Osteoarthritis is a degenerative joint disease that causes pain, stiffness and reduced mobility in the joints. It is the most common form of arthritis and a leading cause of disability worldwide. But just how disabling is osteoarthritis?
What is osteoarthritis?
Osteoarthritis occurs when the cartilage that cushions the ends of bones gradually wears down over time. This results in pain, swelling, stiffness and impaired mobility in the affected joints. The joints most commonly affected are the hands, knees, hips and spine.
Osteoarthritis usually develops slowly over many years. It often starts from middle age onwards and is more common in women and people who are overweight. There are some risk factors that increase the chances of developing osteoarthritis such as previous joint injury, repetitive movements in certain jobs and genetic factors.
How prevalent is osteoarthritis?
Osteoarthritis is an extremely common condition. It affects around 30.8 million adults in the United States. That equates to 13.4% of the adult population over 25 years old having osteoarthritis.
The prevalence of osteoarthritis increases dramatically with age:
|25-34 years old||2.2%|
|35-44 years old||3.2%|
|45-54 years old||6.7%|
|55-64 years old||15.9%|
|Over 65 years||33.4%|
It’s clear from these statistics that osteoarthritis dramatically increases past middle age. By the over 65s, around 1 in 3 people have osteoarthritis.
Osteoarthritis is more frequent in women – around 16% compared to 10% of men over 45 have osteoarthritis. Obesity is another major risk factor, with nearly 50% of obese adults showing signs of osteoarthritis.
How does osteoarthritis impact day-to-day life?
Osteoarthritis can have a major impact on daily living and make normal activities more difficult. The main symptoms people with osteoarthritis experience are:
- Joint pain and stiffness, especially after rest
- Reduced flexibility and range of motion in the joints
- Swelling around the joints
- Tenderness when touching the affected joints
- Creaking or crunching sounds when moving the joints
These symptoms often make daily tasks involving use of the hands, walking, bending and lifting much harder. Standing for long periods or climbing stairs can become painful. The constant pain and stiffness can make it difficult to get a good night’s sleep.
As well as physical impairments, osteoarthritis can negatively impact mental health too. Struggling with pain, reduced mobility and inability to perform usual activities can lead to depression, anxiety and social isolation.
How disabling is osteoarthritis on work and employment?
Osteoarthritis causes a substantial impact on work capacity and employment. Difficulties with mobility, dexterity, lifting and pain can make it challenging to fulfill work duties. This results in many working years lost to disability. Some key statistics on how osteoarthritis affects employment include:
- Up to 11% of people with osteoarthritis under 65 years old report being work disabled.
- Osteoarthritis accounts for 15% of temporary work disability.
- Workers with osteoarthritis miss around 7 more days of work per year than the average.
- Reduced productivity at work costs an estimated $108.1 billion per year.
- Early retirement due to osteoarthritis disability is estimated to cost $12.6 billion per year.
It’s clear osteoarthritis has a major impact on employment and workplace productivity through causing disability. The costs to individuals and the economy are huge.
How osteoarthritis leads to work disability
There are two main ways osteoarthritis contributes to work disability:
- Physical functional limitations – Difficulty with movements needed to perform job tasks.
- Chronic pain – Constant joint pain causes distraction, fatigue and depression.
Together, these physical and mental effects of osteoarthritis impair the ability to meet job demands. People with lower education levels tend to have more physically demanding jobs that become difficult with osteoarthritis disability.
Impact of osteoarthritis on quality of life
Osteoarthritis reduces quality of life through its disabling effects on both physical function and mental health. Some key quality of life impacts include:
- Difficulty performing self-care tasks like dressing, bathing and household chores.
- Problems with daily activities including shopping, cooking and driving.
- Restrictions to hobbies, exercise and social life.
- Mobility disabilities making it harder to walk distances or use stairs.
- Fatigue, pain and depression lowering life satisfaction.
- Social isolation and relationship strain due to disability.
The end result is osteoarthritis has extensive negative effects on independence, wellbeing and participation in normal life activities. Studies consistently show osteoarthritis lowers health-related quality of life scores.
Impact on physical function
Osteoarthritis progressively reduces mobility and physical abilities due to joint stiffness, pain and loss of flexibility. Typical impairments include:
- Reduced walking speed, balance and coordination.
- Difficulty standing up, bending down and lifting.
- Problems climbing stairs, running and jumping.
- Restricted fine hand movements needed for tasks like buttoning.
- Grip weakness making opening jars and carrying objects harder.
Even everyday activities like shopping, cooking, driving and household chores become more challenging. Severe osteoarthritis disability may eventually lead to needing walking aids or wheelchairs.
Impact on mental health
As well as reduced physical abilities, osteoarthritis also negatively affects mental health and wellbeing. Common psychological impacts include:
- Depression – From social isolation, disability and pain.
- Anxiety – Due to disability, dependence and uncertainty over the future.
- Stress – Coping with constant pain and disturbing sleep.
- Low self-esteem – Due to reduced independence and ability.
- Anger – At loss of abilities and the unpredictability of flare-ups.
Coping with osteoarthritis disability often requires psychological adjustment along with lifestyle changes. Counseling or antidepressants may help manage the mental health burden.
How disabling is osteoarthritis pain?
