Osteoarthritis (Osteoarthrosis, Degenerative Joint Disease)
- Care Needs and Mobility Considerations -
Introduction
Arthritis and the rheumatic conditions constitute the major cause of chronic disability in the United Kingdom. They affect 10 million people including 1.2 million under 45 and 30,000 children. Arthritis means inflammation in one or more joints. Movement in the joint is restricted with pain and swelling. The most common types are osteoarthritis (also known as osteoarthrosis) and rheumatoid arthritis. Ankylosing spondylitis and juvenile chronic arthritis (Stills disease) are other types of arthritis. Arthritis may also be found in other disorders (eg psoriasis, colitis, some infections and gout).
The musculoskeletal system refers to the bones of the body, the joints which link them, and the related structures such as tendons, ligaments and muscles. Musculo-skeletal disorders are therefore all those medical conditions which involve these parts of the body.
Rheumatism is a term often used to describe the great number of disorders which affect the musculo-skeletal system. Furthermore a number of other terms are used to describe joint/muscle disorders eg "frozen shoulder", "tennis elbow", fibrositis (fibromyalgia) and polymyalgia rheumatica. Sometimes when only the ligaments, tendons and muscles are the sources of pain and limited function the term soft-tissue rheumatism is used.
Joint hypermobility, which is a hereditary (ie inherited) condition causing looseness and fragility of ligaments and other tissues surrounding the joints, renders the affected person more susceptible to injury. The resultant "hypermobility syndrome" causes problems (strains, sprains, dislocations, fractures or just pain) at various sites of injury, which may, in some cases, be persistent and lead to difficulties with mobility and self-care depending on the parts affected.
The diagnosis is of secondary importance - it is the disability and its consequent needs which are relevant. In all of these conditions there is a great degree of variability in relation to the need for help or effects on walking. To some extent this is dependent on the specific condition, age, severity, treatment and the response of the individual to treatment.
It is highly unlikely that the joints of people past middle age will be as supple, strong and resilient as those of the younger person. X rays of the joints of people past middle age (and sometimes in even younger people) may show abnormalities of the lining cartilage and the bones that make up the joints (eg thinning of the cartilage, "wear and tear", bony outgrowths, etc), but these radiological (ie X ray) findings may be present in very many people who do not have any problems in those joints. An X-ray report of joints which describes "arthritic changes" does not necessarily mean that the person with such changes has any significant pain or problem with that joint.