Osteoarthritis

Osteoarthritis is one of the most common chronic diseases of the musculoskeletal system. Doctors also refer to it as a degenerative joint disease. It occurs when the protective cartilage layer in the joint gradually breaks down. Older people are most commonly affected, but younger people or those who are active in sports can also suffer from it, for example after injuries or if the joint is permanently under strain.

Typical symptoms are pain and stiffness in the joints, which noticeably restrict mobility over time. Osteoarthritis becomes particularly troublesome when everyday tasks become a challenge: Climbing stairs, walking for long periods or gripping small objects. Overall, women are affected slightly more frequently than men.

At the Nuhr Medical Center, we help you regain your mobility and alleviate discomfort in the long term.

What is osteoarthritis?

Osteoarthritis is a chronic, progressive wear and tear of the joints. It occurs when the protective cartilage layer on the joint surfaces of the bones gradually becomes thinner, rougher and more fragile. This cartilage layer acts like a shock absorber and ensures smooth and pain-free movement in healthy joints. In the course of the ageing process, however, the cartilage loses its elasticity and only regenerates to a very limited extent.

If the cartilage is finally severely worn or even completely eroded, the exposed bone ends rub directly against each other. This leads to friction, inflammation and ultimately to changes in the joint, which are accompanied by increasing pain and limited function. What is striking here is that the disease often develops gradually and only becomes symptomatic at later stages.

Which joints are most commonly affected?

In principle, osteoarthritis can occur in any joint. However, changes are particularly common in the following areas:

• Knee joints (osteoarthritis of the knee)
• Hip joints (coxarthrosis)
• Hand and finger joints
• Vertebral joints of the spine (facet syndrome)

The course of the disease varies greatly from person to person: While some people hardly feel any discomfort for many years, others experience a steady increase in pain and limitations. As a rule, it is a slowly progressing process that can be favorably influenced by targeted measures.

What are the causes and risk factors for osteoarthritis?

Cartilage wear and tear over the course of a lifetime

Osteoarthritis is primarily caused by the natural wear and tear of joint cartilage, which decreases with increasing age. The risk increases significantly from the age of 50 in particular. Over the years, the cartilage loses its elasticity, becomes more brittle and regenerates only slowly or not at all.

Influence of gender and genetic predisposition

Women are more frequently affected, which is linked to hormonal factors, among other things. A familial predisposition can also increase the risk. If parents or grandparents suffer from osteoarthritis, there is often a genetic tendency to premature wear and tear of the joints.

Injuries and misalignments as an additional burden

Injuries such as broken bones, torn ligaments or meniscus damage affect the structure of the cartilage. Misalignments, such as knock knees or bow legs, also lead to uneven stress on the joints and can accelerate cartilage wear.

Inflammatory pre-existing conditions

Certain diseases such as arthritis or other inflammatory joint changes can damage the cartilage and exacerbate the progression of osteoarthritis.

Lifestyle as a decisive factor

Overweight and physical strain in everyday life

Too much weight puts strain on the joints, especially the knees and hips. Anyone who frequently lifts, kneels or squats heavily at work puts additional strain on their joints and increases the risk of premature wear and tear.

Choose sport and exercise wisely

Sport is generally healthy, but not every sport is easy on the joints. Activities with a high impact load, such as soccer or handball, can increase the risk of osteoarthritis. However, a lack of exercise is just as harmful. Without regular exercise, the muscles become weaker and the cartilage no longer receives enough nutrients.

One-sided strain due to incorrect movement patterns

Repetitive or incorrectly performed movements, for example due to monotonous activities in everyday life or inappropriate training routines, can also lead to premature joint wear and tear.

When complaints occur

Not all wear and tear automatically causes pain. Complaints usually only occur when the cartilage is already severely damaged. It is only when inflammation or changes in the bone occur that movement restrictions and pain become noticeable. It is therefore important to look out for the first warning signs at an early stage.

How does osteoarthritis manifest itself?

First signs and typical symptoms

Osteoarthritis usually develops slowly. The first symptoms usually only appear occasionally and are often underestimated at first. The symptoms often first occur when exerting oneself, e.g. when climbing stairs, taking long walks or doing sport. Many sufferers report a stabbing pain, especially when making sudden movements. Another typical symptom is a feeling of stiffness in the joints, especially in the morning or after long periods of rest. This so-called morning stiffness usually disappears within 30 minutes.

