Dr Leigh Martens

Osteoarthritis and Osteoporosis: do you know the difference?

Released by NOFSA (National Osteoporosis Foundation South Africa)

The terms osteoporosis and osteoarthritis sound like very similar conditions but in reality they are two very different medical conditions with little in common. In both instances the word ‘osteo’ means bone. Osteoporosis affects the bones directly while osteoarthritis affects the joints between the bones. Therefore, the symptoms are experienced differently, and the diseases develop differently with different methods of treatment.

Osteoporosis

Osteoporosis mostly affects older people (although anyone can develop thin bones). Your bones gradually lose density, becoming thinner and more fragile, and are therefore more likely to fracture. This loss of bone tissue is a result of minerals such as calcium not being replaced quickly enough in the bones, thus causing bones to become weak and brittle. Osteoporosis can result in loss of height, severe back pain, and change in posture. It can eventually affect a person’s mobility to the point where they need a wheelchair.

Risk factors for developing osteoporosis include:

although still more common in women (1 in 3 women), it also affects men (1 in 5 men) and even young people

• age remains a strong risk factor for developing osteoporosis, but it is NOT a normal part of ageing.
• Osteoporosis is a systemic disease
• family history of the disease
• thinness or small frame
• poor diet that is low in calcium and vitamin D
• lack of physical activity
• smoking
• excessive alcohol intake
• use of certain medications, such as steroids.

Treatments for osteoporosis

Known as the silent disease, osteoporosis can progress undetected for many years until entirely without warning, a fracture occurs. Although bone loss cannot be totally reversed, medication can help preserve the remaining bone and is effective in preventing up to 70% of fractures.  Prevention incorporating lifestyle changes is still the route to protection that is most advocated: a diet rich in calcium and vitamin D, regular weight-bearing exercise, and a healthy lifestyle can prevent or lessen the effects of the disease. There are also effective medications that can reduce the risk of fracture. In the event of the most serious complication of osteoporosis, the hip fracture, surgery would be necessary.

Osteoarthritis

This is a painful degenerative joint disease where cartilage has been worn away over time, allowing one bone to rub against another, leading to inflammation, stiffness and pain. It often involves the hips, knees, neck, lower back, or small joints of the hands. It is more common among women than men and generally but not necessarily age-related. It is sometimes the result of joint injury, malformation or genetic defect.

But most often it develops in joints that suffer repeated use of the same movement such as hammering, painting, playing sport, or simply carrying too much weight. Eventually this repeated activity wears away the cartilage that cushions the ends of the bones in the joint (wear and tear changes). As a result, the flexibility of the joint is reduced, bony spurs develop, and the joint swells. Usually, the first symptom is pain that worsens following either exercise or immobility.

It can be a painful, debilitating and mobility-restricting condition. Possibly the best medical practitioner to seek out for verification of this disease, is a Rheumatologist. Rheumatologists not only confirm diagnosis but ensure that the patient is not suffering a similar but different type of joint problem such as gout or rheumatoid arthritis.

Treatments for osteoarthritis

Treatment should be designed to reduce joint pain, increase flexibility and improve joint function. The first clear step is to try and reduce the amount of work that the joint has to do. Carefully planned exercise can be helpful, as well as heat and ice treatments. Most treatments will eventually include painkillers and topical creams, through to anti-inflammatory drugs and even surgery such as joint splinting or joint replacement.

Treatments that encompass both conditions:

Exercise programs that may include physical therapy and rehabilitation, including stretching and strengthening exercises to improve posture and mobility. These exercises should incorporate: walking, low-impact aerobics, swimming, tai chi, and low-stress yoga.

However, people with severe osteoporosis will require careful monitoring and must refrain from extreme and high-impact exercise which may enhance the possibility of a fracture –  and people with osteoarthritis must work very slowly, gradually improving upon the limitations of an affected joint without applying undue stress. Always check with your doctor to determine which exercises are safe for your specific situation.