Important information about Arthritis

Image of destroyed hip joint due to arthritis

There are more than 100 known types of arthritis. Arthritis as such is not a disease but a symptom. It basically means inflamed joint. It can affect everyone, at any age, any gender and any race. It is the leading cause of disability and affects 1 in 5 adults over the age of 18, rising to 1 in 2 over the age of 65. Women are statistically more often affected than men.

What is Arthritis?

The most common form of arthritis is osteoarthritis, a degenerative disease. Every joint surface is covered with a layer of cartilage, a rubber like material that works like a shock ‘absorber’. As cartilage has no blood supply, it cannot grow and does not have any healing potential. This means that any damage done cannot be repaired and will be added to. Over the years the cartilage starts to ‘dry’ out, gets brittle and eventually wares away. This process, the natural degeneration of cartilage, is usually very slow, but certain risk factors such as significant obesity, a family history of arthritis, advanced age, impact sports and previous injuries can speed up the process. Other diseases like diabetes and external factors like smoking or drug abuse are known to accelerate joint degeneration as well. Reduced mobility causing point loading (professional drivers) and excessive overload (roof tilers) also add to faster wear and tear of the joint.

Unfortunately there are no nerve endings inside a joint, so the early stages of arthritis cannot be felt. Hence any minor damages to the joint surface will remain unnoticed. Radiographic images can sometimes show suspicious signs at this stage. In the later stage, when most of the cartilage is worn of and bone ‘scratches’ on bone, the joint will get inflamed, resulting in swelling, warmth and pain. This is the stage when the patient usually seeks medical advice.

A thorough physical exam by consultant orthopedic surgeon Dr. Alf Neuhaus, and radiographic images of both sides for comparison (knees in standing position), will reveal the stage of the arthritis. Based on this, orthopaedic surgeon Dr. Alf Neuhaus will discuss the available treatment options with you and, if applicable, initiate them immediately.

Treatment Options

Keeping a healthy diet and weight as well as an adequate balance between exercises and rests is indispensable at any stage of arthritis. Our UK trained physiotherapist would advise on appropriate exercises to keep the affected joint(s) going without overloading them. Massage therapist can reduce the swelling by applying lymph drainage. Gentle sport activities like using an exercise bike, swimming, yoga or Tai Chi can be performed even at a more advanced age. Excessive running (tennis, squash, etc.) should be avoided. Anti-inflammatory medication, as tablet and/ or as creams applied locally, can help to reduce the inflammation and swelling. Painkillers might be needed if the pain effects you even at rest or at night, but caution has to be applied as they mask the symptoms and might give you the false impression of improvement.

Experienced orthopedic surgeon Dr. Alf Neuhaus can also inject the joint with cortisone, which has an almost immediate effect on the inflammation and therefore the pain. Should the joint still be in the early or moderate stage of arthritis, orthopaedic surgeon Dr. Alf Neuhaus might then inject it with Hyaluronic acid, which works as a powerful lubricant. In case of being the hip joint, these injections are done under X-ray control, using the digital X-ray facility available in Clinica SANDALF. In the later stages, when the cartilage cushion is practically gone and you are walking ‘bone on bone’, the joint might have to be replaced or, depending on the type of joint, fused. Orthopaedic surgeon Dr. Alf Neuhaus would perform this surgery in a nearby private hospital, and he and his team would look after you the whole time of your in- patient stay.


Prevention is the best option. Avoiding repetitive movements especially under additional weight load, avoiding point loading and looking after weight and diet is essential. Orthopaedic surgeon Dr. Alf Neuhaus always advises to try to stay physically reasonable fit and adjust sports activities to the needs of your joints and not to the desire of your competitive mind. Adding food supplements like Glucosamine and Chondroitin, both available at Clinica SANDALF, could slow down the natural process of joint degeneration. Following these guide lines could help your joints going by reducing the effect of arthritis, possibly even that much that you might never have to go down the road of artificial joint replacement.

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