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What is osteoarthritis?
Causes & risk factors
Symptoms
Diagnosis
Treatment
If you ignore osteoarthritis
Prevention
FAQs

Osteoarthritis is best known as the ‘wear and tear’ arthritis that causes the cartilage that lines the bone ends to break down over time due to use. Here at The Feet People in Brisbane, we have extensive experience in treating osteoarthritis all over the lower limbs, as well as the back, with great success. As the therapies that we employ are non-invasive, we see many people who do not wish to or are not eligible to have surgery, or take certain medications.

What Is Osteoarthritis?

Osteoarthritis is a degenerative joint disease that affects the cartilage, the protective tissue that covers the ends of bones in a joint. As the joints are repetitively used over time, the cartilage gradually breaks down, leading to pain, swelling, and reduced joint flexibility. As osteoarthritis progresses, the bones may develop bony growths (called osteophytes) at the joint edges, and the joint space may narrow, leading to stiffness and difficulty walking on the joints. 

Osteoarthritis commonly affects weight-bearing joints like the knees, hips, and spine, as well as the hands and fingers. Osteoarthritis is more prevalent in older individuals, is more common in women than men, and typically presents with asymmetrical joints being involved.

Causes And Risk Factors

Cartilage is the smooth tissue lining that cushions the ends of your bones and allows for smooth movement between the bones, resulting in frictionless joint movement. Unfortunately, your cartilage can gradually deteriorate and when it wears down enough from regular use, to leave the two bone ends to rub against one another, this creates pain and stiffness — this is what causes osteoarthritis. 

It was originally thought that osteoarthritis was only related to the gradual wearing down of this cartilage, however more recently, it has been observed that the entire joint and all of its components are involved. In addition to the cartilage thinning, osteoarthritis causes changes on the surface of the bone, deteriorates the connective tissues surrounding the joint, causes inflammation of the joint lining, and can lead to the development of bone spurs within the joints.

As we use our joints every day, no one is 100% safe from developing osteoarthritis. Factors that may increase your risk of developing osteoarthritis include:

• Age: osteoarthritis can affect people of any age, but is more common in people over 40 as your bones, muscles and joints also age while undergoing wear and tear, leading to degeneration.
  
• Gender: more women than men develop osteoarthritis, particularly over the age of 50 years.
  
• Overuse: if your job or the sports you play cause you to place repetitive stress on your joints, this may increase your chances of developing osteoarthritis. Examples include jobs where you’re on your feet all day, like retail or construction work, or jobs that require heavy lifting, like working for a moving company.
  
• Family history: if a family member has osteoarthritis, then you're more likely to develop osteoarthritis due to inherited genetic traits.
  
• Previous joint injury: injuries that occurred from sports or any other accident, even if they happened years ago, can increase your risk of developing osteoarthritis. This ranges from bone injuries such as fractures to soft tissue injuries such as ligament tears.
  
• Obesity: extra body weight puts more stress on your joints, while fat tissue produces proteins that can cause harmful inflammation in and around your joints. 
  

• Joint abnormalities: some people are born with joint abnormalities or malalignment, increasing the likelihood of uneven stress on the joint surfaces and cartilage damage.
  

• Muscle weakness: weak muscles surrounding a joint may fail to provide adequate support and stability, leading to additional stress on the joint and cartilage.
  

• Other medical conditions: certain medical conditions, such as rheumatoid arthritis, gout, and hemochromatosis, can increase the risk of developing osteoarthritis.
  

Symptoms

The symptoms of osteoarthritis primarily affect the joints, varying from person to person depending on which joints are affected. Symptoms tend to start as mild and gradually worsen over time, whether that be months, years or decades, as the joint continues to deteriorate. Symptoms you should look out for include: 

Over time, as the severity of osteoarthritis worsens, you may also begin to experience the joints becoming unstable and feeling like they’re going to give way, muscle weakness surrounding the affected joints, and the joints becoming deformed or enlarged, particularly with bone spurs developing to further compound a person’s pain, discomfort and movement.

Diagnosis

The most reliable way of diagnosing osteoarthritis is through a combination of a physical exam with x-ray imaging of the affected joints, as well as getting a detailed medical history. During your exam, we’ll assess the painful joints and their movement and other characteristics. As joint pain and swelling can have many causes, it’s important to exclude other causes of joint pain such as capsulitis, synovitis, ligament and soft tissue injuries, and more. Next, we’ll give you a referral for x-ray imaging (and potentially ultrasound if we suspect any damage to soft tissues within or around the joints). On the x-ray, we’ll be looking for findings including a loss of joint cartilage, the narrowing of your joint spaces, and formations of small bony spurs among other features.

Podiatry Treatment

As osteoarthritis can be diagnosed anywhere between its very early and mild stages to its severe stages with significant pain and joint deformities, the best approach to treatment will always be one that is tailored to the changes and symptoms you’re experiencing, and the stage of disease that you’re at. From a podiatry perspective, we work extensively with those with osteoarthritis as there is a lot we can do to improve a person’s comfort, mobility and quality of life - while also helping to slow down the rate of joint damage and degeneration when detected early by putting the right therapies in place.

