Osteoarthritis
Osteoarthritis is a condition that causes your joints to become painful and stiff. It is the most common type of arthritis. It mainly affects people over the age of 40, but it can develop at any age.
Symptoms of osteoarthritis
Osteoarthritis can affect any joint in your body but it usually affects large moveable joints such as your hips, knees and lower back. It can also affect your hands, particularly the base of your thumb and the end joints of your fingers, and your feet.
In healthy joints, cartilage (a shiny gristly material) acts as a shock absorber and provides a smooth surface between the bones to allow easy movement. When a joint develops osteoarthritis, the cartilage breaks down causing pain, swelling and problems moving the joint.
Osteoarthritis progresses slowly and develops over many years. This most common symptoms of osteoarthritis are:
- joint pain and stiffness
- problems moving the joint.
You may also have the following symptoms:
- swelling in or near the joint
- muscle weakness
- a creaking or cracking sound when moving the joint.
Causes of osteoarthritis
We do not know exactly what causes osteoarthritis, but several things are thought to increase your risk of developing it. This includes if you:
- are overweight
- overuse your joint when it has not had enough time to heal after an injury or operation
- have a family history of osteoarthritis
- have other joint conditions such as rheumatoid arthritis, gout, or septic arthritis.
Diagnosing osteoarthritis
Your healthcare provider will ask you about your symptoms and may examine you. They will usually want to check what range of movement you have in your joints.
There are no specific blood tests for osteoarthritis. Your healthcare provider will normally diagnose it based on your symptoms and their examination.
An x-ray is not needed to diagnose osteoarthritis.
If your healthcare provider suspects you might have a different condition, such as a form of rheumatoid arthritis, you may need to have some extra tests. They will arrange any extra tests that you need.
Self care for osteoarthritis
Keeping active is one of the best things you can do to manage your osteoarthritis, it can:
- help to reduce your pain
- keep you moving
- restore your flexibility
- protect your joints against further damage.
Some people worry that they will wear out their joint if they use it too much. But we know that regular physical activity can help to strengthen your joints, muscles and bones.
Some people also worry that pain during physical activity means they are causing harm but it does not. Some pain is OK and will not cause harm. But if you have a lot of pain during physical activity or feel a sharp pain, you should stop and ask your healthcare provider or physiotherapist for advice. You should also get advice if you have pain that is worse than usual the morning after your physical activity.
It is important to find an activity you enjoy as you’re more likely to stick with it. Excellent activities for osteoarthritis include:
- tai chi
- walking
- cycling
- swimming
- water-based exercises
- gentle exercise classes.
If you are not sure which activities are right for you, talk to your healthcare provider about Support for getting active. There are several initiatives to help adults get physically active. Some of them are free or subsidised but you may have to pay for others.
Exercise and arthritis — Arthritis NZ (external link)
There is no special diet that will make your arthritis better, but the Mediterranean diet may help.
The mediterranean diet — Arthritis NZ (external link)
Being overweight increases the strain on your weight-bearing joints such as your knees and your hips. Losing 5 to 10% of your weight — for example, losing 5 to 10 kg if you weigh 100 kg — can help to relieve some strain on your joints and reduce your pain.
How to lose weight — HealthInfo (external link)
Arthritis is a changeable condition. Some days you may have no pain and other days you will. Having pain can be the hardest part of having arthritis. Healthy lifestyle can be very helpful, including:
- eating well
- staying active
- having a good sleep routine
- managing stress.
Living with pain — Arthritis NZ (external link)
There are many aids and devices for osteoarthritis that can make a big improvement to your day-to-day activities.
You can buy shock-absorbing footwear and orthotics to put in your shoes, which you may find helps with your osteoarthritis. If you have osteoarthritis in your knees, you might also like to try using a knee brace or wedge shoe insole.
Other devices that you might find helpful include:
- walking sticks
- braces
- tap turners, tin openers and other kitchen gadgets
- handrails, shower stools and raised toilet seats
- long-handled toenail scissors and shoehorns.
