Your Health

The new mid-life crisis: are you developing osteoarthritis?

Elderly man sitting on a sofa in the living room at home and touching his knee by the pain
Photo of Dr. David Robinson DR. DAVID ROBINSON
Winnipeg Regional Health Authority
Published Friday, March 17, 2017

If you are around 50 years of age, chances are an X-ray would reveal that you have early signs of osteoarthritis - a potentially painful condition of the joints.

That doesn't mean you should start worrying, as not everyone with early signs of osteoarthritis will go on to develop the severe symptoms associated with the disorder.

But it does underscore the importance of understanding the causes of osteoarthritis, how it can affect your health, and what you can do to delay or prevent its development.

Let's start with some basic information. There are more than 100 types of arthritis, with the two most common forms being rheumatoid arthritis and osteoarthritis. 

The former is an autoimmune disease, caused by the immune system attacking healthy body tissue.

But osteoarthritis (OA), which affects about 4.5 million Canadians, is mostly caused by wear-and-tear of the joints, which accumulates as people age. That "wear-and-tear" occurs faster when the joint is damaged by injury, overused in certain jobs, and by being overloaded by being overweight. Birth abnormalities such as hip dysplasia, your genetic background, and even frostbite can also lead to osteoarthritis. There are also some factors we don't understand well. For example, obesity is associated with a higher risk for OA in the hands as well as the knees and hips.

Some of the symptoms of osteoarthritis include a brief stiffness in the morning, and feeling stiff after prolonged inactivity. The knees, hips, lumbar spine, big toe and that joint right at the base of your thumb are the most commonly affected joints.

Diagnosis is usually done by your primary care provider. They will check the range of motion on your joints, and may send you for an X-ray to confirm the diagnosis.

There is no "cure" for osteoarthritis, but there are lots of things you can do to make your joints feel better and most of them don't involve medications.

The most important is to "unload" your joints. If you're overweight, the most straightforward way is to lose weight. We all know how hard this is, but there is a special deal for your joints. For each pound you lose on the scale, you lose three pounds of force off each hip and knee - so even a small amount of weight loss makes a big difference to your joints.

The other way to unload your joints is to strengthen your muscles that cross that joint. Why? Because your muscles are like shock absorbers for your joints. Think of how you might walk down a set of stairs and misjudge the final step. That hard landing sends a shock through your entire skeleton. The difference between that step and a normal step is what your muscles do to absorb shock and unload your joints. The stronger your muscles, the more that force is absorbed, even with usual activities.

You can also unload joints with devices like knee braces and canes.

Drug treatment for osteoarthritis includes medications like acetaminophen, ibuprophen or naproxen to reduce the pain. Cortisone-like drugs can also be injected into the joint and may provide short term pain relief allowing you to exercise.

Joint replacement of the hip or knee may be recommended for patients with chronic pain despite all other forms of medical therapy.

What can you do to prevent osteoarthritis?

First, maintain a healthy weight. It's much easier to maintain a healthy weight than to lose it later. Keep exercising. As the saying goes, "motion is lotion." Regular exercise doesn't wear out your joints; in fact it keeps them healthy by building strong muscles and reducing impact.

Start slow and work your way up to a target of 150 minutes per week. The best exercise is something you enjoy and will keep doing.

And in the end, the best defense is a healthy lifestyle.

Dr. David Robinson is Head of Rheumatology at Health Sciences Centre Winnipeg.

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