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​5 most important questions to ask your doctor about OA

8th May 2018

We all experience aches and pains from time to time. Normally this isn’t a problem. However, when pains become regular they become a cause of concern. Recurring pain or discomfort in the joints may be indications of the onset of osteoarthritis – a condition which, as we age, gradually damages the surfaces of the joints so the joint doesn’t move as smoothly.

Without a clinical diagnosis the aches and pains are often ignored until the condition becomes more pronounced. However, early diagnosis can play a major part in managing the condition. With early diagnosis patients can make changes to their general lifestyle which can reduce and delay the effects.

If you are experiencing any recurring symptoms which are causing concern it would be advisable to consult your GP to diagnose the problem. With a diagnosis and tests like X-Rays, MRI scans or blood tests your doctor can determine the level of your OA and begin to start to discuss treatment options which are recommended by NICE (National Institute for Health & Care Excellence).

There are many sources of information on the Internet, but you will have a range of questions you could ask while you are with your doctor.

Here are 5 key questions to ask your GP

What is osteoarthritis?

The bones in our joints are protected by layers soft tissue (cartilage) which cover the surface of the bones and cushion them when our joints move. Osteoarthritis the degenerative condition and is the natural process of wear and tear on the joint. However, over time this protective layer can wear thin or be damaged reducing the level of cushioning.

As the condition develops the cartilage becomes rougher and more brittle. Underlying bone can thicken and broaden to reduce the pressure on the cartilage. Joints may develop bony outgrowths on the outer edges making it look knobbly. The joint stiffens and becomes painful to move and can become enflamed. Weight bearing joints are the most common areas affected.

What are the causes of OA?

There are many contributing factors affecting the joints. The process of wear and tear is a natural one however there are factors which might speed up the process.

  • Age: Osteoarthritis typically starts as we move closer towards our 50’s.
  • Heredity/Genetic factors: OA can be inherited and can run strongly in families.
  • Injury: Major injuries or operations can adversely affect the joint in later life and increase the risk of developing OA.
  • Obesity: Increased weight increases the forces passing through the joint and subject the cartilage to more pressure. For every 5kg of weight there is a 36% increase in the risk of developing OA as the joints are subjected to additional stresses. It also makes an existing condition worse.

What are the surgical options?

  • A common surgical option is an Arthroscopy. This keyhole procedure allows the cartilage in the knee to be trimmed and flushed out to “tidy” the surfaces.
  • Partial or total joint replacement is an option for severe cases but should always be considered as a last resort.
  • Joint fusion or arthrodesis is a process to fuse together the two bones in the painful joint to help reduce pain.

Are there non-surgical treatments?

There are various treatments depending on the severity or level of the OA

  • Drugs: Commonly OTC painkillers (NSAIDS or paracetamol) are prescribed however it is important to remember that these can only help with the symptoms and not the condition itself. Prolonged use may see the effectiveness of the painkillers reduced over time.
  • Injections: There are treatment options which involve direct injections into the joint. These injections are usually corticosteroids or an alternative is Viscosupplementation which is a lubricating fluid called hyaluronic acid
  • Hot & cold compress: These may provide reduce pain and inflammation.

Is there any way to prevent my condition for worsening?

  • Weight control: OA can affect mobility, so it is important to keep a healthy weight. Weight loss can provide dramatic results. Losing 10% bodyfat can ease joint pain by half.
  • Dietary changes: Diet can help slow the progression of the condition. Including fatty fish like salmon, mackerel, or tuna into your diet 2-3 times per week provide great sources of omega-3 which can reduce inflammation. Fruit and vegetables are loaded with antioxidants which help prevent your cells from damage.

  • Mobility aids and supports: again, these depend on the severity of the condition but can help keep us active and help keep weight under control. Crutches or walking sticks to assist with mobility. Shoe inserts can assist with posture and walking gait. Elasticated supports and sleeves can support joints and reduce swelling.
  • Knee braces have been developed for unicompartmental OA: the brace can reduce the load on one side of the knee joint where cartilage has worn down prematurely. These braces can delay the need for surgery and are now recommended by NICE, OARSI and Arthritis Research.
  • Physiotherapy: strengthening the muscles which support the joint can help reduce wear and tear on the soft tissue. You doctor may refer you for physiotherapy.

Unfortunately, there is no treatment to regenerate our joints or reverse the damage to our joints once it happens so the earlier the condition is diagnosed the sooner effective treatment strategies can be developed and implemented. Slowing the progress of the condition allows us to enjoy life as fully as possible for as long as possible.

So, if you have any of the symptoms and think you may have or may be developing osteoarthritis you should consider discussing the symptoms with your doctor and researching the condition for yourself.

A great place to start is to consult the NICE guidelines.

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