Osteoarthritis is a degenerative disease that affects an estimated 10 to 15% of all adults worldwide aged over 60 (according to WHO). It is usually associated with ageing and is often caused by a pressure exerted on the joints, a deformity or wounded joints, resulting in the deterioration of the cartilage in the joints.
With time, an excessive pressure exerted on the joints will cause irreparable damage to the cartilage, which then affects the joints. The evolution of osteoarthritis is a very complex process and is still being extensively researched.
The development of osteoarthritis
The first signs of osteoarthritis are characterised by the constant thinning of the cartilage layer, which is also known as sclerosis. Subsequently, the severe wear causes the cartilage to diminish and can lead ultimately to its complete disappearance, which can induce damage to the articular capsule and the inner surface, as well as the muscles surrounding the joint. This can cause impaired movement of the articulation, or stiffness and inflammation that can result in pain or deformation of the joint, which can also be very painful. For some people, in the early stage of the disease, the symptoms may not be visible, even though the deterioration of the joint can already be identified on an x-ray picture. However, other people may suffer great pains, although the osteoarthritis may not yet be noticeable. The symptoms can vary greatly from one person to the other.
First signs of osteoarthritis
The first stages of the illness can appear after a ligament has been torn or damage has been caused to the meniscus. As a consequence of this injury, the deterioration of the joint takes place more rapidly. The structure of the cartilage changes and becomes harder or denser, while the cartilage gets thinner. This often happens without the patient being aware of it.
The second stage
Often, the patient will experience pain for the first while doing some sport or performing a heavy task. These pains recede usually for short periods of time, but reappear after a few weeks or a few months in phases. While the cartilage is slowly but constantly becoming thinner and thinner, the pains are becoming stronger. Cysts may begin to develop in the bones, since these are no longer protected by cartilage. The osteoarthritis now evolves slowly around the bone. The patient may unconsciously adopt a posture that will allow him to avoid the pain, but which may also put more pressure on the joints and ultimately cause more pain.
The third stage
The later stage of osteoarthritis is characterised by a malformation of the articulations and the almost complete disappearance of the cartilage. Mobility is limited and the pains are constant, not only when moving but also when the patient is at rest. Symptoms also include inflammations, which can cause additional pains. The patient is not able to find restful sleep and often needs analgesics in order to be able to move around, especially when the osteoarthritis affects one or more leg articulations. Most patient report feeling the pain especially in the morning when doing the first movements of the day. This is sometimes referred to as “start-up” pain, which become less intense after the patient has moved around. Generally speaking, the illness develops itself in phases, with strong phases alternating with milder ones.
To this day, there is no treatment for osteoarthritis. Basically, prevention measures are considered useful. When the illness has reached a severe stage, no medication can help rebuild the cartilage. However, a number of treatment methods can help alleviate the symptoms. These may be different from one patient to another and must be considered on an individual basis. The therapy aims mainly at reducing acute infections that can cause great pains. Bandages or puncture of a joint can also offer some relief. In some cases, cortisone can prove to be an efficient treatment. Chondroprotective agents can also provide an effective form of therapy by protecting the remaining cartilage. However, their efficacy is disputed, and some questions remain whether they can really help the body rebuild new cartilage.
Text: MyH – 05/2017
Translation: MyH – 06/2016