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Understanding Joint Pain - Osteoarthritis
Osteoarthritis is one of the most common forms of arthritis1, and a major symptom is pain2.
Management of osteoarthritis pain involves targeting physical processes in the joint and any nerve pathways that may be involved2.
Osteoarthritis pain is common
Osteoarthritis accounts for 20% of chronic pain worldwide.2
Almost 31% (30.8%) of people over 55 years old in Kuala Lumpur are living with knee pain.3 Knee pain is highest among ethnic Malays, and the prevalence has been reported 43.4%.3
What is osteoarthritis?
Osteoarthritis is a chronic condition characterized by degeneration (break down) of joint structures, resulting in pain, and decreased mobility. It is associated with changes in the body’s ability to repair damage to the cartilage in the joint, and inflammation in the entire joint structure.1,4,5
Osteoarthritis is common in the ageing population due to stress placed on the joint over the years. While it may be described as ‘wear and tear’ on the joint over time, it is considered a disease of the joint rather than a normal part of ageing.1
The most common areas affected by osteoarthritis include the knees, hips, finger joints and lower back.1
Changes to the joint
Normally the cartilage acts as a smooth cushion between the bones that join together at the joint.5 When this breaks down, it causes inflammation in the fluid surrounding the joint, leading to increased fluid in the joint and swelling.5
As the cartilage breaks down, the bone surfaces are exposed and may rub against each other, thickening and creating bone spurs.5
Symptoms
Symptoms of osteoarthritis include:4
Achy joints where the pain feels deep set within thejoint, which is particularly noticeable after extended use.
Limited range of motion in the affected joint,sometimes associated with crepitus (cracking and popping sound in a joint).
Joint stiffness which develops after a period of rest(e.g. sleeping) and lasts for 30 minutes or less.
The pain experienced with osteoarthritis may be constant or intermittent, and may be associated with the activation of nerve pain pathways in the joints or in the central nervous system.6
Osteoarthritis pain may also be influenced by certain environmental factors, such as changes in weather patterns, or it may be brought about by psychological or emotional factors.2 These additional factors are an essential consideration in the diagnosis and management of osteoarthritis, as it is important to note that not all osteoarthritis pain is associated with the joint itself.6
Diagnosis
Osteoarthritis is diagnosed based on the symptoms that the patient reports (stiffness etc.), which are then confirmed using various radiographic and imaging techniques.4
These techniques may include X-Rays, Computed Tomography (CT) scans, Magnetic Resonance Imaging (MRI), ultrasounds or bone scanning.
Management
There is no cure for osteoarthritis but management with medication, non-drug treatment and devices may help ease pain.1 The right therapy will depend on the severity of your condition.
Treatment options may involve lifestyle management options, such as:1,4
Heat and cold packs during flare ups
Weight loss to reduce the demand on the joint
Exercise, physical therapy or occupational therapy to improve mobility and range of motion
Various types of medicines are also available to manage joint and nerve pain. These will be recommended by a doctor based on the needs of each patient.
Occasionally people who experience severe symptoms that don’t respond to common treatments prescribed by their general practitioners will be referred to an orthopedic surgeon.4
If you have any of the symptoms mentioned that are affecting your quality of life, it’s important to seek guidance from your family healthcare provider to discover the treatments that are available to you.
Mat S, Jaafar MH, Ng CT, et al. Ethnic differences in the prevalence, socioeconomic and health related risk factors of knee pain and osteoarthritis symptoms in older Malaysians. PLoS One.2019;14(11):e0225075.
