Osteoarthritis

Chances are, you know someone who has arthritis. Arthritis affects more than 4 million people in Canada. Of the more than 100 diseases and conditions that fall under this category, osteoarthritis is the most prevalent form of joint inflammation.

What is osteoarthritis?

The ends of our bones are covered with an elastic material called cartilage. Cartilage allows our joints to move smoothly and acts like a shock absorber. Osteoarthritis erodes cartilage from the joints. This results in more bone-on-bone interaction, along with an increase in pain, stiffness, and swelling.

Osteoarthritis occurs in hands, hips, knees, feet, spine, and joints that may have been damaged by injury or other diseases such as rheumatoid arthritis.

What are the symptoms?

In general, the symptoms of osteoarthritis develop slowly over months or years.

The progression looks something like this.

1. Pain is triggered by high-impact activities only.
2. Normal activity can trigger pain, and symptoms may develop, such as locking joints.
3. You may have stiff joints when you wake up.
4. Joint pain tends to increase when you use the joint and decrease when you rest.
5. Pain may linger all day and disrupt your sleep.
6. You may develop swelling and creaking in your joints along with reduced flexibility and strength.

What causes osteoarthritis?

“Aging and weight are the two biggest causes for osteoarthritis,” says Dr. Alice Klinkhoff, medical director for the Arthritis Society. “Then there are inherited factors and injuries that predispose people to cartilage damage. Finally, there is the unknown, which is why people are doing research to try to prevent osteoarthritis.”

Klinkhoff is referring to the risk factors for developing osteoarthritis. There are two kinds: inherent, which are factors we can’t do anything about, and external, which are factors we can control to minimize the risk.

Inherent factors

Age: As we age, we increase our chances of developing osteoarthritis. Loss of muscle mass, thinning of joint cartilage, and loosening of ligaments all contribute to increased risk.

Genetics: Researchers are finding that family history is an important factor in our predisposition to osteoarthritis.

Complications from other forms of arthritis: Damage as a result of inflammation from other types of arthritis can leave the joint vulnerable to secondary osteoarthritis.

Sex: Being a woman increases your chance of developing osteoarthritis. Researchers aren’t clear as to why that is, but they suspect it may be linked to the hormone estrogen.

External factors

Weight: Being overweight increases the risk of developing osteoarthritis and will exacerbate your condition and increase your pain.

Lack of exercise: Being sedentary can result in weight gain, increased joint pain, reduced joint mobility, depression, and increased risk for other chronic diseases. Normal wear and tear alone does not cause the joints to degenerate. Regular activity is good for the joints and does not cause osteoarthritis.

Environmental factors: New research has linked synthetic chemicals to an increased risk of developing osteoarthritis (see sidebar on page 57).

Making healthy choices

There’s a lot we can do to reduce our risk of developing osteoarthritis and to improve quality of life when living with osteoarthritis.

Eat a healthy diet

A balanced diet will help achieve and maintain a healthy weight. It may also provide the energy you need for daily activities.

Some general guidelines for a balanced diet include

• eating a variety of foods from each food group to ensure you get enough vitamins, minerals, antioxidants, and other important nutrients
• choosing high-fibre foods including vegetables, fruits, and whole grain breads
• choosing leaner cuts of meat
• eating more fish or vegan sources of proteins
• reducing your intake of excess fats
• reducing your intake of foods and drinks with high sugar, salt, and fat content

Exercise

Exercise strengthens the muscles around the affected joints, providing support and protection. Exercise also increases joint mobility, reduces fatigue and pain, and helps ward off depression.

Winter can pose additional challenges to someone with osteoarthritis. Here are some tips for exercising during the winter, for those who are willing to brave the cold.

• Bundle up! It’s important to stay warm.
• Try snowshoeing or cross-country skiing. Both provide low-impact exercise on your joints.
• Build snowmen.
• Shovel the driveway. Just make sure to take your time and warm up before you start.
• Stay hydrated. No matter what time of year it is, exercise requires constant hydration.

If going outdoors in the winter isn’t your thing, here are some other ways to keep moving.

• March or walk around your home or apartment, including stairs and hallways.
• Engage in active video games such as the Wii system.
• Move to music. Dance if you can.
• Pick up some light weights or use resistance bands while watching TV.
• Swim in an indoor pool.
• Visit the mall or places of interest, such as museums.

Consider complementary therapies

Some complementary therapies shown in recent research to improve quality of life while living with osteoarthritis are:

• acupuncture
• yoga
• visualization/meditation techniques
• massage
• supplements (see below)

You should always consult your health care practitioner before embarking on changes to diet or lifestyle, including complementary therapies.

Did you know?

• In general, 66 percent of those affected by arthritis are women.
• Osteoarthritis accounts for the majority of hip and knee replacements in Canada—more than 80 and 90 percent, respectively.
• The majority of people with arthritis are of working age. Projections indicate that within the next 30 years, nearly 30 percent of the labour force will be affected by osteoarthritis.

Environmental factors: PFOA and PFOS

PFOA (perfluorooctanoic acid) and PFOS (perfluorooctane sulfonate) are synthetic chemicals that can be found in:

• nonstick cookware
• water repellents in clothing
• paints
• cleaning products
• firefighting foams
• electrical products such as semiconductor coatings

These chemicals remain in the environment and in our bodies for a long time. A new study found that women exposed to these chemicals increase their risk of developing osteoarthritis. It is important to note that more work needs to be done to say for sure whether these chemicals do indeed increase the risk of osteoarthritis in women. Researchers believe that women’s increased risk is somehow hormone related.

Although on a personal level it is hard to avoid exposure to these chemicals due to their prevalence in so many industries, there are measures in place to reduce the use of these chemicals on a global level.

In Canada, an agreement was created between Environment Canada, Health Canada, and four companies from the perfluorinated products industry to reduce PFOA and PFOS content in products by 95 percent by the end of 2010. The groups have also voluntarily committed to eliminating the remaining 5 percent by the end of 2015.

“The good thing is that it’s [PFOA and PFOS] coming out of the environment so we are already having less exposure,” says Klinkhoff.

Supplements for osteoarthritis

Here are some of the supplements that may benefit those with osteoarthritis. As always, check with your health care practitioner to make sure a supplement is right for you.