PAIN IN THE KNEE, SHOULDER, HIP - WHEN IS IT OSTEOARTHRITIS?

Studies show that 60 percent of all people over the age of 65 have osteoarthritis, which is the deterioration of joint function. There is no doubt that osteoarthritis is a widespread condition.

But even children and adolescents are at risk if, for example, a hereditary disease leads to instability of the connective tissue or if they are overweight, explains Dr. Thomas Schneider, head orthopaedic surgeon at the Joint Clinic in Gundelfingen.

"Congenital malpositions, for example hip dysplasia, can also lead to early onset of hip osteoarthritis in young adults. Young adults are often at risk of osteoarthritis as a result of poorly healed sports injuries (cruciate ligament rupture, ankle ligament injuries)," says the expert.

But how does osteoarthritis develop? How can I prevent osteoarthritis? How do I notice that I am affected? And what is the difference to arthritis?

Dr. Schneider answers the most important questions at BILD.

What is osteoarthritis?
Dr. Schneider: "The prerequisite for smooth, well-lubricated joints is intact cartilage. In osteoarthritis, the pathological, premature breakdown of cartilage causes the bones to rub against each other and the joints to stiffen. Common: In the initial phase, osteoarthritis is often completely symptom-free. Cartilage degradation and the loss of synovial fluid often only cause pain in an advanced state."

What are the typical causes of osteoarthritis?
Dr. Schneider: "Osteoarthritis can have many causes: Misalignment of the joints, overloading through sport and sports injuries as well as obesity. But lack of exercise, age-related wear and tear and hereditary predispositions also play a role."

In which joints can osteoarthritis occur?
Dr. Schneider: "Osteoarthritis can affect all joints: Spine (facet joint arthrosis), shoulder (omarthrosis), fingers (Heberden's arthrosis), hip (coxarthrosis), knee (gonarthrosis), ankle joints, even the toes."

What "alarm signs" should I see a doctor about?
Dr. Schneider: "Typical of osteoarthritis is the brief onset pain in the morning or at the first movement or after resting. It is often accompanied by swelling and overheating of the joint. Osteoarthritis patients describe the pain as dull and aching.

Stress pain is also characteristic: it occurs when a joint is momentarily overloaded, resulting in tendon or muscle pain around the joint. Acute knee pain when climbing stairs, for example, indicates knee osteoarthritis.

Pain at rest or joint pain at night, on the other hand, are more likely to be signs of arthritis or rheumatic complaints. However, they can also occur with very advanced or inflamed osteoarthritis."

Speaking of arthritis - what is the difference to osteoarthritis?
Dr. Schneider: "Osteoarthritis is characterized by the continuous breakdown of cartilage in the joint space. This degradation is promoted by cartilage injuries, misalignments or injuries to the joint surfaces.

Arthritis also leads to painful restrictions in joint mobility - however, this process is driven by inflammatory processes in arthritis."

How can I prevent osteoarthritis?
Dr. Schneider: "In any case, you should avoid being overweight and relieve the joints through exercise and well-trained surrounding muscles."

So plenty of exercise reduces my risk of osteoarthritis?
Dr. Schneider: "Yes, because regular exercise helps to nourish the joint cartilage. As it has no blood vessels, a minimum amount of exercise is required to supply it with important nutrients via the synovial fluid and thus keep it alive.

Suitable sports for those affected are those that combine low impact with a lot of movement (swimming, cycling, cross-country skiing); you should avoid all sports with high impact and rapid changes of direction (squash, tennis, martial arts, soccer, alpine skiing)."

Can a healthy diet stop the disease?
Dr. Schneider: "Changing your diet cannot cure osteoarthritis, but it has been proven to have a positive effect. A vegetarian diet with lots of fruit and vegetables has a positive effect on osteoarthritis; foods such as cheese, coffee, meat and alcohol have an unfavorable effect on the progression of osteoarthritis."

Can osteoarthritis be cured?
Dr. Schneider: "In the early stages, a minimally invasive arthroscopy (joint endoscopy) can often detect mechanical cartilage friction or pinching and eliminate it permanently. The deterioration process of the joint can then be stopped completely with targeted treatment."

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What does such treatment involve?
Dr. Schneider: "Applied in good time, physiotherapy, muscle training and the use of orthopaedic aids (orthoses) can correct the movement and relieve the joint. Swimming, aqua aerobics and cycling are also recommended due to their gentle movements for the natural regeneration of cartilage affected by osteoarthritis."

And when is a prosthesis necessary?
Dr. Schneider: "If a joint is so badly damaged that everyday movements are only possible with great pain and the cartilage has completely broken down, the orthopaedic surgeon can help with artificial joints (prostheses or partial prostheses).

Artificial joints are very reliable nowadays and can last for decades - provided they are implanted by a specialist. However, many patients put off the necessary prosthesis operation for a long time.

The problem: pain, pain treatment and forced immobility cause additional damage to the other joints. Postponing the operation is therefore often a decision to the detriment of the healthy joints."

What are the chances of success?
Dr. Schneider: "Modern knee replacements or hip replacements have a failure rate of less than one percent. Of course, it is a difficult step to replace your own familiar joint with an artificial one. However, the improvement in quality of life is usually considerable."

Are osteoarthritis symptoms particularly severe in winter?
Dr. Schneider: "Yes, the cold, damp air weakens the metabolism, so inflammatory processes in the joint and tissue are more protracted in winter. The muscles also tense up more, which causes more pain . Spending time in a southern climate or pain-relieving metabolic support through heat therapy can be helpful."

What are the biggest mistakes made by osteoarthritis patients?
Dr. Schneider: " These include overloading and inappropriate exercise. It is also wrong to put up with symptoms and not seek medical advice. This is because suitable treatment (insoles, corrective surgery) can often eliminate the causes of osteoarthritis and preserve the joint.

Other risks include overloading the metabolism, lack of weight control, alcohol, nicotine and a diet high in meat or low in vegetables. A lack of acid-base regulation in the diet also promotes osteoarthritis painand chronic inflammation."