The Complete Guide to Osteoarthritis

This question gets raised a lot, and it's understandable. Osteoarthritis is not an autoimmune disease. The reason for this confusion is that it gets confused with rheumatoid arthritis.

Arthritis has become a catch-all term for over 100 different conditions. Rheumatoid arthritis is an autoimmune disease. It's also one of the more common types of arthritis.

Osteoarthritis doesn't have an immunological component. Feeling your body and joints starting to cause pain and give up on you is frustrating. This is a significant reason for assuming it must be genetic or autoimmune.

Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis. As mentioned earlier, they join a list of at least 100 others. These include rarer ones like lupus and gout.

That said, rheumatoid arthritis is far rarer than Osteoarthritis. It affects about 1/10th of the number of people. With 20% of the Canadian population suffering from arthritis, knowing the differences is essential.

The main differences between Osteoarthritis and Rheumatoid arthritis are the causes. Osteoarthritis is a result of physical wear and tear through activity. Rheumatoid arthritis is a result of an autoimmune disease.

This is where your own body attacks your joints as part of a misguided immune response. There are many other factors at work too, which we will get into later. OA starts later in life, and the aches are smaller and more localized.

In the case of RA joints, it can occur at any time or age, build up fast, and come with more pain and swelling in larger areas. Someone with OA might have soreness or aches in a wrist or a finger joint as they get older. An RA sufferer is more likely to get intense pain in simultaneous joints, such as both wrists.

Many risk factors influence the likelihood of getting Osteoarthritis. These include being older, which increases risk, and your sex. Women are more likely to develop Osteoarthritis than men.

Having your hips and knees support excessive weight increases wear and tear on your joints. Fat tissue also creates certain proteins that lead to joint inflammation. This, in turn, causes further damage to cartilage and joints.

Joint injuries, bone deformities, and repeated joint stress are also factors. Injuries or stress from playing sports or intense physical exertion can increase your risk, even if you healed long ago. Some people are also more genetically susceptible to developing Osteoarthritis.

Metabolic diseases such as diabetes are also key risk factors. Hemochromatosis, or the excessive production of iron, is another one to watch for.

Osteoarthritis is a degenerative disease, worsening over time, especially if untreated. The symptoms to look out for most are:

• Pain or aching
• Swelling
• Stiffness
• Decreased range of motion (or flexibility)

You can add more nuanced symptoms like feeling your joints are grating. This could be a sign that your cartilage has worn down to the point where you're feeling the friction of your bones rubbing against each other. Another one that is sometimes difficult to determine is bone spurs.

These usually form around your joints and resemble hard lumps. As the name suggests, they are actual pieces of bone, and they can take years to discover. While they don't always result in pain, they are often linked to Osteoarthritis.

In terms of pain and stiffness as symptoms, these are straightforward. Aches and soreness usually occur while or after moving. Higher than usual levels of stiffness in your joints may follow after periods of inactivity.

Chronic joint stiffness after waking up in the morning is a potential symptom. If, while massaging your joints, you feel pain or tenderness, this is another one. You may also notice swelling or inflammation around the joint, particularly around your knees.

Range of motion and flexibility is also a key indicator. Issues in either regard are good indicators of potential Osteoarthritis. The inabilities to bend, stretch, or twist your body without discomfort or pain are classic signs.

There are four stages of Osteoarthritis that most patients will go through. These are minor, mild, moderate, and severe. The length of each stage and how you move between them are different for every patient.

Minor

The first stage is minor. At this point, the patient has no pain at all and minor damage to their joints. It's hard even to notice any discomfort at all.

Any soreness or irregularities may happen due to poor sleep, overexertion, or age. None of the chronic symptoms associated with Osteoarthritis are noticeable here. This is the optimal stage to catch Osteoarthritis to prevent further damage, but it's hard to detect.

Mild

During the mild stage, occasional stiffness is normal, especially after inactivity. You may feel pain after hard exertion and start to develop bone spurs. This is the stage where most patients often opt for a back or knee brace while doing heavy lifting or hard work.

Rest helps, as does wearing supportive braces for longer periods. It's still possible to slow arthritis down at this stage. Lifestyle changes, stretching, and proper rest can help.

Moderate

The moderate stage is when a significant number of people start to tackle the possibility of having Osteoarthritis. This is where you first start to notice that your joint cartilage is eroding. Patients also feel and notice the inflammation and discomfort that results.

Pain and symptoms can be daily occurrences. At the moderate stage, patients go to a doctor for answers. They also track their physical exertion levels and avoid movements that trigger joint pain.

Severe

The severe stage is the worst-case scenario. At this point, most of a patient's cartilage is gone, and this causes constant inflammation. Bone spurs have also grown large enough to cause intense pain while moving your joints.

Swelling and a constant ache are common, especially after physical activity. At this stage, pain and symptom management are critical, with surgery being an option for those in extreme discomfort.

Most medication designed to treat Osteoarthritis comes in the form of pain management. This includes over-the-counter options like Advil, Motrin, or Tylenol.

Most ibuprofen and acetaminophen options don't require a prescription. However, a doctor might prescribe you something stronger. Steroid injections might help with swelling and inflammation caused by Osteoarthritis.

You may also opt for nonsteroidal options. These come in the form of topical and non-topical options. There are many nonsteroidal anti-inflammatory drugs (NSAIDs) that require prescriptions.

Voltaren, Lodine, Daypro, Mobic, and Feldene are examples. There are even NSAID creams like diclofenac.

Changing your habits can make a big difference. Weight loss, proper diet and nutrition, and exercise can improve your condition. Other treatments involve physical therapy, stretching, and using orthoses or braces.

Canes can help alleviate pressure or weight off of weak joints. Changes to your home to make movement a little easier are also worth considering.

Surgery is the last resort for those with severe pain from advanced Osteoarthritis. If nothing else seems to be helping, there are three main types of surgical procedures that could help.

The first is realignment surgery. This procedure aims to realign the bones or joints that became crooked as a result of severe Osteoarthritis.

The second type is fusion surgery. This is usually done if replacing the joint isn't feasible. It stops the pain of bones grinding on each other – at the expense of flexibility.

The last is joint replacement, which replaces the affected joint with a prosthetic. While this can provide immediate relief, it can also come with longer-term side effects. It isn't uncommon to require a follow-up treatment or even full replacement every ten years.

Whichever surgery you go with, know that they come with complications. The risk of infection, blood clots, or cracked bones is not insignificant. Always consider all of your options with your doctor first.