Osteoarthritis: Trouble in knees and hips

As people cross the age of 60, stiffness of the knees and hips usually crops in causing difficulty in walking and easy movements of the legs. Osteoarthritis is a degenerative condition of the weight bearing joints of the body. It is an unavoidable condition associated with aging. Knees along with hips bear the total weight of the body, right since a man starts walking. The underlying cause for osteoarthritis is reduced lubrication of the joint, due to reduction in the quantity of lubricating liquid of the joint. This makes the joint stiff. Small new bones called osteophytes start forming on the surface of the joint space. These hamper free movement of the joint causing pain and stiffness. Usually this problem begins after 60 years. But many factors can cause early start. Heavy manual work, osteoporosis, trauma to knees or hips, ill fitting high heeled shoes etc. are some of the causes which can cause early osteoarthritis. All people suffer from this problem, difference being in intensity and duration of pain experienced. Initially one has pain in knees and hips while walking up on stairs or a hill. Later on the pain occurs even while walking on plain ground. The individual may not be able to walk few steps without a support. Stiffness occurring after immobilisation for few hours also becomes problematic. Elderly people mostly develop very stiff knees after sitting for long time as in travelling. In some cases, only the hip joint may be affected. The affected person has pain and stiffness in hip joint. 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 absolute cure by means of drugs. It is better to prevent it or minimise it so that suffering becomes less. Preventive measures have to be started at a younger age because they do not become effective when started later. A good 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 childhood, adolescence and continues doing so, knees remain supple and habituated to that position. If not so habituated, then the concerned person should avoid squatting and always sit straight on a chair. There are specific exercises for knees, which if done regularly from a young age keep the joint flexible and delay changes of osteoarthritis. But exercises done even after are also helpful. If one does not do any exercise, the stiffness of knees is augmented. Pain killer drugs prescribed provide only temporary relief in pain and have harmful effects when taken for long time. Therefore one should take pain killers only when pain is severe. For moderate pain local applications of analgesic ointments is more desirable than taking pills. In severe pain one needs to take pain killers but they should be stopped immediately as soon as some relief is obtained. Hot compression of the affected knees is very useful to reduce stiffness of the joint. It can be done regularly 2 to 3 times. Knee pads should be used to cover the knees when standing or walking. These provide splintage to the knee joint while walking and thus reduce pain. Osteoarthritis is part of life, suffering can be avoided by a healthy life style and suitable exercises. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital