Osteoarthritis is the most common form of arthritis. It causes pain, swelling, and reduced motion in your joints. It can occur in any joint, but usually it affects your hands, knees, hips or spine.
Osteoarthritis breaks down the cartilage in your joints. Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage absorbs the shock of movement. When you lose cartilage, your bones rub together. Over time, this rubbing can permanently damage the joint.
RISK FACTORS FOR OSTEOARTHRITIS INCLUDE
- Being overweight
- Getting older
- Injuring a joint
No single test can diagnose osteoarthritis. Most doctors use several methods, including medical history, a physical exam, x-rays, or lab tests.
Treatments include exercise, medicines, and sometimes surgery.
Causes
Cartilage is the firm, rubbery tissue that cushions your bones at the joints. It allows bones to glide over one another. When the cartilage breaks down and wears away, the bones rub together. This often causes the pain, swelling, and stiffness of OA.
As OA worsens, bony spurs or extra bone may form around the joint. The ligaments and muscles around the joint may become weaker and stiffer.
Symptoms
Symptoms of OA often appear in middle age. Almost everyone has some symptoms by age 70.
PAIN AND STIFFNESS IN THE JOINTS ARE THE MOST COMMON SYMPTOMS. THE PAIN IS OFTEN WORSE:
- After exercise
- When you put weight or pressure on the joint
With OA, your joints may become stiffer and harder to move over time. You may notice a rubbing, grating, or crackling sound when you move the joint.
“Morning stiffness” refers to the pain and stiffness you feel when you first wake up in the morning. Stiffness due to OA often lasts for 30 minutes or less. It can last more than 30 minutes if there is inflammation in the joint. It often improves after activity, allowing the joint to “warm up.”
During the day, the pain may get worse when you are active and feel better when you are resting. As OA gets worse, you may have pain even when you are resting. And it may wake you up at night.
Some people might not have symptoms, even though x-rays show the changes of OA.
Diagnosis
A HEALTH CARE PROVIDER WILL EXAMINE YOU AND ASK ABOUT YOUR SYMPTOMS. THE EXAM MAY SHOW:
- Joint movement that causes a crackling (grating) sound, called crepitation
- Joint swelling (bones around the joints may feel larger than normal)
- Limited range of motion
- Tenderness when the joint is pressed
- Normal movement is often painful
Blood tests are not helpful in diagnosing OA.
AN X-RAY WILL LIKELY SHOW:
- Loss of the joint space
- Wearing down of the ends of the bone
- Bone spurs
Treatment
OA cannot be cured. It will most likely get worse over time. However, your OA symptoms can be controlled.
You can have surgery, but other treatments can improve your pain and make your life much better. Although these treatments cannot make the arthritis go away, they can often delay surgery.
MEDICINES
Over-the-counter (OTC) pain relievers can help with OA symptoms. You can buy these medicines without a prescription.
Most doctors recommend acetaminophen (Tylenol) first. DO NOT take more than 3 grams (3,000 mg) a day. If you have liver disease, talk with your doctor before taking acetaminophen.
If your pain continues, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs). Types of NSAIDs include aspirin, ibuprofen, and naproxen.
Supplements that you may use include:
Pills, such as glucosamine and chondroitin sulfate
Capsaicin skin cream to relieve pain
LIFESTYLE CHANGES
Staying active and getting exercise can maintain joint and overall movement. Ask your health care provider to recommend an exercise routine. Water exercises, such as swimming, are helpful.
Other lifestyle tips include:
Applying heat and cold to the joint
Eating healthy foods
Getting enough rest
Losing weight if you are overweight
Protecting your joints from injury
If the pain from OA gets worse, keeping up with activities may become more difficult or painful. Making changes around the home can help take stress off your joints to relieve some of the pain. If your work is causing stress in certain joints, you may need to adjust your work area or change work tasks.
PHYSICAL THERAPY
Physical therapy can help improve muscle strength and the motion of stiff joints as well as your balance. If therapy does not make you feel better after 6 to 8 weeks, then it likely will not work at all.
Massage therapy may provide short-term pain relief. Make sure you work with a licensed massage therapist who is experienced in working on sensitive joints.
BRACES
Splints and braces may help support weakened joints. Some types limit or prevent the joint from moving. Others may shift pressure off of 1 portion of a joint. Use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.
ALTERNATIVE TREATMENTS
Acupuncture is a traditional Chinese treatment. It is thought that when acupuncture needles stimulate certain points on the body, chemicals that block pain are released. Acupuncture may provide short-term pain relief for OA.
S-adenosylmethionine (SAMe, pronounced “Sammy”) is a manmade form of a natural chemical in the body. It may help reduce joint inflammation and pain.
SURGERY
Severe cases of OA might need surgery to replace or repair damaged joints. Options include:
Arthroscopic surgery to trim torn and damaged cartilage
Changing the alignment of a bone to relieve stress on the bone or joint (osteotomy)
Surgical fusion of bones, often in the spine (arthrodesis)
Total or partial replacement of the damaged joint with an artificial joint (knee replacement, hip replacement, shoulder replacement, ankle replacement, elbow replacement)
Recovery
Your movement may become limited over time. Doing everyday activities, such as personal hygiene, household chores, or cooking may become a challenge. Treatment usually improves function.
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