You can buy these devices:
- online at Arthritis NZ (external link)
- by calling Arthritis NZ on 0800 663 463
- through your occupational therapist.
Sometimes you can use the disability allowance to help with the cost.
Disability allowance — Work and Income (external link)
Arthritis New Zealand has trained arthritis educators who can answer your questions and provide information about ways to live well with osteoarthritis. To contact an educator:
- call 0800 663 463
- fill in this online self-referral form (external link)
Arthritis New Zealand also provides a range of other services and resources.
How we help — Arthritis NZ (external link)
Have regular check-ups with your healthcare provider to monitor your symptoms and check whether any treatments are working for you.
They may refer you to a:
- dietitian for support to lose weight
- physiotherapist
- podiatrist.
Your healthcare provider or general practice team might be able to reduce the cost of your healthcare.
You may be able to get a disability allowance from Work and Income.
Disability allowance — Work and Income (external link)
You may be able to get mobility parking permits, the Total Mobility half-price taxi scheme, and other transport options.
Treating osteoarthritis
There are many complementary and alternative therapies that are popular for relieving symptoms of osteoarthritis. These include:
- acupuncture
- manual therapies such as tai chi, yoga and relaxation techniques
- herbal medicine
- supplements such as glucosamine, chondroitin and fish oils.
We know that acupuncture and some manual therapies may help some people to manage their osteoarthritis. The studies looking at how effective supplements and herbal medicines are show varied results.
Check with your healthcare provider or pharmacist before you try a complementary or alternative therapy to make sure it is safe for you and will not interact with other medications or treatments.
Complementary therapies for arthritis — Arthritis NZ (external link)
Heat relaxes your muscles and increases your blood circulation. To relieve stiffness and pain in your arthritic joints, try:
- warm baths and showers
- saunas
- wheat packs
- hot water bottles.
- Cold numbs the painful area and reduces swelling. Try applying ice packs wrapped in a towel to the painful area for no more than 15 minutes at a time.
- Ask your healthcare provider or physiotherapist whether heat or cold is best for you.
There are many types of medications available for osteoarthritis. Oral pain relievers include:
- paracetamol
- non-steroidal anti-inflammatory drugs (NSAIDs)
- codeine products.
There are also topical (rub on) pain relievers, steroid pills, and other specialist medications. Some are available over the counter at your pharmacy, and others you can only get on prescription from your healthcare provider.
Your health provider will discuss medications and advise what is most appropriate for you. Never take more than the recommended or prescribed dose.
Pain medications — Arthritis NZ (external link)
Steroid injections
In some people with severe osteoarthritis flare-ups, a steroid injection can provide pain relief for up to 3 months. This can be helpful when doing an exercise program or waiting for joint replacement surgery.
But steroid injections are not suitable for everyone and they are not normally recommended for people with osteoporosis.
If you do need a steroid injection, your healthcare provider may be able to do it. Otherwise, they may refer you to another healthcare provider.
Capsaicin cream (Zostrix)
Capsaicin cream blocks the nerves causing pain. You will usually feel a warm almost burning sensation at first, but this quickly eases.
It the cream irritates your skin, stop using it and see your healthcare provider. DermNet NZ – Capsaicin has more information about capsaicin cream.
Capsaicin cream — DermNet (external link)
A physiotherapist can assess your joints and work with you to develop a programme that strengthens and stabilises your joints. If you are eligible, your healthcare provider can refer you to a physiotherapist in the community.
You may prefer to pay to see a physiotherapist privately.
Physiotherapists (internal link)
Podiatrists can look at how you are moving and walking. If your joint is in an abnormal position, joint supports or orthotics in your shoes might to help to reduce the load on your joints. This might help you to walk longer distances.
If your osteoarthritis is causing you severe symptoms, your healthcare provider may recommend surgery.
If they think you might need a hip or knee replacement, they will refer you to a specialist. If you meet the criteria, the specialist will assess you to decide if a joint replacement is the right treatment for you.
Clinical review
This content was written by HealthInfo clinical advisers. It has been adapted for Health Information and Services.