What is osteoarthritis?

Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people worldwide. While it is more common in individuals over 45, it can also develop in younger people. The condition frequently affects weight-bearing joints, such as the knees, hips, feet and spine, as well as the joints of the hands and thumbs.

Once thought to be just wear and tear from ageing, we now understand that osteoarthritis is a complex condition influenced by multiple factors, including genetics, joint stress and inflammation. While there is no cure, there are many ways to manage symptoms and maintain an active, fulfilling life.

How osteoarthritis affects your joints

To understand osteoarthritis, it helps to know how healthy joints function.

Joints are where two bones meet, allowing movement with the help of muscles, ligaments and tendons. The ends of bones are covered by cartilage, a smooth tissue that cushions the joints and absorbs shock. The joint is surrounded by a capsule lined with a synovial membrane, which produces fluid to lubricate and nourish the cartilage.

With osteoarthritis, the cartilage becomes brittle and starts to break down. This causes:

• Joint stiffness and pain, due to the loss of smooth cartilage.
• Floating cartilage fragments in the synovial fluid, which may cause irritation.
• Bone-on-bone contact, leading to discomfort and restricted movement.
• Bone spurs (osteophytes), extra bone formations that develop as the body tries to repair joint damage. These may or may not cause pain but can sometimes restrict motion.

Managing osteoarthritis

There is no cure for osteoarthritis, but symptoms can be effectively managed with lifestyle changes, exercise, weight management and medications.

Exercise and movement

Many people worry that exercising with osteoarthritis will worsen joint damage, but regular movement can actually help reduce pain and improve function. Exercise benefits joints by:

• Keeping them mobile and reducing stiffness.
• Strengthening the muscles that support and protect the joints.
• Improving circulation, which helps deliver nutrients to the cartilage.
• Moving synovial fluid through the joint, keeping it lubricated.

An ideal exercise programme includes:

1. Range-of-motion exercises

Help maintain joint flexibility and reduce stiffness.

• Knee extensions. Sit in a chair, straighten one leg, hold for a few seconds and lower. Repeat 10 to 15 times per leg.
• Heel slides. While lying on your back, slowly slide your heel towards your buttocks, then extend back out.
• Shoulder circles. Roll shoulders forward and backwards in circles.
• Neck tilts. Gently tilt your head side to side and forward and backward to loosen stiffness.

2. Strength training

Supports and protects the joints by strengthening surrounding muscles.

• Seated leg lifts (for knees). Sit with feet flat, lift one leg straight, hold for five seconds, lower and repeat.
• Mini squats (for hips and knees). Stand and squat down slightly, keeping knees behind toes.
• Wall push-ups (for shoulders and wrists). Stand at arm’s length from a wall and do push-ups against it.
• Grip strength exercises (for hands). Squeeze a soft stress ball or use therapy putty.

3. Low-impact activities

Improve fitness without excessive stress on the joints. Aim for at least 150 minutes per week.

• Swimming or water aerobics. Water reduces joint stress.
• Walking. Try even surfaces and use walking poles for support if needed.
• Cycling. Both stationary and outdoor cycling are good options.

Avoid high-impact activities like running or jumping if they worsen symptoms.

4. Balance and coordination exercises

Help reduce the risk of falls and improve stability.

• Single-leg stand. Stand on one leg while holding a sturdy surface for support, hold for 10 to 30 seconds.
• Heel-to-toe walk. Walk in a straight line placing one foot directly in front of the other.
• Tai chi or yoga. Gentle, controlled movements improve balance and flexibility.

It is best to start slowly and gradually increase intensity. A physiotherapist or exercise physiologist can help design a safe and effective programme.

Weight management

Excess weight increases strain on joints, particularly in the knees, hips and spine. Losing even a small amount of weight can:

• Reduce joint pain and improve mobility.
• Decrease inflammation linked to fat tissue.
• Lower the risk of further joint damage.

Since weight loss can be challenging, especially with joint pain, the most effective approach is a combination of gentle exercise and healthy eating. A doctor or dietitian can provide guidance on safe weight-loss strategies.

Medications for pain relief

Medications can help manage pain, but they do not treat osteoarthritis itself. They should be used alongside exercise and other self-care strategies.

• Non-steroidal anti-inflammatory drugs (NSAIDs). Available in oral or topical forms, these reduce pain and swelling. Due to potential side effects, oral NSAIDs should only be taken for short periods.
• Paracetamol. Provides mild pain relief for some people but may not be effective for everyone.

Opioids are not recommended for osteoarthritis pain due to their limited effectiveness and high risk of side effects. Speak with your doctor before starting any medication.

Surgical options

Most people with osteoarthritis do not require surgery, but it may be considered if other treatments do not provide relief.

• Joint replacement surgery is the most common procedure for advanced OA, particularly for the hips and knees.
• Before opting for surgery, it is important to discuss the risks, benefits and recovery process with a healthcare professional.

Final thoughts

Osteoarthritis is a long-term condition, but it is possible to manage symptoms and maintain an active lifestyle with the right strategies. Regular movement, weight management and proper joint care are key to reducing pain and improving function. Small, consistent changes can make a big difference in maintaining mobility and quality of life.

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