2022-05-07T15:41:39+05:30
Representative image of osteoarthritis x-ray (Photo credit: Pixabay)
Editor’s note: Mother’s Day is celebrated across the world on May 8. This is the first article in a multi-part series on common health concerns typically faced by mothers and the best line of treatment for their disease.
Osteoarthritis (OA) is wear and tear of the joint cartilage which, when healthy, is responsible for pain-free and frictionless joint motion. Knees, being major weight-bearing joints are amongst the most commonly affected by OA. Although the causation of OA is multifactorial (biological, genetic, ethnic, emotional, environmental and psychosocial), it appears that women are at almost twice a higher risk of suffering from it than men. Symptoms of pain, stiffness, reduced walking and stair-climbing ability typically begin to appear in women in the 4th and 5th decade, and more so after menopause.
Obesity is by far the most important risk factor for OA in both men and women. Postmenopausal women (> 50 yrs of age) often gain weight and hence increase the weight-bearing stress on their knee cartilages. Estrogen and progesterone hormones have a protective role on the health of cartilage and after menopause, deficiency of these hormones can trigger knee OA in otherwise predisposed knees.
Anatomically, it is suggested that since women have wider hips than men, hence a wider angle formed by hip bones puts more weight-bearing stress eccentrically on the outside of the knees (“knock knee position”), which over time hastens the knee cartilage degeneration. Studies have shown that women have reduced cartilage volume and thickness which makes them furthermore to OA than their male counterparts.
OA affects the active life of an individual, markedly reducing walking ability, especially on stairs and floor level activities. As knee degeneration progresses, lifestyle gets compromised and activities like brisk walking, running or participating even in recreational sports becomes a far cry. All this leads to low self-esteem over time. Hence, timely awareness and treatment of knee OA are advisable.
Women of all ages should take timely precautions to prevent or reduce the risk of OA and if already suffering from it, one should take timely doctor consultation to manage it well and halt or delay its progression.
Regular weight-bearing exercises and a healthy diet are recommended to maintain ideal body weight. Adequate levels of iron intake to increase the haemoglobin, calcium and vitamin D supplementation, especially during pregnancy, lactation and after menopause is essential to reduce bone turnover and prevent the weakening of bones during these times.
Women tend to gain weight during pregnancy which puts increased stress on the knee joints. This increased weight gain, if not lost later, continues to overstress the knee joints, thereby hastening the progression of knee OA. Hence regular exercises on a daily basis (on advise of a doctor) are important to maintain a healthy body weight and prevent exercise-induced knee injury.
Self-medication, ignoring knee pain and delaying doctors’ visits can delay the timely diagnosis which is paramount in halting or delaying knee OA. Various medical (nonsurgical like cartilage supplements, intraarticular injections of visco-supplements) and surgical interventions (knee preservation surgeries) can be advised, on a case to case basis, in the early stages of knee OA to prevent or delay the progression of OA to end-stage arthritis which then results in total knee replacement surgery.
(Dr (Prof) Puneet Mishra is an Additional Director & Unit Head – Orthopaedics, Fortis Hospital Shalimar Bagh.)
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