Osteoarthritis is the most common type of arthritis, a condition which causes pain and inflammation in the joints. It's a 'wear and tear' degenerative disease associated with getting older, but also injuries, occupational over-use and other conditions including gout.
Around 8.75 million people see their GP about osteoarthritis every year in the UK and one in three people over 45 are affected by the aliment. Rheumatoid arthritis is much less common, affecting 690,000 UK people.
Osteoarthritis is caused by cartilage, the tough connective tissue which acts as shock absorbers to your joints wearing thinner and breaking down, causing friction and pain in the joints.
It can affect any synovial joint in the body - synovial joints all include cartilage which cushions the joint, synovial fluid for lubrication, tendons which join muscle to bone and ligaments which join bone to bone stabilising the joint.
Osteoarthritis symptoms can include joint pain, swelling and stiffness. Your joints may also creak and crunch as you move and feel stiff in the morning, but this will ease off by moving around within 30 minutes of getting up.
Your knees, hips and hands are the joints where you are most likely to experience pain first. You may notice your fingers develop bumps and feel stiff and painful, making it more difficult to do everyday tasks such as opening jars, using a keyboard or writing.
Your knees may appear more knobbly and swollen and feel painful when walking or using steps and can sometimes give way underneath you. Hip pain may make it difficult to bend over and affect your walking.
If you're over 50, overweight and have joint pain that gets worse when you move or at the end of the day, then osteoarthritis may be suspected.
Joints can also give way due to muscle weakness or a hard or soft swelling develops around the joints. Your GP may also look for signs of loss of muscle mass loss.
Blood tests, X-rays, CT and MRI scans are usually only done if your GP wants to rule out another condition or injury.
Who gets OA?
Age is one of the most important factors in developing osteoarthritis, most people who have it are usually in their late 40s or older. It's also more common in women and if you're overweight (because of the pressure the extra weight puts on your joints), and if you've injured a joint when you were younger, you're more likely to develop OA in that joint later in life.
Doing a physically demanding job which involves repetitive movements, e.g. digging and lifting can also put you more at risk of osteoarthritis. It can also run in families, but scientists haven't yet identified which genes are responsible for that.
Milder osteoarthritis pain and joint stiffness improves with regular exercise, particularly strengthening exercises and aerobic fitness. Losing weight if you're overweight can also ease symptoms as it takes pressure off the joints.
Drug treatment options includes regular paracetamol and/or a non-steroidal anti- inflammatory drugs (NSAIDs) cream or gel (for knee or hand osteoarthritis). If these don't work you may be prescribed, oral NSAIDs including ibuprofen, diclofenac or ibuprofen or COX-2 selective NSAIDs, such as celecoxib.
Other painkillers include stronger opioids such as codeine, co-codamol and tramadol. Creams are also available including capsaicin (for hand or knee osteoarthritis), which blocks the nerves that send pain messages from the affected area to the brain, as well as corticosteroid injections.
Some research has found supplements may people suffering with osteoarthritis, including glucosamine and chondroitin,and cod liver oil, which both have anti-inflammatory effects. However, the National Institute for Health and Care Excellence (NICE) does not currently recommend any of them.
Gadgets to help open cans and help with other everyday tasks are also helpful.
Eventually though you may need joint replacement surgery. Around 160,000 hip and knee replacements are performed every year in England and Wales.