Osteoarthritis

OA is the most common joint disorder, typically affecting hand joints (especially those involved with a pinch-grip), weight-bearing joints (hips, knees and big toes) and the spine.

In healthy joints, the rubbery cartilage covers the ends of each bone providing a smooth, gliding surface for joint motion and acting as a cushion between the bones. In OA, the cartilage wears away, leading to joint damage.

The cause of OA is not clear. Common risk factors include increasing age, obesity, previous joint injury and overuse. Genetic factors, pre-existing joint disorders such as Rheumatoid Arthritis and metabolic diseases may cause OA.

• Affected joints may swell after extended activity.
• Clicking or cracking sounds occur when bending.
• Bone swelling occurs.

OA can usually be diagnosed based on patients' symptoms and medical examinations. While X-rays are useful for confirming the presence of osteoarthritis, they do not provide details about the degree of pain or disability and are not solely diagnostic.

A combination of lifestyle changes and medications may be used to relieve symptoms:

• Weight loss and exercises that do not involve weight-bearing joints (such as swimming) and provide joint range of motion, muscle strengthening and aerobic fitness.
• Assistive devices such as walking aids, splints and food orthotics with advice of occupational therapists.
• Topical and oral medications (used in step-wise fashion): Paracetamol, NSAIDs
• Joint-injections
  

Surgical management such as joint replacements may be considered at advanced stages.

Consult a Family Physician or Rheumatologist. Education, lifestyle modification, painkillers and intra-articular injections may occasionally be used to relieve discomfort. If OA has resulted in pain, deformity and loss of function, the Orthopaedic surgeon may consider surgery.

This condition is managed by the Division of Rheumatology.