Osteoarthritis

Osteoarthritis is a condition that causes your joints to become painful and stiff. It is the most common type of arthritis. It mainly affects people over the age of 40, but it can develop at any age.

On this page

About osteoarthritis

  • One in 11 adults in Aotearoa New Zealand has osteoarthritis.
  • Osteoarthritis is the leading cause of physical inactivity in people over 65.
  • Osteoarthritis is the main reason people give for early retirement from work.

About osteoarthritis — physiotherapist Kate Bryce talks about osteoarthritis

What happens in osteoarthritis

With osteoarthritis there are changes in your joint tissues, including your:

  • bones — the bone ends can get thicker and extend at joint edges (bony swelling)
  • cartilage — cartilage usually provides a smooth, slippery surface for movement but there are changes to and loss of this covering on the end of the bones
  • joint linings — these make joint fluid to nourish your cartilage but can become inflamed and thickened
  • muscles — your muscles can become weaker, making it harder to support and move the joint
  • nerves — your nerves can become more sensitive.

Your body is constantly changing, as old cells are replaced with new ones. This means you can help the osteoarthritis process and your symptoms. Daily activity and exercise promote helpful changes and do not harm joints.

Rather than thinking of osteoarthritis as 'wear and tear', it is more like a 'wear and repair' process.

Causes of osteoarthritis

We do not know exactly what causes osteoarthritis, but several things are thought to increase your risk of developing it. This includes if you:

  • are overweight
  • overuse your joint when it has not had enough time to heal after an injury or operation
  • do hard, repetitive physical activity over time, such farm work, building or playing professional sport
  • have a family history of osteoarthritis
  • have other joint conditions such as rheumatoid arthritis, gout or septic arthritis.

Symptoms of osteoarthritis

Osteoarthritis can affect any joint in your body but it usually affects large moveable joints such as your hips, knees and lower back. It can also affect your hands, particularly the base of your thumb and the end joints of your fingers, and your feet.

Osteoarthritis develops slowly over many years. This most common symptoms of osteoarthritis are:

  • joint pain and stiffness
  • problems moving the joint.

You may also have the following symptoms:

  • swelling in or near the joint (which may be there all the time or come and go)
  • muscle weakness
  • a creaking or cracking sound when moving the joint.

Diagnosing osteoarthritis

Your healthcare provider will ask you about your symptoms and what things you are finding difficult to do. They may examine you and will usually want to check what range of movement you have in your joints.

There are no specific blood tests for osteoarthritis. Your healthcare provider will normally diagnose it based on your symptoms and their examination.

An x-ray is not needed to diagnose osteoarthritis.

If your healthcare provider suspects you might have a different condition, such as a form of rheumatoid arthritis, you may need to have some extra tests. They will arrange any extra tests that you need.

Self care for osteoarthritis

Open all

Keeping active is one of the best things you can do to manage your osteoarthritis, it can:

  • help to reduce your pain
  • keep you moving
  • restore your flexibility
  • protect your joints against further damage.

Some people worry that they will wear out their joint if they use it too much. But we know that regular physical activity can help to strengthen your joints, muscles and bones.

Some people also worry that pain during physical activity means they are causing harm but it does not. Some pain is okay and will not cause harm. But if you have a lot of pain during physical activity or feel a sharp pain, you should stop and ask your healthcare provider or physiotherapist for advice. You should also get advice if you have pain that is worse than usual the morning after your physical activity.

It is important to find an activity you enjoy as you are more likely to stick with it. Excellent activities for osteoarthritis include:

  • tai chi
  • walking
  • cycling
  • swimming
  • water-based exercises
  • gentle exercise classes.

If you are not sure which activities are right for you, talk to your healthcare provider. There are several initiatives to help adults get physically active. Some of them are free or subsidised but you may have to pay for others.

Exercise and arthritis — Arthritis NZexternal link

There is no special diet that will make your arthritis better, but the Mediterranean diet may help.

Mediterranean way of eating

Being overweight increases the strain on your weight-bearing joints such as your knees and your hips. Losing 5% to 10% of your weight — for example, losing 5 kg to 10 kg if you weigh 100 kg — can help to relieve some strain on your joints and reduce your pain.

Healthy ways to lose weight

Arthritis is a changeable condition. Some days you may have no pain and other days you will. Having pain can be the hardest part of having arthritis.

Pain is normal — we all experience it. Short-term (acute) pain is very useful. It signals that you need to protect whatever part of your body is hurting.

But persistent (chronic) pain from a long-term condition like osteoarthritis is more complex. Your nerve pathways can become sensitised and osteoarthritis pain can be overprotective. This means you feel pain a long time before reaching the point of danger or harm.

We also know that pain, stress, fatigue or depression often make pain worse and create what can feel like a never-ending cycle of pain.

A healthy lifestyle can be very helpful, including:

  • eating well
  • staying active
  • having a good sleep routine
  • managing stress.

