Understanding Osteoarthritis
Osteoarthritis is the most common form of arthritis in the UK, affecting approximately 10 million people. It occurs when the cartilage that cushions the ends of bones within a joint gradually wears down, leading to pain, stiffness, and reduced mobility. The joints most commonly affected are the knees, hips, hands, and spine, though any joint can be involved.
It is not simply a condition of ageing. While it becomes more prevalent with age, osteoarthritis is influenced by genetics, previous injuries, body weight, and occupation. Many patients develop it in their 40s and 50s and live with it for decades, making effective long term management essential.
Recognising the Symptoms
The hallmark symptoms of osteoarthritis include joint pain that worsens with activity and improves with rest, morning stiffness lasting less than 30 minutes (in contrast to inflammatory arthritis, where stiffness lasts longer), reduced range of movement, a grating or crackling sensation in the joint, swelling and tenderness around the joint, and bony enlargements at the finger joints known as Heberden’s nodes (at the end joints) and Bouchard’s nodes (at the middle joints).
Pain that keeps you awake at night or prevents you from carrying out your daily activities suggests moderate to severe disease that warrants active medical management.
How Is Osteoarthritis Diagnosed?
In most cases, osteoarthritis can be diagnosed clinically, meaning through a history and physical examination without the need for imaging. However, X rays and MRI scans are useful for assessing the severity of joint changes and planning treatment, particularly if an injection or surgical referral is being considered.
At Clinique Alpa, a typical osteoarthritis assessment includes examination of the affected joints for swelling, tenderness, and range of movement; checking for Heberden’s or Bouchard’s nodes in the hands; review of any existing imaging or blood tests; and a discussion of how the symptoms are affecting your daily life and mobility.
Treatment and Management
Pain relief: First line treatment includes regular paracetamol and topical anti inflammatory gels applied directly to the affected joint. For more severe pain, short courses of oral NSAIDs such as naproxen or ibuprofen can be effective, though these must be used with a stomach protectant such as lansoprazole or omeprazole in patients with a history of gastric sensitivity.
Exercise and physiotherapy: Structured exercise is one of the most effective treatments for osteoarthritis. Strengthening the muscles around the affected joint reduces load on the cartilage and improves stability. Swimming, cycling, and targeted physiotherapy exercises are particularly beneficial. We can refer you to our in house physiotherapist for a tailored programme.
Weight management: Every kilogram of body weight lost reduces the force on the knee joint by approximately four kilograms during walking. For patients who are overweight, even modest weight loss can produce significant symptom improvement.
Joint injections: Corticosteroid injections can provide rapid relief for acute flare ups. For longer term management, PRP (Platelet Rich Plasma) injections offer a regenerative approach that supports cartilage health without the risks associated with repeated steroid use. We offer both at the clinic.
Supplements: Glucosamine and chondroitin are widely used. The evidence for their effectiveness is mixed, but some patients report benefit. Vitamin D supplementation is recommended for patients with low levels, as vitamin D deficiency is associated with increased joint pain and reduced bone health.
When to Consider Surgery
Joint replacement surgery is highly effective for severe osteoarthritis that has not responded to conservative treatment. The decision to proceed with surgery is based on the severity of symptoms, the degree of joint damage on imaging, and the impact on your quality of life. It is not determined by age alone.
If you are considering surgery, a private GP can provide a referral to an orthopaedic surgeon and ensure you have all the supporting documentation needed for the consultation.
Specialist Referrals and GP Advocacy
Many patients with osteoarthritis feel that their condition is not being managed proactively by their NHS GP. If you are in this position, we can write to your NHS GP recommending specific investigations, specialist referrals, or treatment changes. This GP to GP advocacy can sometimes accelerate access to services that would otherwise involve long waiting lists.
Frequently Asked Questions
Is osteoarthritis the same as rheumatoid arthritis?
No. Osteoarthritis is a degenerative condition affecting the cartilage. Rheumatoid arthritis is an autoimmune disease that causes inflammation of the joint lining. The treatments are different, and distinguishing between them is important.
Can osteoarthritis be cured?
There is currently no cure, but the symptoms can be managed very effectively with the right combination of pain relief, exercise, weight management, and, where appropriate, injections or surgery.
Should I stop exercising if my joints hurt?
No. Stopping exercise leads to muscle weakening, which worsens the problem. The key is to choose the right type of exercise: low impact activities that strengthen the muscles without overloading the joint.
Book an Osteoarthritis Consultation
If you are living with joint pain, stiffness, or reduced mobility, book an appointment at Clinique Alpa for a thorough assessment and personalised management plan.
Written by Dr Mitesh Parmar, MBBS MRCGP, Principal GP at Clinique Alpa.