscles and surrounding joints. In some cases, splints or braces may be warranted. If conservative measures don’t help, surgery will have to be considered; eventually the joint may need to be replaced.
A healthy lifestyle helps as a long-term treatment. You could try the following measures:
nWeight loss: If you’re obese, losing weight will reduce the stress on your weight-bearing joints. This may increase your mobility and limit future joint injury.
nExercise: Regular exercise can help keep your joints flexible. Swimming or water aerobics is often a good choice because the buoyancy of the water reduces stress on weight-bearing joints.
nHeat and cold: Heating pads or ice packs may help relieve arthritis pain.
nAssistive devices: Using canes, walkers, raised toilet seats and other assistive devices can help protect your joints and improve your ability to perform daily tasks.
Be careful and be open with your elderly family members about arthritis. Explain how it affects them so that they recognise their special needs. You can also speak to the doctor for the same.
(The contibutor is a senior orthopaedic and joint replacement surgeon at Sitaram Bhartia Institute of Science and Research, New Delhi.)