London: Osteoarthritis occurs when the cartilage that protects our joints breaks down. The body’s attempts to repair the damage can make it worse, as the synovium — the capsule containing the joint — thickens and produces more lubricating synovial fluid, in turn causing inflammation.
As part of this attempt at repair, extra bone may grow at the joint’s edge, distorting it. The result: stiffness and pain.
In the UK, an estimated nine million people have osteoarthritis, which most commonly hits the joints that take the most strain — more than two million over-45s have it in their hips, and five million in their knees — but it can affect any joint, from the fingers to the toes.
Prevent Arthritis and Get Rid of Joints Pain and Back Pain
Age-related ‘wear and tear’ is clearly a factor, but the exact cause of osteoarthritis remains unclear. Injuries may play a part, and there is evidence the condition is inherited. Women suffer more than men, thought to be due to the drop in estrogen during menopause.
While not many of us punish our joints in quite the same way as Andy Murray, punish them we do — being overweight increases the risk of arthritis by at least four times.
Every additional pound of weight increases the load on each knee by four pounds, with every step wearing down the cartilage. There is also evidence that fat cells release chemicals that cause inflammation.
And sedentary lifestyles don’t help, as a lack of exercise weakens the muscles and ligaments that support joints. The good news is that, although there is no cure for osteoarthritis, there is much that can combat it — and the pain it causes.
What to do if it’s early days
There are two things you can do to avoid osteoarthritis or keep it at bay once joints start to stiffen and feel painful: stay active and watch your weight.
‘Staying mobile and maintaining good muscle strength is the best way to keep osteoarthritis at bay,’ says Professor Philip Conaghan, a consultant rheumatologist at Leeds Teaching Hospitals NHS Trust, who led the National Institute for Health and Care Excellence’s latest review of treatment guidelines.
It’s a myth that exercise can lead to osteoarthritis by wearing down joints (unless you’re an elite athlete with a punishing regimen).
In fact, joints supported by weak muscles are more susceptible to arthritis. Tellingly, the average body mass index (BMI) of hip surgery patients in the UK in 2016 was 28.8 (overweight).
And with an average BMI of 31, many of those who had a knee replaced were obese. But even when osteoarthritis has set in, it’s not too late to do something about it.
Steps to avoid the surgeon
In his NHS clinic, Professor Conaghan sees patients with knee, hip and other joint pain aged from about 40 to 75, ‘and among them, muscle weakness is almost universal’, he says.
His advice is simple: ‘First get strong, then get fit. Just telling people to walk round the block is a bad starting point — because they are weak, they can’t walk at a brisk pace and they’re not getting any benefit.
‘But once they’ve built up some muscle strength, they can start on aerobic fitness, such as on an exercise bike or cross trainer, or swimming. Walking laps in a swimming pool is a fabulous exercise for weak people.’
And exercise really will help, with overwhelming evidence that it ‘significantly reduces pain and improves function, performance and quality of life in people with knee and hip osteoarthritis’, as a review in the journal Annals of Physical and Rehabilitation Medicine said this year. dailymail