Osteoarthritis is a degenerative disease that is the result of a loss of cartilage in the joints, often due to age-related wear and tear. The condition can cause severe pain and loss of mobility as it develops, although in its early stages the symptoms are milder and more manageable.
Symptoms of osteoarthritis
Typically osteoarthritis causes the following symptoms:
- Pain in the affected joint particularly during or after moving
- Loss of mobility
- Stiffness particularly after inactivity or first thing in the morning
- Swelling or a feeling of heat in the affected joint
- The development of bony spurs
- A grating sensation in the affected joint
- Worsening pain as the bones start to rub together
Osteoarthritis and mental health
However, someone with the condition may also develop other symptoms which, while they may be less well-known, are no less challenging. Osteoarthritis can have a significant impact on person’s quality of life, particularly as the disease progresses, and living with severe pain and loss of function may lead to mental health problems, most commonly depression or anxiety. Sadly, this can become a vicious cycle as having mental health problems can lead to a worsening of arthritis symptoms.
Anxiety is a feeling of tension and worry and may be accompanied by increased blood pressure. Depression is characterised by feelings of sadness and a loss of interest in normal activities, as well as other symptoms including lack of energy, sleep problems or feelings of worthlessness. According to the Arthritis Foundation, rates of depression can be anything from two-times to ten-times greater in people with arthritis compared to the rest of the population. Figures vary depending on the type of arthritis and the amount of pain experienced. Unsurprisingly those in the greatest pain are the most likely to be anxious or depressed.
Link between pain and depression
Scientists aren’t completely clear why pain and depression are so strongly linked. While it is likely that declining quality of life is a factor, living with pain increases stress levels and this, in turn, affects chemicals in the brain and nervous system. Cortisol, serotonin and norepinephrine impact your mood, thinking and behaviour and may trigger depression. When you are depressed, your ability to cope with pain can be lower. Some studies also appear to show that people with depression have higher levels of C-reactive protein which is a marker of inflammation.
Living with the pain of osteoarthritis can be exhausting and it can be hard to exercise or do the things you used to enjoy. If you also have other conditions, such as a heart condition or diabetes, this can make it even more difficult and you may become more isolated. All of this can exacerbate the problems of living with chronic pain. As orthopaedic surgeons, we don’t just ask our patients about their physical health but also about their mental and emotional health as the two are so closely linked.
Osteoarthritis and sleep
Feelings of helplessness and a loss of control as well as the tendency to ruminate on pain and physical disability all impact on a person’s ability to manage their pain levels.
If you are in a lot of pain it can be harder to sleep and scientists are increasingly recognising a link between poor sleep and the ability to cope with pain. They refer to this as central sensitisation and pain sensitivity can be up to 10 times worse in these cases. Dehydration can also exacerbate painful joints as cartilage is made up largely of water so it is essential to drink enough water particularly during the hot summer months.
As well as the pain you are experiencing from your damaged joint, osteoarthritis causes problems in other parts of your body, too. This is because you compensate for the painful limb which puts a greater strain on other parts of the body. It is common, for example, for patients with knee osteoarthritis to develop foot pain.
Ostoearthritis is a complex condition that can have a significant impact on your quality of life. It is important to get a diagnosis early on and to work with an orthopaedic surgeon who can offer effective treatment to help you manage the disease. Contact us if you would like further information.
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Please be reassured that despite the ongoing UK Covid-19 pandemic, orthopaedic treatments are now again being routinely offered to patients. Having the vaccine does not mean that your treatment won’t go ahead. However, in some circumstances, such as for planned surgery, it is advisable to delay it by a couple of weeks to ensure your body responds in the optimum way to the vaccine. If in doubt, please talk to your orthopaedic consultant or contact us for more guidance to help get your orthopaedic treatment back on track.
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