Osteoarthritis (OA) is the most common cause of disability in the US. Studies reveal among adults aged 60 years and above, the prevalence rate for knee OA is around 10% in men and 13%¹ in women. OA is characterized by the breakdown of cartilage in the joints, which worsens over time. Cartilage is the tissue between bones of a joint that lubricates the bones and provides adequate cushioning. When this tissue breaks down, the bones rub against each other, resulting in pain, swelling, and decreased function.
Osteoarthritis is a degenerative joint disease, meaning it gradually progresses to the more advanced stages as the cartilage degeneration worsens. This article takes an in-depth look at osteoarthritis progression, what causes it, and how to slow it down.
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Experts confirm that once OA starts, it may take years to reach a severe stage. However, in extreme cases, OA progresses rapidly to complete the destruction of the cartilage within a few months. Some of the factors that determine the rate of OA progression include:
The severity of your symptoms at the time of diagnosis
The specific joints affected by the condition
Your overall health
Your physical activity and how much you use the affected joint
A recent study² reveals that OA of the knee tends to progress faster in older persons and those with OA in more than one joint. It also progresses much faster in people with a high BMI. If you suspect you have osteoarthritis, it is crucial that you visit your doctor immediately. Early diagnosis and treatment can help slow down the progression of OA.
There are several stages of OA, and it is important to know the signs and symptoms of each so you can take steps to alleviate the symptoms and slow down the disease progression. The following are the stages of OA progression.
The early stages
In the first stage of osteoarthritis, the cartilage that coats the ends of your bones and cushions your joints will start to thin. The smooth surfaces of cartilage and the lubricating fluid inside will gradually wear down. During this stage, the affected joints may occasionally feel stiff and uncomfortable, and moving the joints after a brief period of inactivity can be quite challenging. However, the pain may not last long, and the joint movement tends to improve and last for the rest of the day.
People with moderate OA often feel pain whenever they move the affected joints. Typical activities like walking, putting on shoes, or dressing can become difficult and painful. During this stage, the space between the joint bones starts to narrow, meaning the cartilage has deteriorated further.
Severe OA stage
An OA is classified as severe if the pain and limited movement has become a constant issue. At this point, X-ray images show virtually no space between the joint bones, meaning the bones have started rubbing against each other every time you move.
As mentioned earlier, several factors can cause your OA to progress. These include:
Studies reveal individual genetic³ features can increase the risks of developing OA. These features determine how your body produces cartilage and how the bones fit into each other at the joint. These genetic factors can also influence the rate at which your OA progresses.
Extra weight puts a lot of pressure on the hips and knees, which causes the cartilage in your joints to deteriorate quickly. Specifically, research shows a heightened rate of OA progression in obese people⁴ as compared to people with healthy weights. Essentially, obesity affects the production of hormones and the immune system, which worsens OA symptoms, leading to heightened damage in the affected joints. Studies also reveal that extra weight aggravates OA-induced inflammation.
Joint injuries, including repetitive injuries to the affected joints, lead to further cartilage breakdown. Injuries cause OA flare-ups if they damage the cartilage, bone, or both. Injuries from accidents or sporting activities may change the mechanics of the joint, thus triggering further deterioration characterized by constant flare-ups.
OA is a degenerative condition that gets worse with age. Osteoarthritis onset usually occurs after the age of 40; and by 65 years of age, most people with OA could have moved several stages towards the severe stage.
Some foods are known to worsen the symptoms of OA over time. People with OA are likely to have high blood cholesterol, and eating foods high in cholesterol can progress the condition quickly. Specifically, some of the foods associated with increased inflammation and which should be limited for people with OA include, but are not limited to, sugar, salt, saturated fat, refined carbs, Omega-6 fatty acids, dairy products, and alcohol.
In the early stages, OA can be treated through a combination of physical therapy, regular exercise, weight loss, and assistive devices. Your primary healthcare doctor can also recommend lifestyle changes and over-the-counter medication, specifically nonsteroidal anti-inflammatory drugs (NSAIDs). You may also be advised to try some home remedies that help manage pain and inflammation, such as heat and cold therapies.
However, as the condition progresses to reach the severe stage, these methods are less likely to be effective. Some of the methods to treat advanced OA include:
A doctor may recommend stronger medications, including high-dose NSAIDs, Ultram, Cymbalta, or corticosteroid injections into the affected joint.
If the advanced stage OA impacts your life quality, replacement surgery may be preferred. Some of the types of OA surgery for treating severe OA include:
Osteotomy: During an osteotomy, the surgeon reshapes the bones in the affected area to realign the knee joints and prevent them from rubbing against each other.
Arthroscopic debridement: The main goal of this surgical procedure is to remove loose pieces of bone and cartilage that could settle in your joints due to OA damage.
Total joint replacement: The surgeon can also remove the damaged tissue entirely and replace the joint with an artificial one made of metal or plastic.
There are several healthy lifestyle choices that can help ease the symptoms and slow down OA progression. These include:
Maintaining a healthy weight
As mentioned earlier, excess weight exerts extra pressure on weight-bearing joints, including the hips and knees. For each pound you add to your weight, nearly four pounds of pressure to your knees is added, thus substantially increasing the strain on your hips. The additional stress degenerates the cartilage cushioning the joints, thereby worsening OA symptoms over time.
Additionally, obese people have an increased amount of fatty tissue that produce proteins called cytokines, which is responsible for significant inflammation in your body. In your joints, the cytokines damage tissues by altering the functioning of cartilage cells. Losing even a few pounds of weight can help slow down the rate of OA progression substantially.
Control blood sugar
High blood sugar levels speed up the production of molecules that stiffen cartilage. Diabetes is also known to trigger systemic inflammation that causes cartilage loss over time. Recent studies reveal almost half of Americans⁵ diagnosed with diabetes have arthritis, further confirming the theory that a strong connection between high blood sugar and joint damage exists.
Physical activity is one of the most effective treatments for OA as it assists in slowing down the progression. Engaging in at least 30 minutes of moderately intense exercise five times each week helps strengthen the muscles supporting your hips and knees to ensure optimal stability. Exercise also lowers blood sugar while boosting your weight loss efforts. Some of the recommended exercises to engage in include walking, gardening, vigorous chores, swimming, and dancing.
It also pays to protect your joints to prevent injuries from accidents that could worsen your OA. Some tips to protect your joints include wearing the right shoes, choosing an appropriate exercise regime, wearing knee guards, paying attention to your posture, and not over engaging in physical activities.
Pro tip: Whether at home, in the field, or at work, always use your strongest and largest joints when lifting. You should also take as many breaks as possible during physical activity.
Choose a healthy lifestyle
Several lifestyle habits affect the risk of a flare-up of your OA symptoms. You can slow down the rate of your OA progression by choosing a healthy lifestyle. This can be achieved in a number of ways including choosing a healthy diet, staying active and keeping fit, maintaining a healthy weight, improving sleep habits, using arthritis-friendly gadgets, getting a massage, and staying informed about your condition by working closely with your healthcare provider.
The following are some of the facts about OA:
Osteoarthritis affects 32 million⁶ Americans.
OA is the leading cause of disability in the USA
Women are more likely to develop osteoarthritis⁷ than men
Osteoarthritis and rheumatoid arthritis are two different types of arthritis
Osteoarthritis can affect sleep and mood
The best chance to stop or slow down the rate of OA progression is through early diagnosis and treatment. Additionally, maintaining a healthy lifestyle through dietary changes, exercise, adequate sleep, and managing stress can slow down the progression substantially. If you have symptoms of OA, talk to your health care provider today. Your doctor may examine you and will consider your symptoms to help you understand the osteoarthritis stages. The physician will also develop a treatment plan that fits your stage and lifestyle.
Osteoarthritis (OA) | Centers for Disease Control and Prevention
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