Osteoarthritis is a degenerative joint disease in which the tissues within the joint break down over time. It is the most common type of arthritis and occurs more frequently in older adults.
People with osteoarthritis usually experience joint pain and, after periods of rest or inactivity, stiffness that lasts for a short time. The most commonly affected joints include:
Hands (ends of the fingers and at the base and ends of the thumbs).
Knees.
Hips.
Neck.
Lower back.
Osteoarthritis affects each person differently. For some, the condition is relatively mild and does not interfere with daily activities. For others, it can cause significant pain and disability. Joint damage usually develops gradually over several years, although it may worsen rapidly in some individuals.
Researchers do not know what triggers the breakdown of tissues in the joint. However, as osteoarthritis develops, it can damage all areas of the joint, including:
Cartilage is the tissue that covers the ends where two bones meet to form a joint.
Tendons and ligaments.
Synovium, the lining of the joint.
Bone.
Meniscus in the knee.
As the damage to soft tissues in the joint progresses, pain, swelling, and loss of joint motion may develop. If you experience joint pain, you may become less active, which can lead to muscle weakness and put more stress on the joint. Over time, the joint may lose its normal shape. Small bone growths, called osteophytes or bone spurs, may develop around the edges of the joint. The shape of the bone may also change. Fragments of bone or cartilage can break off and float inside the joint space, causing further damage. Researchers continue to study the causes of pain in people with osteoarthritis.
Anyone can get osteoarthritis; however, it is more common as people age. Women are more likely than men to have osteoarthritis, especially after age 50. For many women, it develops after menopause.
Younger people can also develop osteoarthritis, usually as a result of:
Joint injury.
Abnormal joint structure.
Genetic defect in joint cartilage.
Symptoms of osteoarthritis often develop gradually and usually start in one or a few joints. Common symptoms include:
Pain with joint use, which may improve with rest. For some people, in the later stages of the disease, the pain may be worse at night. Pain can be localized or widespread.
Joint stiffness, usually lasting less than 30 minutes, occurs in the morning or after a period of rest.
Joint changes that can limit joint movement.
Swelling in and around the joint, especially after a lot of activity or use of that area.
Changes in the joint’s range of motion.
Feeling that the joint is loose or unstable.
Osteoarthritis symptoms can affect joints differently. For example:
Hands. Bony enlargements and shape changes in the finger joints can happen over time.
Knees. When walking or moving, you may hear a grinding or screeching noise. Over time, muscle and ligament weakness can cause the knee to buckle.
Hips. You might feel pain and stiffness in the hip joint or in the groin, inner thigh, or buttocks. Sometimes, the pain from hip arthritis can radiate (spread) to the knees. Over time, you may not be able to move your hip as far as you used to.
Spine. You may feel stiffness and pain in the neck or lower back. As the spine changes, some people develop spinal stenosis, which can lead to additional symptoms.
As symptoms worsen over time, activities that were once easy—such as stepping up, getting on or off the toilet, rising from a chair, gripping a pan, or walking across a parking lot—can become difficult.
Pain and other symptoms of osteoarthritis may lead to fatigue, sleep problems, and feelings of depression.
Cause of Osteoarthritis
Osteoarthritis occurs when the cartilage and other tissues within the joint break down or undergo structural changes. This is not simply due to wear and tear; rather, changes in the tissue can trigger the breakdown, which typically happens gradually over time.
Certain factors may make it more likely for you to develop the disease, including:
Aging.
Being overweight or obese.
History of injury or surgery to a joint.
Overuse from repetitive movements of the joint.
Joints that do not form correctly.
Family history of osteoarthritis.
There is no single test for osteoarthritis. Diagnosing the condition may include the following:
Give your doctor a medical history that includes your symptoms, any other medical conditions you or your close family members have, and any medications you are taking.
Having a physical exam to check your general health, reflexes, and problem joints.
Having images taken of your joint using:
Magnetic resonance imaging (MRI) can show damage to soft tissues in and around the joint. Generally, MRI helps health care providers evaluate a joint that is locking or giving out.
X-rays can show loss of joint space, bone damage, bone remodelling, and bone spurs. Early joint damage does not usually appear on X-rays.
Having blood tests to rule out other causes for symptoms.
Taking joint fluid samples to look for other causes of joint pain, such as infection or gout.
The goals of your treatment for osteoarthritis include:
Reducing pain and other symptoms.
Improving joint function.
Stopping the disease from progressing.
Maintaining a health-related quality of life to help prevent disability.
Treating osteoarthritis usually begins with:
Learning about osteoarthritis. Your doctor may recommend classes that you can attend or online programs you can join.