You can also use techniques to help you manage your pain:

  • relaxation techniques such as breathing and mindfulness
  • distraction techniques including physical activity, reading or listening to music.

Living with pain — Arthritis NZexternal link

There are many aids and devices for osteoarthritis that can make a big improvement to your day-to-day activities.

You can buy shock-absorbing footwear and orthotics to put in your shoes, which you may find helps with your osteoarthritis. If you have osteoarthritis in your knees, you might also like to try using a knee brace or wedge shoe insole.

Other devices that you might find helpful include:

  • walking sticks
  • braces
  • tap turners, tin openers and other kitchen gadgets
  • handrails, shower stools and raised toilet seats
  • long-handled toenail scissors and shoehorns.

You can buy these devices:

Sometimes you can use the disability allowance to help with the cost.

Disability allowance — Work and Incomeexternal link

Arthritis NZ runs a free service called Arthritis Assist. The team includes health coaches, a healthcare educator and a pharmacist. They provide advice over the phone on all forms of arthritis, including on treatment options, pain management, exercise and nutrition.

To contact Arthritis Assist:

Arthritis Assist call back form — Arthritis NZexternal link

Arthritis NZ also provides a range of other services and resources.

How we help — Arthritis NZexternal link

Have regular check-ups with your healthcare provider to monitor your symptoms and check whether any treatments are working for you.

They may refer you to a:

  • dietitian for support to lose weight
  • physiotherapist
  • podiatrist.

Your healthcare provider or general practice team might be able to reduce the cost of your healthcare.

You may be able to get a disability allowance from Work and Income.

Disability allowance — Work and Incomeexternal link

You may be able to get mobility parking permits, the Total Mobility half-price taxi scheme, and other transport options.

Treating osteoarthritis

Open all

There are many complementary and alternative therapies that are popular for relieving symptoms of osteoarthritis. These include:

  • acupuncture
  • tai chi, yoga and relaxation techniques
  • herbal medicine
  • supplements such as glucosamine, chondroitin, curcumin and fish oils.

We know that acupuncture and some manual therapies (for example, stretching, and soft tissue and joint mobilisation) may help some people to manage their osteoarthritis. The studies looking at how effective supplements and herbal medicines are show varied results.

Check with your healthcare provider or pharmacist before you try a complementary or alternative therapy to make sure it is safe for you and will not interact with other medications or treatments.

Complementary therapies for arthritis — Arthritis NZexternal link

Heat relaxes your muscles and increases your blood circulation. To relieve stiffness and pain in your arthritic joints, try:

  • warm baths and showers
  • saunas
  • wheat packs
  • hot water bottles.

Cold numbs the painful area and reduces swelling. Try applying ice packs wrapped in a towel to the painful area for no more than 15 minutes at a time.

Ask your healthcare provider or physiotherapist whether heat or cold is best for you.

There are various medicines that might help you to manage pain. They are usually not enough on their own. Non-drug treatments like exercise programmes help osteoarthritis pain more than most medicines and without side effects.

If you are taking medicines for pain, it is best to try lower risk medicines first (for example, paracetamol, and anti-inflammatory creams or gels). If these do not give enough relief, you can try other medicines (non-steroidal anti-inflammatory drugs or NSAIDs) — usually for a short time, to reduce the risk of side effects.

Talk about your pain relief medicine options with your healthcare provider or pharmacist. They can advise what is best and most appropriate for you.

A steroid injection may be recommended for some people.

Pain relief medicines for adults

Pain medications — Arthritis NZexternal link

Steroid injections

If you have severe osteoarthritis flare-ups, a steroid injection may provide pain relief for up to 3 months.

But steroid injections are not suitable for everyone. If you are having joint replacement surgery in the next 6 to 12 weeks, they should be avoided.

Care is needed with repeated injections because of the potential harm, such as increasing the amount of cartilage loss. This means steroid injections are not a good long-term option for managing osteoarthritis pain.

If you need a steroid injection your healthcare provider may be able to do it, or they may refer you to another healthcare provider.

A physiotherapist can assess your joints and work with you to develop a programme that strengthens and stabilises your joints. If you are eligible, your healthcare provider can refer you to a physiotherapist in the community or specific programmes for osteoarthritis if they are available in your area.

You may prefer to pay to see a physiotherapist privately.

Find a physio — Physiotherapy New Zealandexternal link

Podiatrists can look at how you are moving and walking. If your joint is in an abnormal position, joint supports or orthotics in your shoes might to help to reduce the load on your joints. This might help you to walk longer distances.

Find a podiatrist — Podiatry NZexternal link

Most people with osteoarthritis never need joint replacement surgery. You can do many things to manage your osteoarthritis, such as exercise and eating well.

If your osteoarthritis is causing you severe symptoms and is having a big impact on your life your healthcare provider may refer you to a specialist. If you meet the criteria for a joint replacement, you will be assessed to decide if surgery is right for you.