Osteoarthritis, arthritis, rheumatism - you've probably heard all these terms before when it comes to joint pain. But do you really know what osteoarthritis is?
What is osteoarthritis?
Osteoarthritis is a complex disease affecting the entire joint structure, including the cartilage, subchondral bone, ligaments, synovial tissue and surrounding muscles(1). It results mainly from the progressive breakdown of cartilage, the smooth, shock-resistant tissue that covers the ends of the bones in a joint, allowing smooth, pain-free movement. This can lead to pain, stiffness and loss of mobility, as well as inflammation of the joint and deterioration of the surrounding bones(2).
It can affect any joint, but is most common in weight-bearing joints such as the knees, hips and spine, as well as in the hands(4).
What are the different stages of osteoarthritis?
It is possible to classify osteoarthritis of the hip (coxarthrosis) and osteoarthritis of the knee (gonarthrosis) into different radiological stages according to the Kellgren and Lawrence classification. The Kellgren and Lawrence score is a method used to assess the severity of osteoarthritis based on X-rays, taking into account a number of factors such as osteophytes and pinching of the joint space. This classification has four levels: suspected osteoarthritis, mild, moderate and severe.
Suspicion of osteoarthritis(1)is characterised by a doubtful pinching of the joint space, with the appearance of possible osteophytes.
The mild stage(2) shows a probable pinching of the joint space and the appearance of osteophytes.
At the moderate stage(3) there is an appearance of moderate osteophytes, pinching of the definitive joint space, some sclerosis, and possible deformation of the bone ends.
Finally, the severe stage(4) is manifested by the appearance of large osteophytes, a remarkable pinching of the joint space, severe sclerosis and definitive deformation of the bone ends. To find out more about the stages of osteoarthritis, read our article.
What are the different types of osteoarthritis?
Osteoarthritis of the knee (gonarthrosis)
This form of osteoarthritis affects the knee joint, where the femur (thigh bone), the tibia (leg bone) and the patella (also known as the patella) meet (7). There are 2 types of gonarthrosis: patellofemoral osteoarthritis and medial or lateral femorotibial osteoarthritis (2). The knee joint is one of the most complex in the human body, combining movements of flexion, extension and slight rotation (8). Articular cartilage, which covers the bone ends and enables frictionless movement, gradually wears away in osteoarthritis. This wear leads to a loss of the cushioning function of the cartilage and bone damage (2). To find out more, read our article on gonarthrosis.
Osteoarthritis of the hip affects the joint between the thigh bone (femur) and the pelvis. This joint is essential for walking, running and maintaining posture, which puts a lot of stress on it. The cartilage in this joint, known as articular cartilage, gradually wears away, leading to bone-on-bone friction, causing pain and inflammation (5).
Osteoarthritis of the thumb (rhizarthrosis)
This specific form of osteoarthritis affects the joint at the base of the thumb (trapeziometacarpal joint), causing pain and loss of strength in the thumb-index pinch (10). It corresponds to the progressive destruction of the cartilage of the joint between the trapezium and the first metacarpal (3,4,11).
Osteoarthritis of the fingers
Osteoarthritis of the fingers is a form of osteoarthritis that affects the joints of the fingers, in particular the distal and proximal interphalangeal joints, as well as the trapeziometacarpal joint. This degenerative condition is characterised by progressive wear of the articular cartilage, leading to pain, stiffness and sometimes visible deformities such as Heberden's and Bouchard's nodules.
Cervical and lumbar osteoarthritis
Cervical and lumbar osteoarthritis affect the joints of the spine in the neck and lower back respectively. Cervical osteoarthritis affects the cervical vertebrae, while lumbar osteoarthritis affects the lumbar vertebrae (14). Symptoms can vary.
Osteoarthritis of the big toe (hallux rigidus)
Hallux rigidus is a form of osteoarthritis that affects the metatarsophalangeal joint of the big toe. It leads to progressive degeneration of this joint, characterised by pain, loss of mobility and often the formation of osteophytes (bony growths) that restrict movement, particularly dorsiflexion.
Osteoarthritis of the shoulders (omarthrosis)
This form of osteoarthritis affects the shoulder joint, involving the humerus (arm bone), the scapula (shoulder blade) and sometimes the clavicle. This complex joint, made up of several sub-units, is often affected by osteoarthritis, particularly in the sternoclavicular joint (59-90% of cases), the acromioclavicular joint (over 50% of cases) and the glenohumearal joint (15-20% of cases) (13).
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What causes osteoarthritis?
