By Siew Ooi Peng, AA Pharmacist.

Osteoarthritis is the most common chronic condition of the joints, affecting millions of people worldwide. OA can affect any joint but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe. It occurs when the protective cartilage on the ends of your bones deteriorates over time. Cartilage is a protein substance that serves as a “cushion” between the bones of the joints. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone leading to joint damage and more pain.

above shows the evolution of joint in osteoarthritis.

Above shows the evolution of joint in osteoarthritis.4

Risk Factors

  • Being overweight
  • Age risks increases for those above 40 years old
  • Females
  • History of joint injury
  • A genetic defect/family history
  • Occupations stress or sports related

Sign and symptoms

  • Pain
  • Tenderness
  • Stiffness
  • Loss of flexibility
  • Grating sensation
  • Bone spurs

Pharmacological Interventions

Osteoarthritis is a long-term disease. There is no cure but pharmacological treatments are available to manage symptoms including:

  • Acetaminophen/Paracetamol
  • Oral NSAIDs (Ponstan, Voltaren)
  • Topical NSAIDs (In the form of gels, creams, patches)
  • Tramadol
  • Intra-articular corticosteroid injections

Non-pharmacological Interventions

1) Weight Loss

Each unit of weight loss will lead to reduction of load exerted on the knee per step during daily activities.

2) Physical Activity

Exercise is effective in hip and knee OA, producing improvements in pain, physical function, and walking distance.

3) Physiotherapy

Physiotherapy improves muscle strength, balance, coordination and joint mobility.

4) Thermotherapy

Application of heat or cold for the purpose of changing the cutaneous, intra-articular and core temperature of soft tissue help in managing the symptoms

5) Occupational Therapy

Example of drink labelled ‘zero sugar’ while using aspartame and acesulfame potassium as artificial sweetener and its nutrition facts showing 0% total sugar.


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