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The Menopause Exchange Blog

ALL ABOUT OSTEOARTHRITIS

In addition to articles on the menopause, The Menopause Exchange regularly features topics relevant to women of menopausal age.

Osteoarthritis, the most common cause of joint pain, affects more than eight million people aged 45 and over in the UK. It affects joints such as your knees, hips or hands when your body’s normal repair process can’t keep up with the everyday wear and tear that your joints go through.

This article was included in issue 76 (spring 2018) of The Menopause Exchange newsletter. 

Who does it affect?
Osteoarthritis usually starts from the late-40s onwards. We don’t fully understand why it’s more common in older people, but studies suggest that this may be due to the muscles weakening and the body being less able to heal itself, or the joint slowly wearing out over time.

For most joints, especially the knees and hands, osteoarthritis is more common and more severe in women. Women account for around 60% of hip and knee replacement operations, the majority of which are due to osteoarthritis.

What are the risk factors?
Osteoarthritis is caused by a mixture of factors. Being overweight can increase your risk of developing osteoarthritis, especially in your knee. It also increases your chances of osteoarthritis gradually becoming worse. Normal activity and exercise don’t cause osteoarthritis, but doing very hard activities over and over or physically demanding jobs can increase your risk. A major injury or operation on a joint may lead to osteoarthritis in that joint later in life.

Nodal osteoarthritis, which mainly affects the hands of middle-aged women, runs strongly in families, but it’s unclear which genes are involved. Arthritis Research UK is currently funding a study to identify genes that lead to the development of osteoarthritis but have so far been undetected. Identifying these genes could help us develop better treatments that are specific to someone’s type of osteoarthritis.

Signs and symptoms
People with osteoarthritis experience joint pain, stiffness and swelling, and often describe a grinding or grating sensation in their joints, which restricts movement. The pain tends to be worse when people move their joint or at the end of the day.

People’s arthritis symptoms often vary for no clear reason – and they may have good and bad spells. Some people find that changes in the weather make their pain worse, especially damp weather along with falling atmospheric pressure. Others find their pain varies depending on how active they’ve been.

Exercise
It’s important to keep your joints moving and your muscles strong. If osteoarthritis is causing you pain, you may not want to exercise, but this can increase stiffness and, in the long term, your muscles will weaken, making exercise even more difficult for you.

If you have joint pain, start gently and gradually increase the length of time you’re exercising. You can break this into smaller chunks if you need to. Doing five to 10 minutes of exercise each day is a good start to keep your joints moving and your muscles strong. You should try to gradually increase the amount of exercise you do over time.

Strengthening exercises will improve the strength and tone of the muscles that control your joints. This will help to protect your joints and make them more stable, and it has also been shown to reduce joint pain. Aerobic exercise helps you sleep better, improves your general health and wellbeing and can reduce pain by releasing hormones called endorphins.

Swimming, hydrotherapy and T’ai chi are some forms of exercise that can be good for osteoarthritis. A physiotherapist can advise on the best exercises for you. You can also talk to your GP about the Exercise on Prescription scheme that’s available in some areas.

Managing your weight
Evidence shows that being overweight increases the strain on your joints – especially your knees. No special diet has been shown to help with osteoarthritis, but if you need to lose some weight we would recommend that you stick to a balanced, reduced-calorie diet combined with regular exercise. Other measures can also help you manage the strain on your joints, such as pacing your activities through the day, wearing shoes with thicker soles and using a walking stick or other support when walking.

Treatments and surgery
Painkillers, such as paracetamol, often help with pain and stiffness, although they don’t affect the arthritis itself and won’t repair damage to your joint. They’re best used occasionally when your pain is very bad or when you’re likely to be exercising.

Topical creams and gels containing non-steroidal anti-inflammatory drugs (NSAIDs) or capsaicin, the chemical that makes chillies hot, can be useful for hand or knee osteoarthritis. You need to apply these creams regularly for at least two weeks to start seeing the benefits.

If these medicines aren’t effective, then the next step is to take some oral NSAIDs (tablets or capsules) such as ibuprofen or naproxen. People who take oral NSAIDs regularly should also use medicines called proton pump inhibitors (PPIs) to protect their stomach. People with asthma, high blood pressure, kidney or heart disease, or taking other medicines, should consult their GP before taking NSAIDs, as these may not be suitable for them.

Surgery, such as joint replacement, may be recommended if your pain is very severe or you have mobility problems.

There are many complementary therapies and herbal remedies claiming to help with osteoarthritis. These include specific dietary supplements, homeopathy and acupuncture. Some people do feel better when they use complementary treatments. However, on the whole, these treatments aren’t recommended for use on the NHS because there’s no clear evidence that they work.

For more information
Arthritis Research UK invests in breakthrough treatments, the best information and vital support for everyone affected by arthritis. Anyone who wants information, advice or support about arthritis can visit www.arthritisresearchuk.org or call Arthritis Research UK’s helpline on 0800 5200 520 (9am-8pm, Monday-Friday).

Created Spring 2018

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