There are many risk factors favouring the onset of osteoarthritis, including:
Ageing
Osteoarthritis is an age-related degenerative disease, affecting 1 in 3 people over the age of 65. It results from the progressive wear and tear of articular cartilage and a reduction in its ability to regenerate(15).
Heredity
A genetic predisposition can make some people more susceptible to developing osteoarthritis(16).
Joint injuries
Trauma or previous injuries, such as fractures or sprains, can damage the cartilage and joints, increasing the risk of osteoarthritis(16).
Obesity or overweight
Excess weight puts extra pressure on weight-bearing joints such as the knees and hips, accelerating the wear and tear of cartilage(16).
Joint anomalies
Congenital anomalies or joint malformations can predispose a person to osteoarthritis(17,18)
Gender
Women are more affected by osteoarthritis than men, particularly after the menopause(19).
What are the symptoms of osteoarthritis?
The symptoms of osteoarthritis vary depending on the severity and location of the disease, but generally include(9):
Joint pain Pain can occur during or after movement, and sometimes even at rest(6).
Joint stiffness Particularly after periods of inactivity, such as waking up in the morning or after sitting for a long time(6).
Loss of flexibility Decreased range of movement in the affected joint(14).
Sensation of grinding or cracking Friction of the bones may cause a grinding or creaking noise when the joint is moved(20).
Swelling Inflammation of the joint can cause swelling around the joint(21).
Deformity In advanced cases, the joint may become deformed(22).
What are the consequences of osteoarthritis?
Osteoarthritis can have a significant impact on quality of life:
Chronic pain Stiffness and pain can impair mobility, making it difficult to carry out daily tasks(14).
Reduced mobility La raideur et la douleur peuvent entraver la mobilité, rendant difficile l'accomplissement des tâches quotidiennes(23).
Functional disability In severe cases, osteoarthritis can lead to partial or total disability, requiring mobility aids or adaptations to the home environment(23).
Psychological impact Chronic pain and loss of mobility can affect mental health, leading to feelings of frustration, depression or anxiety(23).
Reduced autonomy Simple tasks may become impossible without assistance, affecting the person's independence(23).
Did you know ?
+595 millions
of people worldwide would suffer from osteoarthritis in 2020(36).
60%
der Fälle von Osteoarthritis sind Kniearthrosen(37).
60%
of cases of osteoarthritis are knee osteoarthritis(37).
23%
of osteoarthritis cases are osteoarthritis of the hands(37).
FAQ about osteoarthritis
Our medical team answers the questions you may have.
It is advisable to avoid pro-inflammatory foods such as added sugars, saturated fats and processed products. Eating a diet rich in fruit, vegetables, whole grains and oily fish can help reduce inflammation(30). We have an article dedicated to this subject. If you'd like to find out more, don't hesitate to consult it: Osteoarthritis of the knee: better living through diet
To manage osteoarthritis, it is crucial to stay active with suitable exercise, maintain a healthy weight, use support devices if necessary, and follow a treatment plan prescribed by a health professional. Complementary therapies (such as acupuncture, massage or yoga) can also provide additional relief(30).
Osteoarthritis can occur at any age, but is more common in people over 65. However, joint injuries caused by excessive contact stress are common in young adults, with one in 12 people aged between 18 and 44 affected by this type of injury. And it accounts for 12% of cases of osteoarthritis of the lower limbs(16,31,34).
There is no single effective treatment for all patients with osteoarthritis. A multimodal approach that combines medication, biomechanical intervention (wearing an orthosis), physiotherapy, lifestyle modifications and, in some cases, surgery, is often the most effective. Treatment must be tailored to the symptoms and needs of each individual(32).
Rheumatic diseases include a variety of heterogeneous conditions affecting mainly the joints, periarticular structures and tissues of the musculoskeletal system. Some of these diseases affect connective tissue, while others, such as osteoarthritis, rheumatoid arthritis and spondyloarthritis, are mainly joint diseases. Osteoarthritis being the most common form of arthritis, a general term for inflammation of the joints(38).
The effective treatment of osteoarthritis of the knee (or gonarthrosis) requires multidisciplinary management. Among the various healthcare professionals involved, the physiotherapist may play a particularly important role. But when is their input required? And what is there exact role?
Osteoarthritis of the knee: what kind of sport should I do?
Do you suffer from osteoarthritis of the knee and want to start, continue or resume a sporting activity... but are you worried about the limitations that your disease could impose on you?
Did you know that osteoarthritis (OA), a common joint disorder affecting over 500 million people worldwide, is closely linked to obesity ? OA causes cartilage loss, chronic pain, and limited joint motion, primarily in the knees, hips, hands and spine. One of the most significant, yet preventable, factors contributing to OA is obesity and being overweight.
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