What can indicate the onset of osteoarthritis

In the early stages, the joints often only hurt during certain movements. Over time, however, the pain can also become noticeable at rest and intensify at night. Many patients notice a cracking or crunching in the joint. Mobility decreases and simple everyday activities such as getting dressed or squatting become increasingly difficult. Sometimes affected joints such as the knee or ankle suddenly give way. This can lead to unsteadiness when walking or even cause falls. If the hand is affected, gripping or opening objects becomes much more difficult.

Complaints in an advanced stage

As the disease progresses, the affected joints become more sensitive and react with pain when stressed or touched. Swelling often occurs. Visible changes also occur. These include, for example, thickened finger joints or a change in the leg axis. Such deformities are usually accompanied by permanent pain and significantly restricted mobility. The pain then occurs not only when moving, but also when sitting or lying down. It is often described as drilling or pulling. Even brief exertion is enough to trigger the symptoms. This is often accompanied by rapid joint fatigue.

Some joints react with irritation and produce more fluid. This results in so-called joint effusions. This is also referred to as osteoarthritis. It is important to note that osteoarthritis is not one of the classic inflammatory rheumatic diseases such as rheumatoid arthritis.

What are the stages of osteoarthritis?

To assess the severity, osteoarthritis is divided into four stages, depending on the extent of the cartilage damage and the visible changes in the joint:

Stage 1 – early stage

• Slight thickening of the bone tissue underneath the cartilage
• No joint space loss yet
• No or minimal osteophyte formation (bony marginal ridges)
• Usually little or no discomfort

Stage 2 – Mild osteoarthritis

• First narrowing of the joint space
• Onset of osteophyte formation
• Irregularity of the cartilage surface
• Complaints usually only under heavy load

Stage 3 – Moderate to advanced osteoarthritis

• Clearly pronounced osteophytes
• More advanced cartilage damage
• Visible irregularities and deformations
• Pain even during everyday movements, limited joint function

Stage 4 – final stage

• Severe to complete narrowing of the joint space
• Cartilage severely destroyed or no longer present
• Bones rub against each other, deformities and joint stiffening possible
• Pain even at rest, severe movement restrictions

How is osteoarthritis diagnosed?

The diagnosis begins with a detailed consultation. The doctor will ask when the symptoms started, how the pain manifests itself and how the symptoms have changed over time. Pre-existing conditions, previous injuries or family history also play an important role.

This is followed by a thorough physical examination. The affected joint is checked for mobility, stability, tenderness and visible changes. These initial impressions often provide important indications of possible osteoarthritis.

Imaging procedures are used to confirm the diagnosis:

• X-rays show typical changes such as a narrower joint space, bone pull-outs or deformations in the joint.
• Ultrasound examinations help to assess soft tissue structures such as tendons and ligaments. Joint effusions or signs of inflammation can also be easily detected.
• MRI scans, i.e. magnetic resonance imaging, provide more precise information about the condition of the cartilage and changes in the bone or surrounding tissue, especially in the early stages of the disease.
• Blood tests are usually carried out to rule out inflammatory joint diseases such as rheumatism, as osteoarthritis itself does not show any typical blood changes.

At the Nuhr Medical Center, we combine modern diagnostics with a wealth of experience in order to provide targeted treatment at an early stage and maintain the best possible quality of life.

How can osteoarthritis be treated?

It is currently not possible to cure osteoarthritis. Nevertheless, the progression and symptoms can be effectively influenced with targeted therapy. If started early, treatment can help to maintain mobility and ensure quality of life in the long term.

The choice of suitable measures depends on the affected joint, the severity of the disease and individual factors such as body weight, muscle strength and mobility. The aim is to alleviate pain, reduce inflammation, improve joint function and avoid or delay surgical interventions as far as possible.

Exercise as a central component of therapy

Regular exercise is an essential part of any osteoarthritis treatment. Targeted physiotherapy exercises strengthen the muscles, promote joint stability and relieve pain. Suitable sports include cycling, swimming and aqua aerobics. Exercising in water is particularly beneficial, as the buoyancy relieves the joints and at the same time creates a gentle training stimulus.