Exercising can reduce joint pain and stiffness and increase flexibility, muscle strength, and endurance. Remember to start any exercise program slowly and take the time to adjust to the new level of activity. You should speak to your doctor or physical therapist about a safe, well-rounded exercise program, which may include:
Range-of-motion and stretching activities to keep your joints limber.
Strengthening exercises performed with weights or exercise bands to strengthen muscles that support joints affected by arthritis.
Exercises in the water help reduce joint stress during exercise.
Balance and agility exercises to help you maintain daily living skills.
Low-impact activities that give you moderate activity without stressing the joints. These may include walking, cycling, swimming, tai chi, water aerobics, or a low-impact aerobics class.
Managing your weight can help reduce the stress on joints. In addition, if you are overweight or obese, losing weight can help reduce pain, prevent further injury, and improve joint mobility. This can be especially helpful for weight-bearing joints such as your knees or hips.
Using braces or orthotics prescribed by your doctor and fitted by a health care professional may help stabilize a joint affected by osteoarthritis.
Some people may need medications to help manage the symptoms of osteoarthritis, including:
Oral pain relievers.
Oral anti-inflammatory medications are used to treat pain and inflammation.
Topical creams, rubs, or sprays that you apply to the skin over sore joints to relieve pain.
Corticosteroids are strong inflammation-fighting drugs that are usually injected into the joint to relieve pain temporarily. Because they are potent drugs, your doctor will determine how many injections you should receive and how often to achieve the desired benefit.
Hyaluronic acid substitutes (viscosupplements), which are injected into the knee to replace a normal joint component involved in lubrication and nutrition, are sometimes recommended for knee osteoarthritis.
Selective serotonin and norepinephrine reuptake inhibitors that you take orally to help control chronic (long-term) pain.
If other treatments are not helping and if the joint damage is extensive, some people may have surgery. When considering surgery, many factors may determine if it is the right option, including your age, pain intensity, the degree to which arthritis interferes with your lifestyle, level of disability, and occupation. Surgeries may include one or more of the following:
Osteotomy: Surgical removal of a piece of bone.
Partial or total joint replacement surgery: Removal of part of or all of the damaged joint and replacement with a new joint made of plastic, metal, or ceramic.
Other therapies, such as massage, can increase blood flow and bring warmth to the area. Some research shows that acupuncture may help relieve osteoarthritis pain. Doctors believe that the needles stimulate the release of natural, pain-relieving chemicals produced by the nervous system. Before using other therapies, talk to your doctor about the best options for your treatment.
Treating osteoarthritis requires a team effort involving you and several types of health care professionals. These may include:
Rheumatologists specialize in arthritis and other diseases of the bones, joints, and muscles.
Primary care doctors, such as family physicians or internal medicine specialists, coordinate care among different health providers and treat other problems as they arise.
Orthopedic surgeons specialize in treatment and surgery for bone and joint diseases.
Physical therapists help improve joint function.
Occupational therapists teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
Dietitians teach about nutrition and healthy weight maintenance.
Nurse educators, who help you understand your condition and help start treatment plans.
Physiatrists (physical medicine and rehabilitation specialists) supervise exercise programs.
Psychologists or social workers who help with psychosocial challenges caused by medical conditions.
Chiropractors focus treatment on the relationship between the body’s structure, mainly the spine, and its functioning.
There are many things you can do to help you live with osteoarthritis, including:
Heat and cold therapies can reduce joint pain. Heat therapy increases blood flow, pain tolerance, and flexibility. Cold therapy numbs the nerves around the joint to reduce pain and may relieve inflammation.
Support or assistive devices, such as a cane or walker, can help you move around safely, provide stability, and lower pain. If you have arthritis in your hands, you may find it helpful to use grip aids, such as jar openers.
Try to avoid repetitive motions, such as frequent bending.
Shoe inserts or braces can support your joint and reduce pain and pressure in the area. This can be helpful when you stand or walk.
Make appointments to see your health care provider. This allows you to participate in your treatment and talk about your symptoms. Some people find it helpful to join a class that provides information on osteoarthritis and how to manage its symptoms, allowing them to live an active lifestyle.
Support groups, both online and in your community, can help you cope and offer tips on how to manage having the disease and live a healthy lifestyle emotionally.
Source:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Osteoarthritis.
https://www.niams.nih.gov/health-topics/osteoarthritis
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This information is for educational purposes only and should not replace professional medical advice. Always consult with your healthcare provider for diagnosis and treatment recommendations specific to your condition.