Your treatment will also vary depending on the location of your osteoarthritis - we’ll employ different therapies depending on whether your osteoarthritis is affecting your knee joint, hip joint, midfoot, big toe, ankle, and the like. Overall, we may use:

• Footwear assessment recommendations: with osteoarthritis, we want to do everything we can to help your body absorb shock in order to lower the impact forces on your joints. As such, we’ll review your current footwear and if it lacks the shock absorbing and supportive features that are best for your body, we’ll recommend the best shoes to help you manage your osteoarthritis.
  
• Footwear modifications: our podiatry clinics are unique in that we’re also able to modify your existing footwear so they can continue to support your feet, ankles and legs in the best ways.
  
• MLS laser: the MLS laser is a brilliant tool that helps to relieve pain and swelling, while improving your mobility and function. It also helps to accelerate tissue repair along with many other benefits. You can learn more about how laser works specifically on arthritis pain here.
  
• Activity modifications: depending on which joints are affected by osteoarthritis, we’ll discuss the common activities you do on a daily basis, both in terms of exercise and at home, and make recommendations on ways to decrease specific activities that will be aggravating the affected joints and causing you pain, as well as leading to further degeneration. In terms of exercise, many people find that changing to low impact physical activity such as swimming and cycling helps them get much relief from their joint pain and other symptoms while enabling them to stay active.
  
• Physical therapy: while it may seem counterintuitive to talk about strengthening, stretching and range of motion exercises for your joints when you’re experiencing joint pain, research very strongly supports the effectiveness and benefits of tailored exercise in the management of osteoarthritis. Here, your podiatrist will work with you to develop a specific program to help you maintain your joint strength, stability and movement - so your joints can best support you comfortably throughout your days.
  
• Custom foot orthotics: foot orthotics can have immense benefits in everything from offloading painful, swollen joints, to providing the cushioning and support you need to optimise your comfort and help slow the progression of your symptoms. The orthotics you will get are custom prescribed and designed, meaning that your podiatrist chooses every single feature and material that your orthotics will have to offer you the best support.
  
• Ankle foot orthotics (AFOs): by wrapping around and stabilising the ankle, reducing pressure on inflamed joints, and improving gait mechanics, AFOs help to alleviate pain, prevent joint deformities, and enhance mobility, making it easier for those with osteoarthritis to perform daily activities and maintain a better quality of life. The AFOs we offer are custom prescribed, designed to address a person’s unique foot and ankle needs.
  

Other recommendations to support your foot health with osteoarthritis include:

• Weight loss if required, to reduce the load placed on the joints like the knees
  
• GP-prescribed medications e.g. Acetaminophen, Nonsteroidal anti-inflammatory drugs, COX-2 inhibitor, disease-modifying anti-rheumatic drugs, viscosupplementation.
  
• Corticosteroid injections
  
• If your pain is causing disability that is not being relieved through non-surgical treatments, then a referral to discuss the role that surgery may play could be required. 
  

What Can Happen If I Ignore Osteoarthritis?

If left untreated, osteoarthritis can cause a number of complications or other health effects not directly related to the joint disease including:

• Increased risk of falling as osteoarthritis decreases joint strength and function, and weakens muscles.
  
• Bone spurs may start to develop and cause pain
  
• Further damage can be done to the tendons and ligaments, which can decrease their effectiveness and lead to weakened bones. 
  
• Septic arthritis - an infection that forms in the joints that can lead to joint deformity. It's extremely difficult to fix without reconstructive surgery. 
  
• Osteonecrosis - although rare, this condition occurs if the damage reaches a certain point, it can affect the amount of blood that flows to the bones. Without blood, the bones will weaken, break down and die. 
  

Prevention

There are a number of lifestyle changes that may help to reduce your risk of developing osteoarthritis:

• Maintain a healthy weight: excess weight puts additional stress on the joints, particularly weight-bearing joints like the knees and hips. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce the risk of developing osteoarthritis and alleviate symptoms if it's already present.
  

• Stay physically active: regular physical activity, including low-impact exercises like walking, swimming, or cycling, can help keep the joints flexible and strengthen the surrounding muscles. 
  

• Protect your joints: avoid activities that put excessive strain on the joints or involve repetitive motions. When participating in sports or other physical activities, use proper equipment and techniques to protect your joints from injury.
  

• Take breaks during repetitive tasks: if your job or daily activities involve repetitive movements, try to take regular breaks to rest and stretch your joints.
  

• Avoid smoking: smoking has been linked to an increased risk of developing osteoarthritis, so quitting smoking can have a positive impact on joint health.
  

• Eat a balanced diet: a diet rich in fruits, vegetables, whole grains, and lean proteins can provide essential nutrients for joint health. Omega-3 fatty acids, found in fish and certain nuts and seeds, have anti-inflammatory properties that may be beneficial for joint health.
  

FAQs