Osteoarthritis is a very common condition, affecting the joints, often described as "wear and tear" arthritis. This can start from our teens and gets worse as we grow older.

The amazing thing is how much it varies from person to person. If you look at two people, who have had identical jobs and identical stresses on their joints through their lifetimes, you could well find one with their joints in virtually pristine condition, and the other with visibly misshapen and painful joints that do not function normally.

Osteoarthrosis and osteoarthritis are terms which are used virtually interchangeably. Osteoarthrosis means a condition where the joints are affected by degeneration. Osteoarthritis implies the same, but the "itis" adds the meaning that the joints are red, hot, swollen, and painful (inflamed).

Most of the time people with this condition do not have inflamed joints, although they may well be painful and, to some extent, deformed. Thus, in truth, osteoarthrosis is probably a more accurate overall description of the condition. However as most people refer to the condition as osteoarthritis, this is the term used below.

Osteoarthritis is not usually a progressive and crippling arthritis in the way that some other forms, such as rheumatoid arthritis, can be. It may begin at a very young age, so do not worry too much that it means you are "over the hill". Changes of osteoarthritis have been found in the bones of teenagers.

The joints that are affected ache and you may feel or hear them crunching or cracking. The range of movement of the joints may be reduced, and they may become visibly knobbly.

Sometimes the pain gets worse and the joint becomes swollen. This is usually short lived, and the symptoms return to how they were, but you should see your doctor.

Osteoarthritis is more likely to affect your hips or knees, and also the end joints on your fingers, but it can affect any joint.

The standard explanation for osteoarthritis is that it is a result of "wear and tear". This does account for a large percentage of the problem, but there are many examples of people who have had very similar lives, one of whom will have virtually perfect joints, while the other will have really quite severe osteoarthritis. Thus there must be an inbuilt susceptibility to or, on the other hand, protection against osteoarthritis.

Diagnosis is usually made by the doctor from talking to, and examining, the patient. When a particular joint becomes worse, your doctor may arrange X-rays and blood tests, to confirm the diagnosis, and to help rule out the more aggressive types of inflammatory arthritis.

For the most part treatment is to keep mobile and active, taking pain killers (analgesics) such as paracetamol or paracetamol-based medications, and if necessary, especially when the joints are swollen, hot and more painful (inflamed), anti-inflammatory drugs, such as aspirin and ibuprofen.

You should speak to your doctor. He or she will advise appropriately, and prescribe if necessary. Physiotherapy techniques can also be helpful, both in the form of active treatment, and in the form of exercises which you can continue on your own.

The physiotherapist, and sometimes an occupational therapist, may advise on aids and appliances to help you get around or to make certain activities easier, in the home or workplace, such as a walking stick, rails near the bath, adaptations to taps and electrical plugs etc. Do not let this description worry you. Most people have a mild degree of osteoarthritis, and it is only when it is more troublesome that these sort of approaches are necessary or helpful.

There is evidence that a chemical called glucosamine may help in osteoarthritis. In the UK this is available over the counter, but as the evidence is mixed and seems to suggest better effects from one type of glucosamine than others, NICE does not recommend its use by the NHS.

Another recent addition to the treatments available is a cream to apply to the affected area, which is based on chilli peppers. This again has withstood medical scrutiny and has been shown to be helpful to some people. You would have to discuss with your doctor whether it is appropriate for you.

If a particular joint or joints are causing problems, which the above methods are not containing, your doctor may refer you to a specialist. Sometimes treatments such as injections to the joint can help, but if the joint is very worn, the question of surgery may be raised.

There are operations to reduce the wear and tear on the joint, but the major procedure used these days is a joint replacement. Though other joints can be replaced, the hip is the replacement that has been going for longest, and in recent years knee replacements have also become widely used. Your family doctor and your specialist will discuss the pros and cons of these procedures.

It is wise not to embark on a joint replacement too soon, as we are living longer these days, and the replacement is likely to wear out or go wrong after a number of years. Subsequent options for further surgery are limited.

Having said that, people who have a joint replacement usually remark on the sudden loss of the severe pain they had before. One drawback can be that the joint is so much better that they do more and notice, as a result, that another part of them is holding them back and needs attention!

Complementary medicine

There are a number of complementary medical approaches to osteoarthritis, including nutritional medicine, acupuncture, homoeopathy, and herbal medicine. The research evidence on the effectiveness of these is sometimes lacking and conflicting, but many patients find help from one or other of these approaches.

Injuries involving the joints tend to lead to an increased risk of osteoarthritis affecting that joint in later life (usually many years later).

• Avoid being overweight. Excess weight increases the load on the joints.
• Remain active.
• Seek advice from your doctor or physiotherapist if you develop joint problems.

• Arthritis Research Campaign
• Arthritis Care
• Arthritis Foundation
• Glucosamine therapy for treating osteoarthritis (Cochrane Database of Systematic Reviews, 2005)

Books

Cooking for arthritis, by Michelle Berriedale-Johnson

Recipes to help sufferers of arthritis.

The arthritis cookbook, by Jo Hampton

The Arthritis Cookbook and Drug Free Treatment Plan. Includes vegetarian options.