Osteoarthritis is a degenerative condition of the weight bearing joints of the body. It is an unavoidable condition associated with aging. As people cross the age of 60 and above, stiffness of the knees and hips begins causing difficulty in walking and easy movements of the legs. Knees are the worst affected joints as they bear the brunt of the total weight of the body from the time one starts walking as a toddler. Hips are affected next. Basic underlying cause for osteoarthritis is reduced lubrication of the joint due to reduction in the quantity of synovial fluid (lubricating liquid of the joints). Due to this, the affected joints become stiff. Small new bones called osteophytes start forming on the surface in the joint space. These osteophytes further hamper free movement of the joint causing pain and stiffness. Usually, this problem begins after the 6th decade of life. But many factors precipitate it earlier. Heavy manual work, osteoporosis, previous trauma to knees or hips, ill fitting high heeled shoes e.t.c. are some of the causes which can cause osteoarthritis as early as 50 years. No one is exempt from the suffering caused by this age related problem. Difference being, some individuals suffer less and some suffer more. Earliest sign of osteoarthritis is pain in the knees while walking. This becomes more marked while climbing stairs or uphill, movements which place extra burden on the knees. Gradually pain occurs even on walking on plain ground. As the problem increases, pain occurs after walking only a few steps and sometimes walking few steps also becomes difficult and one has to use a stick for support. With further advancement, some unfortunate people become handicapped being unable to walk unless somebody holds and supports them. Stiffness is another bothersome symptom, particularly after prolonged immobility. Stiffness in the knees and difficulty in initiating the first step after sitting for a long time as in travelling is a common experience for middle aged and elderly persons. Hips are usually affected after knees in osteoarthritis but can be affected earlier. In some cases, only the hip joint may be affected. Symptoms remain the same, only difference is that the affected person has difficulty to walk due to pain and stiffness in hip joint. Pain and stiffness may be associated with swelling of the joints. This condition is diagnosed by the typical symptoms and signs, X-rays of the joints and other imaging techniques. Being a degenerative condition, there is no total treatment available for this condition by means of drugs. It is better, at a younger age, to prevent it or minimize it so that suffering becomes less. This is because preventive measures are not so effective when started after the problem has started. A nutritious diet, intake of calcium supplements when necessary helps to keep the bones and joints strong and retards development of early osteoarthritis. If one is used to sitting in the squatting position from early adolescence or teenage and continues doing so, knees remain supple and habituated to that position. If not so habituated then the concerned person should avoid a squatting position and always sit straight on a chair. There are specific exercises in yoga which if done regularly from a young age keep the joint flexible and delay changes of osteoarthritis. But exercises done after osteoarthritis develops also help in small amount. If no exercise is done at any point, it only aggravates the situation.Pain killer drugs prescribed provide only temporary relief in pain and have harmful effects when taken for long time. Therefore one should resort to pain killers only when pain is severe. An adult can and should be able to tolerate mild pain without any treatment. For moderate pain, local applications of analgesic ointments are more desirable than taking pills. In severe pain, one needs to take pain killers but should be stopped immediately one gets some relief. Doing hot fomentation of the affected knees is very useful to reduce stiffness of the joints and can be done regularly 2 to 3 times. Knee caps or pads should be used to cover the knees when standing or walking. These provide splintage to the knee joint while walking and thus reducing pain. Osteoarthritis should be accepted as part of life. Suffering can be avoided by a healthy life style and suitable exercises. The author is a specialist in Internal Medicine rachna212002@yahoo.com