Weight reduction to relieve the joints

Being overweight increases the pressure on the joints considerably and is a significant risk factor, especially for osteoarthritis of the knee and hip. Even moderate weight loss can reduce symptoms and significantly improve the effectiveness of therapy. At the Nuhr Medical Center, we support you with professional nutritional advice and individually tailored exercise programs.

Making everyday life easier with orthopaedic aids

Depending on the joint and the course of the disease, aids such as supports, orthoses or crutches can make everyday life easier. They stabilize the affected joint, improve mobility and contribute to safety when walking. In addition, ergonomic everyday objects such as bottle openers or gripping aids can promote independence.

Physical forms of therapy

At the Nuhr Medical Center, we use various physical treatments to effectively alleviate the symptoms of osteoarthritis. These include heat packs, cold treatments, therapeutic massages, electrotherapy and ultrasound therapy as well as hydrotherapy applications in the exercise pool. These measures have a pain-relieving effect, relax the muscles and improve circulation. At the same time, they support the regeneration of the affected tissue and promote your mobility.

Our experienced therapists will explain the effect of each treatment, adapt the intensity to your needs and show you how you can actively do something for your joint health outside of the treatment sessions. This makes the therapy not only effective, but also suitable for everyday use.

Occupational therapy to promote everyday skills

Especially with osteoarthritis in the fingers or hands, it is important to carry out movements in such a way that the joints are relieved. Occupational therapy at the Nuhr Medical Center teaches you how to perform everyday tasks gently – from opening a glass to writing or gripping small objects.

Our occupational therapists will show you step by step how to maintain your hand strength, use aids sensibly and remain as independent as possible despite limitations. The aim is to ensure your quality of life and maintain your independence in everyday life, even with advanced osteoarthritis.

Drug therapy options

If necessary, anti-inflammatory drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) can be used to reduce pain. These are available as tablets or for local application in the form of gels. In acute episodes of inflammation, cortisone injections into the affected joint can bring about a significant improvement in the short term. However, they should only be used in a targeted manner and for a limited period of time in order to avoid side effects.

Surgical measures for advanced osteoarthritis

If conservative therapies are no longer sufficient, surgical intervention may be necessary. Possible procedures include joint-preserving operations such as arthroscopic cleaning or, in the case of severe joint wear, the use of an endoprosthesis. The decision to operate is made on an individual basis and is only made after careful consideration of all conservative options.

Complementary therapy methods

In addition to conventional medical treatment, alternative methods such as acupuncture, injections with hyaluronic acid or nutritional supplements such as glucosamine and chondroitin can also be used. The Nuhr Medical Center will discuss with you individually whether such procedures make sense.

Nutrition as a supportive measure

A balanced and anti-inflammatory diet can be a useful addition to treatment for osteoarthritis. Fresh vegetables, fruit, wholegrain products, omega-3-rich fish such as salmon and high-quality vegetable fats are recommended. Sugar, alcohol and animal fats should be avoided wherever possible. Our nutrition experts will be happy to advise you on a suitable diet.

What can you do yourself for osteoarthritis?

Everyone can actively contribute to positively influencing the course of osteoarthritis. A joint-friendly lifestyle not only supports the therapy, but can also alleviate symptoms in the long term. It is particularly important to exercise the joints regularly and purposefully without overloading them. Joint-friendly sports such as cycling, swimming or Nordic walking are ideal for strengthening the muscles and maintaining mobility.

It is also helpful to recognize misalignments in good time and have them corrected, for example with orthopaedic insoles. In everyday life, stressful movement patterns should be avoided, such as constant heavy lifting or kneeling for long periods. It is also worth paying attention to ergonomic working practices at work. If you lose excess weight or keep your weight stable, you will also relieve the strain on your joints, especially the knees, hips and spine.

A balanced diet with lots of vegetables, healthy fats and little sugar also has a positive effect. It can dampen inflammatory processes in the body and improve general well-being.

At the Nuhr Medical Center, we support you in integrating these strategies into your everyday life. We give you practical tips for better joint health, help you start an adapted exercise program and accompany you on your way to a better quality of life.