Osteoarthritis and social inequalities: why are some people more affected than others?

What is osteoarthritis? 

Osteoarthritis is a chronic joint disease characterized by the progressive deterioration of the cartilage covering the ends of the bones. This causes pain, stiffness, and sometimes lower mobility in the affected joints. Osteoarthritis can affect any joint, but it is most commonly seen in the knees, hips, hands, and spine. It affects millions of people worldwide and is one of the leading causes of motor disability in adults. Although osteoarthritis is frequently associated with aging, it can also occur earlier, particularly in people with a history of joint trauma or specific risk factors.

The most common symptoms of osteoarthritis 

The symptoms of osteoarthritis can vary in intensity and develop gradually. Joint pain is the most common symptom and often occurs during movement or after prolonged physical activity. Stiffness is also common, particularly in the morning or after a long period of inactivity. Some patients notice cracking or rubbing sensations in the joint. Over time, osteoarthritis can lead to loss of mobility, joint deformities, and a significant reduction in quality of life, which impacts daily life, work, and leisure activities.

Osteoarthritis causes and risk factors 

Osteoarthritis results from a combination of biological, mechanical, and environmental factors. Age is the main risk factor, but gender also plays a role, with women being more affected after menopause. Joint trauma, bone deformities, and certain inflammatory diseases can also contribute to the onset of osteoarthritis. Lifestyle factors such as excess weight, obesity, and a sedentary lifestyle contribute to joint wear by increasing the mechanical load on the joints. Finally, working conditions and certain occupations involving repetitive movements or lifting heavy objects can also increase the risk.

Osteoarthritis and living conditions: what is the link? 

Osteoarthritis and social inequalities 

Numerous studies show that osteoarthritis does not affect all populations in the same way. Social inequalities play a major role in the prevalence and severity of the disease. People living in poor economic conditions often have a higher risk of osteoarthritis and faster progression of symptoms. These differences can be explained by increased exposure to risk factors related to work, lifestyle, diet or access to healthcare.

The link between income level and access to healthcare 

Standard of living directly influences osteoarthritis management. People with limited income have fewer opportunities to see a specialist regularly, follow appropriate treatments or access rehabilitation equipment. The lack of supplementary insurance or difficulty travelling to specialised medical centres exacerbate these inequalities. This situation can lead to delayed diagnosis and rapid progression of symptoms, thereby increasing the risk of disability.

Osteoarthritis and food: the impact of unhealthy diet 

Diet plays an indirect but significant role in osteoarthritis. A diet low in essential nutrients and high in processed foods and saturated fats can promote inflammation and contribute to weight gain, both of which are aggravating factors for the joints. Low-income populations often have limited access to healthy foods, which can increase the risk of developing osteoarthritis or symptoms worsening.

Osteoarthritis and working conditions: what occupations are at risk? 

Osteoarthritis and physically demanding jobs

Occupations involving repeated physical exertion or joint movements that place a heavy strain on the knees, hips or hands increase the risk of osteoarthritis. Manual labourers, farmers and warehouse workers are particularly vulnerable. Carrying heavy loads, awkward postures and repetitive movements contribute to premature wear and tear of the cartilage and promote the onset of the disease.

Osteoarthritis and lifting heavy objects

Carrying heavy loads is a mechanical factor that aggravates osteoarthritis. Even when the job does not require constant effort, occasional but repeated strain can cause microtrauma to the joints. Over time, this microtrauma accumulates and accelerates degradation of the cartilage, causing pain and limiting mobility.

Osteoarthritis and sedentary lifestyle: what about office jobs? 

Contrary to popular belief, sedentary occupations are not spared. Lack of exercise leads to a decrease in muscle tone, reducing the natural protection of the joints. Osteoarthritis can then develop more easily, particularly in the knees and spine. A balance between activity and rest remains essential for maintaining joint health.

Osteoarthritis: gender- and age-related differences 

Osteoarthritis in men and women: what is the difference? 

Women are generally more affected by osteoarthritis, especially after menopause. Hormonal changes, particularly a decrease in oestrogen, seem to play a role in weakening the cartilage. Men are more affected by osteoarthritis caused by trauma or physically demanding occupations. These differences highlight the importance of tailoring prevention and treatment procedures according to gender.

Osteoarthritis in senior population: is it an age-related disease? 

Osteoarthritis is often perceived as a normal consequence of ageing, and it is true that its prevalence increases with age. In older people, cartilage degradation is often progressive and leads to significant functional limitation. However, viewing osteoarthritis solely as an age-related condition can delay diagnosis and treatment, particularly in younger people.

Osteoarthritis in young people: an underestimated phenomenon 

Osteoarthritis can also affect younger people, particularly those with joint trauma or those who practise intensive sports or have physically demanding jobs. This phenomenon is often underestimated, as the disease is still associated with ageing. Recognising the symptoms of early osteoarthritis is essential in order to limit its effects and adapt working conditions or the type of exercise.

Preventing disease and limiting inequalities among osteoarthritis patient

The importance of exercising 

Regular, appropriate physical activity is essential for preventing osteoarthritis or limiting its progression. Muscle strengthening and joint mobility protect cartilage and improve joint function. Prevention programmes must be accessible to everyone, regardless of their standard of living or type of occupation.

Improving access to healthcare and reducing inequalities 

Rapid access to diagnostic tools, appropriate treatment and rehabilitation is crucial to battling inequalities among osteoarthritis patients. Public health policies must aim at facilitating access to specialists, rehabilitation equipment and preventive care for vulnerable populations.

Towards recognition of osteoarthritis as a public health issue

To limit the impact of inequalities, osteoarthritis must be recognised as a genuine public health issue. This involves raising public awareness, training healthcare professionals and adapting prevention and treatment policies to the social and economic status of patients. A comprehensive approach would reduce disparities and improve patients' quality of life.