Early osteoarthritis with narrowing of the joint space

In the early stages of osteoarthritis the patient may be aware merely of discomfort and stiffness in the joint.  In these circumstances physiotherapy can help significantly to maintain mobility.  Maintaining mobility can support the ‘nutrition’ of the articular cartilage but also maintains muscle bulk and support around the joint, helping to reduce symptoms.  Beyond that, simple painkillers and anti-inflammatory medication can improve symptoms allowing the patient to continue to function at home, in work and frequently in sports, often to a reasonable level.

Some patients have found that articular cartilage supplements, such as glucosamine and chondroitin, can have a beneficial effect but this is far from proven.  My own thoughts are that it is unlikely to cause harm and in my opinion, in the early stages of osteoarthritis, taking articular cartilage supplements at suggested doses is an entirely sensible and reasonable course of action.

As the condition progresses a change in activities, particularly reducing activities that ‘impact’ the articular cartilage such as running and impact sports, will be required to allow the individual to tolerate the symptoms.

Unfortunately as the wear and tear progresses further this sort of ‘conservative management’ becomes less effective.  In the hip and knee, pain and stiffness worsens and the patient can start to limp.  In these circumstances using a stick, as a support, might be of help.

More advanced disease with complete lack of joint space

In the hip and knee, as the condition progresses, the patient can start to experience pain at night, pain at rest, difficulty in putting on shoes and socks, climbing stairs and going about their everyday activities and one reaches the limits of conservative management.

It is at that stage, as the symptoms progress and the resulting limitation worsens such that the patient is unable to go about their desired activities, that surgery might be considered in an attempt to improve symptoms.

© Andrew R J Manktelow – 2019