Chronic joint pain is the hallmark symptom of osteoarthritis. This persistent pain contributes greatly to osteoarthritis disability and lowering quality of life. Studies reveal:
- Over 90% of people with hip and knee osteoarthritis suffer frequent pain.
- 40% rate their osteoarthritis pain as moderate to severe.
- Severe joint pain is linked to 3 times higher risk of disability.
- Pain severity is strongly associated with lower functioning and wellbeing.
Along with causing distress, osteoarthritis pain leads to disability by:
- Increasing stiffness and loss of mobility in joints.
- Disturbing sleep and causing fatigue.
- Reducing muscle strength due to favoring painful joints.
- Causing distraction, low mood and anxiety.
Effective pain management is therefore essential to reduce the disabling effects of osteoarthritis pain on physical and mental health.
Disability from hip and knee osteoarthritis pain
Among all forms of osteoarthritis, pain in the hips and knees is most debilitating. This is because these large weight-bearing joints are crucial for activities like walking, standing up and climbing stairs. Severe hip and knee osteoarthritis leads to:
- Difficulty walking distances or navigating steps.
- Problems getting in and out chairs, cars and the bath.
- Discomfort standing for long periods eg. cooking or shopping.
- Sleep loss from pain turning in bed.
- Need for walking aids like canes or wheelchairs.
All these effects greatly reduce mobility and independence. Knee and hip osteoarthritis alone is responsible for over 90% of the disability burden from osteoarthritis.
Hand osteoarthritis and disability
Although less severe than hip and knee osteoarthritis, hand osteoarthritis also causes significant disability. Pain, stiffness and deformities in the fingers hamper everyday tasks like:
- Writing, typing and using phones, tools or kitchen utensils.
- Opening jars, bottles, doors and carrying shopping.
- Doing up buttons, zips, jewelry and shoelaces.
- Personal care activities like brushing hair and teeth.
This makes hand osteoarthritis especially disabling for home duties, work and self-care. Severe hand osteoarthritis may progress to deformities like bent fingers.
How effective is treatment for reducing osteoarthritis disability?
While not yet curable, osteoarthritis treatments aim to minimize symptoms, slow progression and limit disability. Main treatment approaches include:
- Medications – Painkillers like paracetamol or NSAIDs reduce pain and stiffness.
- Lifestyle changes – Exercise, weight loss and aids/braces support joints.
- Physiotherapy – Stretches and exercises maintain strength and mobility.
- Surgery – Joint replacements can relieve severe osteoarthritis.
Along with medical treatments, aids like walking canes and occupational therapy can also minimize disability. But how much do the treatments really help?
Treatment benefits on pain and disability
Research indicates treatments provide moderate improvements in osteoarthritis symptoms and disability:
- Exercise reduces pain by 20-30% and improves functioning.
- Joint replacements lower pain by around 60% and disability by over 80%.
- Losing 5% of body weight cuts knee osteoarthritis disability risk by over 50%.
- Assistive walking devices lessen load on joints and improve mobility.
But treatments have limits – severe osteoarthritis cannot be cured and joint damage cannot be reversed. So treatments mainly focus on managing and coping with disability.
Challenges in treating osteoarthritis disability
There are several challenges when it comes to minimizing osteoarthritis disability:
- No cure – Joint damage from osteoarthritis is irreversible.
- Progressive nature – Most treatments only slow worsening rather than stop it.
- Joint replacements eventually wear out.
- Lifestyle changes and physiotherapy require long-term effort.
- Side effects of medications like stomach ulcers or dependency.
- Surgical risks from joint replacement procedures.
Therefore people with osteoarthritis need to utilize multiple approaches over many years to manage symptoms and sustain quality of life.
Outlook for future osteoarthritis disability
Due to increasing life expectancy and obesity rates, projections indicate osteoarthritis will become even more disabling in the future. Forecasts suggest:
- Prevalence of osteoarthritis will rise around 40% by 2040 as populations age.
- Total osteoarthritis disability could nearly double from 2015 to 2040.
- Work disability and lost productivity will increase over 50% by 2040.
- Joint replacement surgeries will grow 170% in the US and 100% in the UK by 2030.
These projections paint a worrying picture of rising osteoarthritis disability burden on individuals and healthcare systems in coming decades.
Strategies to reduce future osteoarthritis disability
To counteract forecasts of dramatically worsening osteoarthritis disability, strategies should focus on:
- Health promotion to reduce obesity and injury risks.
- Early diagnosis and interventions to minimize irreversible joint damage.
- Improving access to therapy, braces, aids and joint replacement surgery.
- Better pain management and maintaining function.
- Supporting work participation through aids and workplace adaptations.
Research into disease-modifying drugs to repair cartilage damage may also yield future benefits. But preventing obesity and injury will be key to easing the impending osteoarthritis disability burden.
Osteoarthritis is already responsible for enormous disability worldwide through causing chronic pain, reduced mobility and poor mental health. It has huge costs to quality of life, employment and society. With osteoarthritis prevalence increasing with age and obesity, its disabling effects will worsen significantly in future decades.
While not curable, a multipronged approach of medical treatment, lifestyle adaptation, pain management and joint surgery can greatly minimize osteoarthritis disability. But preventing obesity and injury will be crucial to containing the vast financial and personal burden of osteoarthritis disability expected in our aging and overweight populations.