Osteoarthritis In Young People

New Knowledge Reveals It Isn't Just The 'Wear And Tear' Disease Of Getting Old...

The Short Answer –

Misconceptions say osteoarthritis is purely a disease of ‘wear and tear’ around your joints. The same ‘theory’ assumes osteoarthritis will therefore only affect you when you get old. Yet there are numerous cases of osteoarthritis in young people?

If the above is true, how could this be possible? This article explains the fatal flaw behind the thinking that osteoarthritis will not affect young people….

The Old ‘Knowledge’ Of Osteoarthritis…

Osteoarthritis is essentially a degenerative condition that could affect any of your joints. For a variety of reasons that I cover in the next section, cartilage gets damaged and wears away.

Cartilage normally acts as a form of shock-absorbing cushion in your joints. When this is broken up you will eventually be left with bone grinding on bone in your joint.

The result is a condition that, once started, cannot be reversed, has no cure and is extremely debilitating. 

It is predominantly found in people from 40 years old onwards, most commonly affecting your knees or fingers.

The original thinking of scientists and doctors was that osteoarthritis was simply caused by repeated use of a joint, gradually wearing down the cartilage over years and years.

However, osteoarthritis is also found in young people, from teenage years upwards, which generated further research into why this was happening…

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Why Do We See Osteoarthritis In Young People?

New research has actually identified that osteoarthritis is NOT purely a disease of wear and tear. In actual fact, damage to any part of the joint ‘matrix’, which includes supporting muscles, synovium, ligaments and tendons can all cause osteoarthritis.

Typically, damage to the supporting part of your joint will cause an abnormal weight balance, putting excess pressure on one side of your joint (or on one complete joint over another).

It is highly likely the sensation of pain may cause you to subconsciously alter the way in which you use that joint. While you may be doing this without even thinking about it, to avoid the pain – this could cause the onset of osteoarthritis.

As commented on by Amoako et al in Clinical Medical Insights: Arthritis and Musculoskeletal Disorders,

“Diagnosis of OA in the athlete is often delayed and difficult because of high tolerance to pain, as well as the athlete’s preference for expedited return to play.”

The simplest example of this would be someone who hurts their knee playing sport. Walking afterwards, requires just a slight chance in your gait (the way you walk), which applies more pressure to your other knee.

The injury itself could theoretically cause osteoarthritis in your sore knee, while putting all your weight on the other one while you ‘get better’, could cause enormous damage. Your ‘good’ knee is know carrying twice it’s normal weight.

If we accept the damage to any part of the joint matrix can cause osteoarthritis to develop, then it is easy to see why people can develop the disease at almost any age.

Indeed, one particular study (Missouri Medicine) showed that more than 80% of American football players who showed a previous knee injury went on to develop osteoarthritis within 10 to 30 years of competing.

Potential Causes Of Osteoarthritis In Young People…

Osteoarthritis in young people requires a slightly different set of circumstances to develop than it does in the elderly. After reaching 65, it is quite likely that your reason for developing will actually just be down to genuine, balanced wear and tear.

One such review (‘Hip and Knee Osteoarthritis Affects Younger People, Too’ in the Journal Of Orthopaedic & Sports Physical Therapy), obesity, injury and hip deformities are named as major reasons for developing osteoarthritis in your knees or hips. 

There are however a whole range of potential causes of osteoarthritis in young adults (14-40). These include –

  • Leading a sedentary (non-active) lifestyle
  • Poor posture when sitting for long periods
  • Heavy lifting (potentially with poor technique, but not necessarily)
  • Doing an office job with large amounts of sitting at a desk/ computer
  • Being overweight or clinically obese
  • Being very active (running lots of marathons for example)
  • Playing impact sports such as rugby or football
  • Joint injuries
  • Birth defects such as hip dysplasia or different length legs
  • Hormone disorders that affect growth
  • Diabetes
  • Osteoarthritis in the family

How Does It Feel to Have Osteoarthritis – What Should I Look Out For?

