Osteoarthritis (OA), sometimes called degenerative arthritis or "wear and tear" arthritis, is the most common type of arthritis. OA is a degenerative joint disease.
One in two adults will develop OA in their knees, and one in four will develop symptoms of hip OA by age 85.
It can damage any joint in the body, but it most commonly affects joints in the hands, feet, spine, knees and hips.
Causes of osteoarthritis
Osteoarthritis is associated with aging, but the exact cause is unclear. OA results when the protective cartilage on the ends of your bones wear down over time. This leaves bone rubbing against bone, causing inflammation.
The inflammation causes swelling and pain, and eventually distorts the originally smooth surface of the joints. Bits of bone or cartilage can break off and float inside the joint space. This causes pain and interferes with the joint movement.
As OA progresses, you will experience loss of cartilage, bone spurs around the affected joint and muscle weakness of the extremity.
Your chances of developing OA are higher if you have any of these risk factors:
- Age. Your risk of developing OA increases as you get older.
- Sex. Women are at higher risk for getting OA.
- Deformities. Malformed joints or defective cartilage can increase the risk of OA.
- Injuries. Accidents and sports injuries may increase your risk.
- Excess weight. Being overweight places more stress on weight-bearing joints, particularly your knees.
The symptoms of OA often begin gradually, then worsen over time.
Signs of a problem include:
- Joint pain, especially after overuse or long periods of inactivity, such as sitting for a long time
- Creaking or grating sounds in the joint
- Swelling, stiffness, limited movement of the joint, especially in the morning
- Weakness in muscles around the sore joint
- Deformity of the joint
You should see your doctor when you have joint pain or stiffness that lasts more than a few weeks.
To diagnose OA, your physician will perform a physical exam, checking the affected joints for tenderness, redness or swelling. You will also be asked about the history of your pain.
Your physician may also order imaging and lab tests to further aid in making a diagnosis.
Tests may include:
- X-ray, which can show bone spurs around a joint and cartilage loss between the bone and the joint
- Blood tests, which can help rule out other causes of joint pain, such as rheumatoid arthritis
- Arthrocentesis, a procedure that involves withdrawing fluid from a joint for testing to identify the cause of joint pain
There is no known cure for OA. The goal of treatment is to reduce joint pain, lessen inflammation and improve joint function.
Treatments may include a combination of:
- Over-the-counter pain medicine, such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve), have been shown to be effective for mild to moderate pain.
- Topical pain medicines, such as creams containing capsaicin.
- Viscosupplementation, which is an injection of hyaluronan into the joint, which helps lubricate the joint.
- Corticosteroid injections can further help alleviate pain.
Wearing shoes with good shock-absorbing soles can give relief during daily activities or exercise.
Advanced OA in the lower body can be relieved by canes, walkers, crutches and orthopedic shoes.
Carrying excess weight results in additional stress on the joints. Losing just five pounds can reduce the weight impact on your joints by at least 15 pounds. The more you lose, the more you and your joints will benefit.
Exercise and physical therapy
Strengthening the muscles around the arthritic joint - especially the knee, lower back and neck - can reduce pain and absorb energy around the joint.
For example, if you have arthritis in the knee, a combination of non-weight bearing exercises such as cycling or swimming, and strength training can help your knee function.
If arthritis pain is limiting your mobility, your physician may recommend assistive devices to help you and prevent accidents.
Recommendations might include having handrails and grips installed in the shower, or elevated toilet seats for easier rising after sitting.
Heat and ice
Heat can keep joints and muscles moving easily, as well as reduce pain.
Using ice after activity can help with pain and reduce any swelling.
Corticosteroid injections to the inflamed joint may be given if other pain medicines do not work. Because repeated cortisone injections can be harmful to the cartilage, they are reserved for those with severe symptoms.
If conservative treatments don't alleviate the pain and discomfort, surgery may be an option. There are two types of surgical procedures:
- Osteotomy. This procedure repositions the bones to redistribute stress on the joint.
- Joint replacement. In total or partial joint replacement, the damaged joint surfaces are replaced with plastic and metal devices (called prostheses).
The less stress you place on your joints, the less likely they are to wear out prematurely.
To reduce your chance of getting osteoarthritis:
- Maintain a healthy weight
- Do regular, gentle exercise (for example, walking, stretching, swimming or yoga)
- Avoid repetitive motions and risky activities that may contribute to joint injury, especially after age 40
- Maintain good posture to keep excessive pressure off your joints
- Wear protective equipment, such as wrist pads and helmets, to protect your joints
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