Osteoarthritis: This Common Disease May Be Painless at First

Noted Czech physical therapist Prof. Kolář writes that osteoarthritis has a prevalence of about 12 – 15% in the general population. This increases considerably with age; over 80% of those over 75 suffer from it. It is somewhat more common in women.

Early-stage osteoarthritis is painless, as the joint cartilage itself is not innervated. Eventually, the joint degenerates enough to cause pain and limit mobility.

What Causes Osteoarthritis?

Basically, overloading and genetics. Osteoarthritis causes loss of articular (joint) cartilage and formation of osseous (bony) growths on joint surfaces. It is the latter that mostly cause pain and limit mobility in advanced disease. Osteoarthritis is mostly related to joint overloading, but can be caused by a number of factors:

• Aging-related degenerative changes. The condition is most common in people over 55.
• Obesity. Extra pounds put extra strain on load-bearing joints like knees and hips.
• Generally any long-term joint overloading.
• Genetics.
• Metabolic conditions, such as diabetes or gout.
• Inflammatory conditions, like rheumatoid arthritis.
• The condition is somewhat more common in women.

You should know: Overloading your joints increases your risk of developing osteoarthritis at some point. Poor seated posture, which overloads the spine and certain other areas, has become common in modern times, but can be rectified. Read about healthy sitting or find a therapeutic office chair.

Osteoarthritis Symptoms: May Be Absent in Early Stages

The stereotypical image of osteoarthritis (the most common specific form of what is commonly called just “arthritis”) is an old granny with swollen and achy knees. However, the condition may affect any number of joints around the body. Common localizations include the knees (gonarthritis), hips (coxarthritis), and the joints between vertebrae in the spine (spondyloarthritis).

The early stages of osteoarthritis rarely show any symptoms. While you’re losing cartilage, you still have enough that it doesn’t show. Once sufficiently advanced, the problem often appears suddenly when the joint is overloaded, injured, or chilled. Symptoms of more advanced disease include:

• pain, characteristically when one begins a motion
• pain from exertion; advanced cases may also cause pain at rest
• stiff joints
• swelling or other deformity
• shearing sensation when moving
• limited mobility, including limited ability to walk if load-bearing joints are affected, or impairment in daily tasks and fine motor control if minor joints are affected

Orthopedist Prof. MUDr. Ladislav Šenolt Ph.D. (link in Czech) says:

The course of the disease varies considerably from patient to patient. Mismatch between clinical symptoms and condition of the joint as seen on X-ray is common.

Physical therapist Mgr. Kateřina Klimešová adds:

Sometimes, people have severe pain but only minimal changes visible on X-ray, while other people may have major changes with little pain.

Osteoarthritis Treatment: Activity and Wellness Help

Definite diagnosis of osteoarthritis is made by a physician from X-ray images. You should see a doctor if you suffer from joint pain or stiffness. Early-stage disease responds to rest and exercise, but advanced cases often require total joint replacement surgery.

MUDr. Monika Urbanová (link in Czech) of the Prague Rheumatology Institute says:

There is currently no cure for osteoarthritis. In the early stages, recommendations relate mainly to lifestyle changes – often weight reduction in the obese, which can help considerably for knee arthritis in particular. A reasonable level of physical exercise is also recommended.

Activities recommended include cycling (or exercise biking) and swimming. Conversely, one should avoid sports that put a high degree of strain on joints, such as bodybuilding, mountain climbing, or those that involve running and jumping.

Mgr. Kateřina Klimešová (link in Czech) adds:

Aside from recreational-level cycling and swimming, we also recommend the increasingly popular Nordic walking (in Czech).

What helps relieve osteoarthritic joint pain?

• Rest
• Reduced exertion and lifestyle changes
• Cane or crutches to reduce joint load when walking
• Regular exercise to prevent joint stiffening
• Pool exercises
• Hot tub baths
• Analgesic electrotherapy

If your condition is painless, doctors recommend:

• Increased regular physical activity
• Heat applications, such as baths or heated blankets
• Therapeutic wellness and spa treatments
• Rehabilitation
• Regular exercise at home

Even if you’re not experiencing any pain, don’t overexert yourself. Don’t put off visiting your doctor until the pain begins; instead get a head start on treatment recommendations and possibly medication.

Further Reading:

• Osteoarthritis – basic coverage in Lékařský slovník. Online professional dictionary (in Czech).
• Osteoarthritis review by Doc. MUDr. Vladko Horčička, CSc., of the 3rd Internal Medicine Dept., Olomouc University Hospital. Interní medicína pro praxi. Peer-reviewed journal article (in Czech).
• Osteoartróza: Projevy a léčba (“Osteoarthritis: Symptoms and Treatment”). Review article by MUDr. Monika Urbanová of the Prague Rheumatology Institute (in Czech).
• Osteoartróza ručních kloubů (“Osteoarthritis of the Hand Joints”). Review article by Prof. MUDr. Ladislav Šenolt, Ph.D., of the Prague Rheumatology Institute (in Czech).
• Osteoarthritis – medical school primer at WikiSkripta (in Czech)
• Osteoarthritis on the English Wikipedia
• Osteoarthritis at the Mayo Clinic