The most common symptom is of course pain in one particular joint.

When you are young it is very common to overlook this and assume that it will just get better.

Maybe the pain does go away for a while and then comes back – and then goes away again with a few painkillers.

Obviously, it is possible that you have just hurt your knee/ wrist/ ankle etc – but when it doesn’t fade or comes back then alarm bells should start to ring and you need to get yourself to a doctor.

With no cure of osteoarthritis, the earlier you can get it diagnosed and start treating it, the better your chances are of slowing/ preventing its progress.

Typical signs to look out for include –

  • Grating sensation when moving the painful joint
  • Limited movement
  • Stiffness in the morning, which can be ‘worked off’ within 30 minutes
  • A ‘click’ when you move your joint
  • Tenderness and possibly swelling on your joint – it will be painful to touch
  • Non-inflamed lumps (known as bone spurs that form on your joint)
  • Stiffness after sleeping or other periods of rest
  • External swelling around your joint.

What Should I Do Next – Diagnosing Osteoarthritis…

If you, or someone you know, is suffering with any of the symptoms listed above, then you should get to your local doctor.

They can carry out a series of diagnostic tests to rule out other problems and give you a definitive diagnosis. This will typically follow the same basic pattern –

Verbal Consultation. A discussion around your pain and your family history (osteoarthritis has a strong family connection)

Physical Examination. They will look at your affected joint against it’s opposite side, checking movement, pain and inflammation.

Blood Tests. There is no test for osteoarthritis in young people, but they can rule out other similar forms of arthritis such as rheumatoid arthritis or gout.

X-Rays. These can help to assess any damage to your joint such as cartilage loss, although they wont show damage to the remaining joint matrix.

MRI/ CT Scans. These aren’t often used, but can be utilised to show damage to the surrounding soft tissue and joint matrix.

How Do I treat It If I Do Have Osteoarthritis?

It would be very easy to spin out a whole range of generic treatments for osteoarthritis in this section.

However, the reality is your treatment plan needs to be specialised to the joint(s) that you are suffering with.

It’s easy to say exercise for example, but which exercises? Not all activity is good, especially if you have osteoarthritis in the knee, or ankle.

Losing weight is great – but only if you are overweight in the first place and even then it’s not that effective if the osteoarthritis is in your fingers! Although surprisingly it does have some effect on your fingers, explained here.

The point I am making is that, while most treatments do not differ according to your age, they do differ according to which joints are affected. Just click the links below to go the relevant page if you want treatment advice on specific joints.

The Final Word –

If you are in your 20’s, the chances are that osteoarthritis is the last thing on your mind. And so it should be.

However, this does not change the fact the osteoarthritis in the young DOES happen. And, worse still, when you are young you’ve got even more years to make your joints last.

Then there is the disturbance that poorly managed or well developed osteoarthritis can make to you life, both throughout education and beyond.

It is essential therefore at the first sign that your joint pain wasn’t just a one-off from being kicked playing sports or hunching over a desk, that you get to your doctor.

Getting an early diagnosis and taking preventative actions really can make all the difference to your quality of life, and without a cure available, that is the best you can achieve.

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References Used –

1. Adae O Amoako and George Guntur A Pujalte. (May 2014). Osteoarthritis in Young, Active, and Athletic Individuals. Clinical Medical Insights: Arthritis and Musculoskeletal Disorders.
2. K L Rall, G L Mcelroy, T E Keats. (June 1964). A Study Of Long Term Effects Of Football Injury To The Knee. Missouri Medicine.
3. ILANA N. ACKERMAN, PT, PhD, JOANNE L. KEMP, PT, PhD, KAY M. CROSSLEY, PT, PhD, ADAM G. CULVENOR, PT, PhD, RANA S. HINMAN, PT, PhD. (2017). Hip and Knee Osteoarthritis Affects Younger People, Too. Journal Of Orthopaedics & Sports Physical Therapy.

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