Cartilaginous joints are most prone to osteoarthritis- examples of these joints include knee joints, hip, and spinal joints. The process is simply a degeneration of the cartilage covering the bones in the joint. If it occurs in the spine is it known as “spondylosis”.
As mentioned above, osteoarthritis can occur without any symptoms, or there may be some pain, crunchiness in the joint (crepitis), or maybe locking or giving way in later stages. Osteoarthritis is the most common cause of knee and hip replacements.
Healthy articular cartilage undergoes a good amount of compression and decompression through the day. If we use a hip joint as an example, think about how the joint moves when you walk. Bringing the leg forwards will compress some of the joint and allow the rest to decompress, and bringing it back will do the opposite. If you were to start shuffling and taking shorter strides, then some of this cartilage will be under more pressure, and other areas may never be compressed. This is one opportunity for osteoarthritis to begin- “use it or lose it” is a good mantra here!
Overuse or misuse of a joint can also lead to osteoarthritis, which makes sense when you think about the example above: over-compression in one area and under-compression elsewhere is not good for the joint.
This helps to explain the symptoms a patient might feel. As the joint surface becomes more rough, movement can become more crunchy. Locking can be caused by loose bodies of cartilage in the joint, or the osteophytes (boney growth) that form to both fill the space left by lost cartilage and in an attempt to stabilise the joint. This occurs in the latest stage of osteoarthritis.
More specifically, an osteoarthritic hip is often stuck in a slightly flexed (forward) position, which means that strides are normally shorter and the body may have to compensate for lost movement elsewhere, such as in the lower back. The small joints in fingers can be visibly affected, becoming stiff and appearing swollen. These swellings are called Herberden or Bouchard nodes depending where they form, but these terms are only used for osteoarthritis and do not constitute a diagnosis in themselves. Other conditions can appear similarly, so it’s best to have any changes looked at.
Osteopathic treatment will not cure arthritis, but by passively moving a joint in the way it’s meant to can help improve its health- we’re going back to compressing and decompressing in more evenly.