It is when you are young that you should think of osteoarthritis

An unstable gait doesn’t help one’s confidence,” says 80-year-old Kusuma Nayak, whose social commitments suffered because of osteoarthritis. “What kept me going was that I never allowed myself to wallow in self-pity.”

It started with stiffness in the knees. “I lived with the pain for a while and started complaining only when it became unbearable,” she says. She was 62 when she consulted an orthopaedic who advised her to exercise in moderation.

As a state-level badminton player in school and an avid traveller, Nayak didn’t think she’d end up with osteoarthritis, especially because no one else in the family suffered from it. “Thinking back, the injuries I sustained as a child while playing could have contributed to it.”

Following a strict regimen of exercise and medication, Nayak managed the disease as best she could. For a while, that helped, but osteoarthritis is a degenerative disease. “My condition worsened. It became so bad that I could not stand for even 5 minutes.”

She was on a cruise to Alaska when she realised she couldn’t ‘manage’ the disease any more. Medication had no effect either. “The pain played spoil-sport. I had to be put in a wheel-chair – something I’d been avoiding.”

When she returned from her trip, her doctor suggested surgery. “I looked at the surgery as carpentry work,” she says. “I haven’t had any pain after the post-op pain.”

She was 71 when she opted for surgery on both knees simultaneously. “That was the second-best decision I ever made,” she says, smiling. “The first was marrying my husband.”

Today, her day starts with 40 minutes of brisk walking, tending her garden and managing the house. “I also regularly do the exercises I learnt at my physiotherapy class,” she says.

Osteoarthritis is the most common joint disorder caused by the wear and tear of the joints, says Dr Sanjay Pai, consultant orthopaedic surgeon at Fortis Hospitals, Bangalore. “It is degenerative and cannot be prevented, only delayed.”

Bones are supported by cartilage (connective tissues) and muscles. Osteoarthritis causes the cartilage to decline and muscles to weaken. This causes excessive pain in the joints, usually affecting the hands, feet, spine, hips and knees as these bear the weight of the entire body.

Although osteoarthritis is related to aging, the cause is often unknown. Women are two to three times more likely to get it than men. Some orthopaedics believe this may be because of a woman’s body structure — their bodies are designed to give birth and they have more flexibility in their lower limbs than men. Moreover, post-menopause hormonal changes also affect the cartilage.

The best way to enhance the quality of life for patients is to relieve pain, avoid being overweight, and strengthen the muscles with light exercise and day-to-day activities.

Daily exercise is also the single most important way to delay the onset of osteoarthritis. “This is something we do not consider when young. The body needs to be flexible and strong, and even daily chores in the house can help,” says Nayak.