Osteoarthritis: Its not only for the old

When you think about osteoarthritis (OA), you probably associate it with old age. But although most common among older people, people younger than 45 years old can also suffer from this form of arthritis. Osteoarthritis is a degenerative joint disease that mainly affects the cartilage. Osteoarthritis is also known as degenerative arthritis, degenerative joint disease, and wear-and-tear arthritis.

Cartilage is the protective tissue in the joint. When it breaks down, as is the case with OA, the bones rub together. This often results in stiffness, pain, and creaking. These symptoms may come and go and generally worsen over time.

Osteoarthritis affects joints that have been continually stressed throughout the years. Although any joint can be affected, the most affected joints tend to be the knees, hips, fingers, and the lower spine region. The pain can be worse in the mornings when it is cold.  

Prevalence and risk factors

Osteoarthritis is one of the ten most disabling diseases in the world. The burden of OA might be greater in developing countries where life expectancy is rising and access to joint replacement therapy is not as readily available as in the developed world.

According to statistics from the World Health Organisation (WHO), 9.6 per cent of men and 18 per cent of women aged over 60 years have symptomatic OA. Much younger people can develop the condition as a result of injury to the affected joint.

Osteoarthritis can affect people of both genders. However, in younger people, OA is slightly more common in men until the age of 45. After the age of 45, OA tens to be more common in women.  

Occupational hazard

There are studies that show that OA is more prevalent in rural farming, fishing, and mining communities. People involved in those occupations repetitively stress one joint of a group of joints, wearing down its cartilage. For example, farmers often spend their days standing and bending over, which stresses their knee and hip joints. Cotton and tea pickers use their hands a lot, hence they’re likely to experience osteoarthritis in their finger joints.

People who regularly take part in joint-intensive sports may also have an increased risk of developing osteoarthritis. People with poor posture or who have had joint injury are also at an elevated risk of developing OA.

Genetic factors

OA tends to run in families. However, people inherit an increased risk of developing osteoarthritis, not the condition itself.

A study published in Nature Genetics in 2018 identified nine novel genes that increased the risk of developing osteoarthritis. This discovery might inform the development of new ways of treating the condition.

Obesity

Being overweight or obese also increases the risk of developing OA. The extra weight on joints, such as knees and hips, increases stress, and could hasten the breakdown of cartilage.

Researchers estimate that a force nearly three to six times one’s body weight is exerted across the knee while walking. This means being only 10 pounds overweight increases the pressure on your knees by 30 to 60 pounds with each step. Obesity has also been associated with higher rates of hand osteoarthritis. This suggests the involvement of a circulating systemic factor as well.

Studies have shown that persons in the highest quintile of body weight have up to 10 times the risk of knee OA than those in the lowest quintile. Data shows that obese women have nearly four times the risk of knee OA compared to non-obese women. For obese men, the risk of developing knee OA is five times greater than that of non-obese men.

Osteoarthritis vs Rheumatoid arthritis

Although they share some symptoms, osteoarthritis is a different condition from rheumatoid arthritis (RA). Arthritis is an umbrella term used to describe inflammation of the joints. While OA is a degenerative disease caused by the wear-and-tear of cartilage over time, rheumatoid arthritis is an autoimmune disorder.

The immune system of a person suffering from RA mistakes the protective cartilage around the joints to be a threat to the body. The immune system attacks the cartilage, leading to symptoms that are similar to those caused by OA.

In rheumatoid arthritis, there tends to be fluid buildup within the joints, causing pain, swelling, and inflammation. Rheumatoid arthritis usually causes inflammation in many different joints throughout the body at the same time. This is unlike osteoarthritis where the symptoms are usually isolated to a single joint or a group of joints.

What triggers osteoarthritis?

Osteoarthritis symptoms tend to come and go throughout the day. The symptoms seem to be triggered by certain conditions. Although triggers vary from person to person, here are some of the most common:

Staying still for too long can cause your joints to stiffen, and likely to hurt when you try to move. Lack of activity while sleeping may partly explain why OA symptoms seem to be worse in the morning.

Research has also shown that periods of stress are linked to an exaggerated perception of pain. You might have a flare-up of OA symptoms when you’re stressed.

Then there are weather changes. People with OA report flare-ups during cold, damp weather.

Diagnosis and treatment

A slow-developing condition, osteoarthritis can be difficult to diagnose in the early stages. It is often diagnosed after one has an accident or incident that requires an X-ray. It can also be diagnosed using an MRI scan, blood tests to rule out other conditions that cause joint pain, and joint fluid analysis to determine whether an infection is the underlying cause of inflammation.

The treatment of OA is centered on symptom management. Over-the-counter medication, home remedies, and lifestyle changes are often enough to provide relief from bothersome symptoms.

The recommended lifestyle changes include weight loss, regular gentle exercise, and getting adequate sleep. Experiment with heat or cold therapy to relieve pain and stiffness. This means applying a cold or hot compress to the sore joints for 15-20 minutes several times a day.