Osteoarthritis
Osteoarthritis cannot be cured but early diagnosis can help slow its progression and much can be done to ease its effects. So what is osteoarthritis?
It really starts with the role of cartilage on our joints. This smooth, elastic substance covers the bony surfaces of joints and helps the bones to glide over one another, absorbing energy from impact and movement. OA occurs when this cartilage roughens, grows brittle, breaks down, and wears away, causing bone to rub on bone which results in the thickening of the bone and the formation of bony spurs. The resultant grating and inflammation too often causes pain, swelling, stiffness, and reduced mobility and function. Weight bearing joints like the spine, hips and knees are most affected by OA.
The actual cause of OA is actually unknown, but it is accepted that there are a number of factors that include, heredity, gender, trauma, age, occupation and obesity, that contribute to the condition. Although it can develop in younger people it generally occurs in older people, especially women. It often begins after menopause.
It is not known why older people are more at risk, but key factors are thought to be, muscle weakening, weight gain, and the body becoming less able to heal itself. Occupations involving repetitive mechanical stress are also associated with OA, farmers and builders are vulnerable groups. (We have rather a lot of these in Cornwall!). Obesity is again cited as a key factor in the progression of the disease putting pressure on load bearing joints, particularly knees, hips and the spine.
Fractures involving joint and ligament damage also increase the likelihood of developing OA. That risk more than triples following a major injury to a weight bearing joint. Another risk area is after an injury or an operation to a joint which might lead to subsequent osteoarthritis at the site. Also excessive exercising of a joint will also place that joint at risk in the future. Also exercising too soon after an injury has had time to heal may lead to osteoarthritis in that joint.
Most people with OA lead a healthy active life by managing their symptoms and making practical adjustments to everyday life. The key things to consider are regular exercise, a healthy diet, weight management, physical therapy and certain drugs are available to deal with the pain and inflammation.
Osteoporosis
Affecting a staggering 1 in 3 women and 1 in 5 men, this debilitating bone disease is rife amongst us. Often referred to as “brittle bone “disease, it arrives with no warning, progresses painlessly and silently, and it is only when our bones are at risk to fracture are we then aware of the condition.
It is caused by reduced bone mineral density causing bones structure degradation. The result is a risk of a fragility fracture, a broken bone which occurs because bone is abnormally thin. These fractures occur typically in the hip, spine and wrist. After the age of 30, bone density gradually decreases, but there is a significant decrease in women postmenopausal owing to the decrease in estrogen levels.
Most common are hip fracture and in a recent study it was found that 20% would actually die within the first year, 30% would suffer permanent disability, 40% would no longer be able to walk independently and 80% will have their daily living ability adversely effected.
Whist screening is still insufficient to highlight this condition early in a patient’s life, prevention is critical. The key areas are again proper nutrition, exercise and changes to lifestyle and use of certain drugs. Weight bearing exercises (light weights) have been shown to stimulate bone production, even light exercises like jogging, walking, aerobics can help strengthen bones.
Calcium intake is an important element for osteoporosis prevention. Oral intake should be at least 1200 to 1500 mg every day, supplemented with vitamin D to help increase the absorption. Also caffeinated drinks that decrease calcium absorption should be limited.
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