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Osteoarthritis

Osteoarthritis represents more than 90% of all arthritis and is estimated to affect one in 8 (13%) Canadians. It is caused by a breakdown in the cartilage in joints resulting in bones rubbing together leading to pain, stiffness and eventual loss of use. Some forms of OA are genetically driven, while others are a result of injury, overuse, or advanced age. 

Women and men are equally likely to be affected by osteoarthritis. It strikes most commonly after the age of 45, but people of all ages—from children to senior citizens-are at risk. 

Osteoarthritis can affect any joint, but hands and weight-bearing joints—including the spine, hips and knees—are most often affected. Other joints, like shoulders, elbows, and ankles, are less likely to be affected unless the joint has been damaged by injury.

The most common signs and symptoms of OA are:

Pain and stiffness in a joint or several joints lasting more than two weeks
Joint stiffness when getting up in the morning or after a period of inactivity, lasting less than 30 minutes
Very early symptoms of OA are intermittent pain with strenuous activity; with time, the pain is present more often 
Joint crepitus (grinding)

If you are experiencing one or more of these signs, see your Doctor, Pharmacist or other member of your health care team about assessing your symptoms. 

Osteoarthritis (OA) Management and Treatment
While OA has no known cure, treatments exist that minimize pain and maintain joint health.  

Depending on the severity, there are a number of different treatment options for OA. These include lifestyle interventions, exercise, medications and surgery.

Weight loss and lifestyle changes are vitally important for mild, moderate and severe OA. By following an appropriate exercise routine and losing weight, if need be, people with OA may not need to reach for pain relief medication, or may need it less often. OA often affects load-bearing joints, like the hips and knees, and research has shown that being overweight even by 10 to 20 lbs can significantly increase the risk of knee damage. Therefore, one of the best things a person with OA can do to improve their arthritis is work to achieve and maintain a healthy body weight.

Exercise is an important component of a plan to treat OA. The key is to participate in the right kinds of exercise. Generally, exercises that put less stress on joints, like swimming and other water-based types of exercise, are ideal. However, many people find it difficult to get started on an exercise program because of their pain. In this case, many Doctors recommend taking a pain reliever about 30 minutes prior to starting exercise. Depending on a person's joint complaint, using ice or heat, according to one's preference, is a non-medicinal treatment that may be effective to help people with OA exercise effectively and with enjoyment.

In mild to moderate cases of OA, joint pain may be sufficiently treated with an over the counter pain reliever, like acetaminophen. Acetaminophen can be effective in reducing pain, but cannot stop joint damage.  If a pain reliever like acetaminophen is not enough, a non-steroidal anti-inflammatory drug (NSAID) may be needed. Examples of NSAIDs include ibuprofen and naproxen. Some more powerful NSAIDs require a prescription. NSAIDs can reduce joint inflammation and pain, but do not prevent joint damage. It is important to speak to your Doctor or Pharmacist before taking NSAIDs for OA to ensure they are appropriate for you.  Cox-2 inhibitors, such as celecoxib, are another class of medications that reduce inflammation and pain, but may cause fewer gastrointestinal side effects than NSAIDs. 

In certain cases, an injection of corticosteroid, sometimes called 'cortisone', into the affected joint can help reduce the inflammation of advanced OA. These injections can help in situations where mobility is impacted or pain is severe. However, corticosteroid should only be injected into an affected joint once in a while (less than three times per year), as multiple injections may actually weaken the cartilage, causing further joint damage. Corticosteroid injections are not a long-term treatment, but can be used occasionally when pain and inflammation is particularly bad.

Joint surgery is an option if joint damage progresses to the point where mobility is seriously compromised. The most common type of joint surgery for OA is joint replacement. Knees and hips are the most common joints to be treated with joint replacement surgery.