Foot Health

Osteoarthritis, the most common type of arthritis

Osteoarthritis, pronounced (AH-stee-oh-ar-THREYE-tis), is the most common type of arthritis and is seen especially among older people affecting millions of people worldwide. Osteoarthritis most affects cartilage (KAR-til-ug), the hard but slippery tissue that covers the ends of bones where they meet to form a joint. Healthy cartilage allows bones to glide over one another. It also absorbs energy from the shock of physical movement. Osteoarthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. The surface layer of cartilage breaks and wears away. This allows bones under the cartilage to rub together, causing pain, swelling and loss of motion of the joint. Over time, the joint may lose its normal shape. Also, small pieces of bone – called osteophytes or bone spurs – may grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space. This causes more pain and damage.

Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, feet, knees, hips and spine.

Osteoarthritis affects the entire joint, from the wear and tear of the cartilage, and causes changes in the bone, the connective tissues that holds the joint and muscle together. It also causes inflammation of the joint lining. Some risk factors for getting osteoarthritis include being overweight, age (osteoarthritis increases with age), sex, (women are most likely to develop osteoarthritis), joint injury, joints that are not properly formed or out of alignment, a genetic defect in joint cartilage, and stresses on the joints from certain jobs and playing sports.

Symptoms

Symptoms often develop slowly and worsen over time. They include:

• Pain: Affected joints might hurt during or after movement.

• Stiffness: Joint stiffness might be most noticeable upon awakening or after being inactive or sitting for a while.

• Tenderness: Your joint might feel tender when you apply light pressure to or near it.

• Loss of flexibility: You might not be able to move your joint through its full range of motion.

• Grating sensation: You might feel a grating sensation when you use the joint, and you might hear popping or crackling.

• Bone spurs: These extra bits of bone, which feel like hard lumps, can form around the affected joint.

• Swelling: This might be caused by soft tissue inflammation around the joint.

When to see a doctor

If you have joint pain or stiffness that doesn’t go away, make an appointment with your doctor. Once you go to the doctor, you will have a physical exam to check your affected joints for tenderness, swelling, redness and flexibility. There may be imaging tests such as x-rays or MRI. There may be blood tests to look at the joint fluid.

There is no cure for arthritis, however, symptoms can be managed through various forms of treatment, behavior strategies and education. Doctors often combine treatments to fit a patient’s needs, lifestyle and health.

Medications that can help relieve osteoarthritis symptoms, primarily pain, include acetaminophen, and non-steroidal anti-inflammatory drugs (NSAIDs) can be used to relieve pain. Care must be taken not to take too many because they can cause a number of problems such as an upset stomach and damage to the liver and kidneys. Sometimes pain-relieving gels can be applied to the skin over the affected joint. These have fewer skin effects and may relieve pain just as well.

Physical therapy: A physical therapist can show your exercises to strengthen the muscles around your joint, increase your flexibility and reduce pain. TENS (Transcutaneous electrical nerve stimulation therapy) – low-voltage electrical current to relieve pain – also provides short-term relief for some people with knee and hip osteoarthritis.

Occupational therapy: An occupational therapist can help you discover ways to do everyday tasks without putting extra stress on your already painful joint.

Injections: A cortisone shot or even a joint lubricant such as hyaluronic acid may also help.

Surgery: May be needed to realign or replace the joint to relieve the pain.

Lifestyle and home remedies: Exercising and losing weight if you’re overweight are important ways to lessen the joint pain and stiffness of osteoarthritis. Low-impact exercise is best and can increase your endurance and strengthen the muscles around your joint, making it more stable. Try walking, bicycling or water aerobics.

Movement therapies: Such as tai chi and yoga involve gentle exercises, and stretching combined with deep breathing also helps to relieve stress.

Heat and cold: Moist heat can help muscles relax and ease pain, while cold can relieve muscle aches after exercise and decrease swelling and muscle spasms.

Capsaicin: Topical capsaicin, a chili pepper extract, applied to your skin over an arthritic joint can help relieve joint pain.

Braces or shoe inserts: Shoe inserts or other devices might help reduce pain when you stand or walk. These devices can support your joint to help take pressure off it. Other devices such as a cane or walker can help relieve stress on your joints and takes weight off your knee or hip as you walk. Always hold the cane in the hand opposite to the leg that hurts.

Food: The type of foods you eat can increase inflammation and pain in your joints. Try to avoid or limit foods such as refined carbohydrates: French fries and other fried foods, soda, and other sugar-sweetened beverages, red meat (burgers, steaks) and processed meat (hot dogs, sausage) and margarine, shortening, and lard. Instead, try an anti-inflammatory diet that includes green leafy vegetables such as spinach, kale and collards, nuts like almonds and walnuts, fatty fish like salmon, mackerel, tuna and sardines, and fruits such as strawberries, blueberries, cherries and oranges.

Supplements: Such as glucosamine and chondroitin and Omega-3 fatty acids might help relieve pain and improve function.

Complications

Osteoarthritis is a degenerative disease that can worsen over time, often resulting in chronic pain. Joint pain and stiffness can become so severe to make daily tasks difficult. Depression and sleep disturbances can result from the pain and disability of osteoarthritis.

 • For more information email us at foothealth242@gmail.com, or to see a podiatrist visit Bahamas Foot Centre, Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Hilltop Medical Centre, East Terrace Centreville or telephone 394-5820; or Lucayan Medical Centre, East Sunrise Highway, Freeport, Grand Bahama, every first and third Thursday, telephone 373-7400.

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