As of: March 30, 2024, 4:00 p.m
By: Laura Hindelang
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Osteoarthritis is a joint disease in which the cartilage wears away. Those affected usually only notice the disease when the damage affects the bone.
In a healthy joint, bones are protected by cartilage. In osteoarthritis, the cartilage is damaged and worn out prematurely. Over time, the bones rub against each other, causing great pain. In Germany, more than five million people are affected, especially older people: from the age of 65, almost half of women and almost a third of men suffer from osteoarthritis. In principle, the disease can occur in any joint. The most commonly affected areas are the knees, hips and fingers.
Causes and symptoms of osteoarthritis
Osteoarthritis joint wear © IMAGO/Zoonar.com/Kasper Ravlo
The causes of osteoarthritis are varied, but they are always due to the fact that the overload on the joint cartilage outweighs its ability to regenerate. In addition to age-related wear and tear, osteoarthritis can have the following causes:
Misalignments of the joints
Overload due to work or sport
Overweight
Lack of exercise
Joint infections caused by bacteria
Long-term consequences after traumatic injuries
Inflammatory rheumatic infection (also called “secondary osteoarthritis”)
Osteoarthritis is a gradual process. Those affected usually only notice the damage to the cartilage when the defects already extend to the bone underneath the cartilage.
Which forms of osteoarthritis can occur:
Hip osteoarthritis |
Often caused by hip dysplasia, blockages in the joint or cartilage injuries caused by accidents |
|---|---|
Finger arthritis |
Associated with reduced strength, dexterity and holding ability in the hand and finger joints |
Knee osteoarthritis |
can occur throughout the joint or just in one chamber of the knee joint |
Spine (facet joints) |
In facet joint syndrome, the individual facet joints rub against each other painfully because the cushioning cartilage layer is missing |
Spine (intervertebral disc) |
When bone parts rub together, bone structures are formed. They hurt when you move and can lead to paralysis and paralysis due to pressure on nerves or nerve roots |
Ankle osteoarthritis |
Occurs in relatively young patients, often as a result of sports accidents |
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Joint pain can be the first symptoms of osteoarthritis
In contrast to the cartilage layer, which does not contain any nerve endings to sense pain, the outer periosteum is sensitive to pressure and sends out severe pain when the joint moves. Other signs of osteoarthritis can include the following symptoms:
Start-up pain (when running you feel a pulling or tight feeling after a few meters)
Joint stiffness or morning stiffness (very stiff joints after getting up)
Joint pain during exertion (exertion pain)
Joint swelling
Constant pain in the joint
Tense muscles around the joint
Movement restrictions
In the beginning, the joint pain only occurs after physical exertion. Over time, pain also develops in normal everyday life. As osteoarthritis progresses, pain can occur even when resting or at night.
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Course: Consequential damage from osteoarthritis becomes a vicious cycle
The water retention in the articular cartilage gives the healthy cartilage tissue elasticity and robustness. With osteoarthritis, the tissue loses its ability to retain water. As a result, the joint surface is no longer smooth, but becomes rough, cracked and continues to deteriorate.
The increased friction in the joint causes cartilage material to detach from the joint surfaces. After the complete loss of cartilage, even bone splinters can appear. In addition, the cartilage wear can lead to “activated osteoarthritis”, a variant combined with inflammation. The joint swells, heats up and hurts. This inflammatory reaction accelerates further cartilage breakdown.
Over time, every movement can become torture for osteoarthritis patients. © Astrid08 via imago-images.de
As the cartilage loss increases, the joint loses its natural shape. Misalignments can arise or existing misalignments can be reinforced. Over time, the adjacent joint surfaces and bones are also affected. The pain keeps getting worse, so those affected usually protect their joints. In the long term, the surrounding muscles deteriorate, meaning the joint is no longer supported efficiently. The many additional loads increase the wear of the cartilage and the osteoarthritis progresses - a vicious circle for the patients.
Orthopedic surgeons can diagnose “osteoarthritis”.
In order to detect osteoarthritis as early as possible, taking an anamnesis is crucial. If they suspect degenerative joint disease, patients should describe to the doctor as precisely as possible when, where and to what intensity pain occurs. An orthopedic specialist can then carry out a detailed examination. Various tests and imaging procedures such as x-rays and ultrasound can provide information about the health of the joints.
The doctor can diagnose osteoarthritis using X-rays © IMAGO/Zoonar.com/Birgit Reitz-Hofmann
Arthosis is currently not curable. The goal of every therapy is to preserve the existing cartilage, slow down closure and reduce pain. The treatment methods are varied and depend on the affected joint.
Non-drug therapy for osteoarthritis
Exercise is particularly important in the early stages of the disease. Targeted exercises (physical therapy) can make the joints mobile again. Doctors recommend moderate endurance sports with flowing movements, such as swimming, cycling or Nordic walking. Heavy physical strain and jerky movements should be avoided.
You should also avoid unhealthy and inflammatory foods and beverages such as meat and alcohol. With a balanced diet (fruit, vegetables, high-quality vegetable fats), obesity – another stressful factor in osteoarthritis – can be prevented or reduced. Other treatment options include:
X-ray stimulation irradiation
Current therapy
Bandages
Walking sticks
Orthopedic-technical aids: arthrosis splints, insoles, buffer heels, wedge soles, rolling aids
Heat, cold and electrotherapy
Drug therapy for osteoarthritis
The doctor can prescribe pain-relieving and anti-inflammatory medications in tablet form or inject them directly into the joint. The most important medications in osteoarthritis therapy are so-called non-steroidal anti-inflammatory drugs (NSAIDs). These are painkillers and anti-inflammatory drugs that relieve the symptoms. However, since painkillers can always cause unwanted side effects, medication should not be a long-term solution.
When should osteoarthritis be operated on?
Whether and when an operation makes sense depends primarily on how severely the osteoarthritis affects the quality of life. At the latest when you take painkillers every day, you should consider a surgical procedure. An operation can serve different purposes:
Joint preservation: The orthopedist removes loose pieces of cartilage using a mirror or corrects a joint misalignment.
Joint prosthesis: The affected joint is replaced with a prosthesis.
Joint stiffening: The joint's natural ability to move is switched off, eliminating pain.
A healthy lifestyle can prevent osteoarthritis
The most important factor in preventing joint wear and tear is a healthy lifestyle. Lack of exercise and excess weight take a toll on the cartilage layer. Because without movement, no lubricating fluid is formed that protects the cartilage from abrasion. You should exercise regularly and get enough exercise in everyday office life, for example by taking short walks.
With so-called mobility exercises you can specifically train the mobility of the joints. Because every additional kilo of body weight puts strain on the joints, if you are overweight you should definitely lose weight. You should also drink enough fluids, preferably water. The cartilage tissue needs fluid to stay supple.
This article only contains general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. It in no way replaces a visit to the doctor. Our editorial team is not allowed to answer individual questions about medical conditions.