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The most common type of arthritis, affecting millions of people worldwide, is osteoarthritis. It happens when the protective cartilage that cushions the ends of the bones deteriorates over time.
Although osteoarthritis can affect any joint, it most commonly affects the hands, knees, hips, and spine.
The symptoms of osteoarthritis can usually be managed, but the joint damage cannot be reversed. Staying active, maintaining a healthy weight, and receiving certain treatments may help slow disease progression and improve pain and joint function.
WHAT ARE THE SYMPTOMS OF OSTEOARTHRITIS?
Osteoarthritis symptoms frequently appear gradually and worsen over time. Among the signs and symptoms of osteoarthritis are:
- Pain: Affected joints may experience pain during or after movement.
- Stiffness: Joint stiffness may be most noticeable upon waking up or after a period of inactivity.
- Tenderness: When you apply light pressure to or near your joint, it may feel tender.
- Loss of flexibility: You may be unable to move your joint through its entire range of motion.
- Grating sensation: When you use the joint, you may experience a grating sensation and hear popping or crackling.
- Spurs on the bones: Extra bone, which feels like hard lumps, can form around the affected joint.
- Swelling: This could be the result of soft tissue inflammation around the joint.
WHAT ARE THE CAUSES OF OSTEOARTHRITIS?
Osteoarthritis develops when the cartilage that cushions the ends of your bones in your joints deteriorates over time. Cartilage is a tough, slick tissue that allows for nearly frictionless joint motion.
If the cartilage completely wears away, bone will rub against bone.
Osteoarthritis is frequently referred to as a wear and tear condition. However, osteoarthritis affects the entire joint, not just the cartilage. It alters the bone and deteriorates the connective tissues that hold the joint together and connect muscle to bone. It also causes joint lining inflammation.
WHAT ARE THE RISK FACTORS OF OSTEOARTHRITIS?
The following factors can increase your risk of osteoarthritis:
- Older age: The likelihood of developing osteoarthritis rises with age.
- Sex: Women are more likely than men to develop osteoarthritis, though the reason for this is unknown.
- Obesity: Carrying extra body weight contributes to osteoarthritis in several ways, and the more you weigh, the more likely you are to develop it. Weight gain puts strain on weight-bearing joints like your hips and knees. Furthermore, fat tissue generates proteins that can cause harmful inflammation in and around your joints.
- Joint injuries: Injuries, such as those sustained while participating in sports or as a result of an accident, can increase the risk of osteoarthritis. Even injuries from many years ago that appear to have healed can increase your risk of osteoarthritis.
- Stress on the joint on a regular basis: If your job or a sport causes repetitive stress on a joint, that joint may develop osteoarthritis.
- Genetics: Some people are predisposed to osteoarthritis.
- Deformities of the bones: Some people are born with faulty joints or cartilage.
- Certain metabolic diseases: Diabetes and a condition in which your body has an excess of iron are examples of these (hemochromatosis).
WHAT IS THE DIAGNOSIS OF OSTEOARTHRITIS?
During the physical exam, your doctor will look for tenderness, swelling, redness, and flexibility in the affected joint.
Imaging tests
Your doctor may advise you to take photographs of the affected joint.
- X-rays: Cartilage does not appear on X-ray images, but it is revealed by a narrowing of the space between the bones in your joint. An X-ray can also reveal bone spurs near a joint.
- Magnetic resonance imaging (MRI): An MRI creates detailed images of bone and soft tissues, including cartilage, by using radio waves and a strong magnetic field. An MRI is not usually required to diagnose osteoarthritis, but it can provide additional information in complex cases.
- Lab tests: Analyzing your blood or joint fluid can aid in the confirmation of the diagnosis.
- Blood tests: Although no blood test exists to diagnose osteoarthritis, certain tests can help rule out other causes of joint pain, such as rheumatoid arthritis.
- Analysis of joint fluids: A needle may be used by your doctor to draw fluid from an affected joint. The fluid is then tested for inflammation and to see if your pain is the result of gout or an infection rather than osteoarthritis.
WHAT ARE THE TREATMENTS FOR OSTEOARTHRITIS?
Osteoarthritis cannot be reversed, but treatments can alleviate pain and improve mobility.
Medications
Among the medications that can help relieve osteoarthritis symptoms, particularly pain, are:
Acetaminophen: Acetaminophen (Tylenol, among others) has been shown to help some people with mild to moderate osteoarthritis pain. Taking more acetaminophen than recommended can cause liver damage.
- NSAIDs (nonsteroidal anti-inflammatory drugs): When taken at the recommended doses, over-the-counter NSAIDs such as ibuprofen (Advil, Motrin IB, and others) and naproxen sodium (Aleve) typically relieve osteoarthritis pain. Prescription-only NSAIDs are available.
NSAIDs have been linked to stomach upset, cardiovascular issues, bleeding issues, and liver and kidney damage. NSAID gels, which are applied to the skin over the affected joint, have fewer side effects and may relieve pain just as effectively.
- Duloxetine (Cymbalta): This medication, which is typically used as an antidepressant, is also approved to treat chronic pain, including osteoarthritis pain.
Therapy
- Physical therapy: A physical therapist can demonstrate exercises that will help you strengthen the muscles around your joint, increase your flexibility, and reduce your pain. Regular gentle exercise on your own, such as swimming or walking, can be just as beneficial.
- Occupational therapy: An occupational therapist can assist you in determining how to perform daily tasks without putting additional strain on your already painful joint. For example, if you have osteoarthritis in your hands, a toothbrush with a large grip may make brushing your teeth easier. If you have knee osteoarthritis, a bench in your shower could help alleviate the pain of standing.
- Transcutaneous electrical nerve stimulation (TENS): This method of pain relief employs a low-voltage electrical current. Some people with knee and hip osteoarthritis benefit from it in the short term.
Surgical and other procedures
If conservative treatments are ineffective, you may want to consider procedures such as:
- Cortisone injections: Corticosteroid injections into your joint may relieve pain for a few weeks. Your doctor numbs the area around your joint before inserting a needle into the joint space and injecting medication. Cortisone injections are generally limited to three or four per year because the medication can worsen joint damage over time.
- Lubrication injections: Hyaluronic acid injections may relieve pain by providing some cushioning in your knee, but some research suggests that these injections provide no more relief than a placebo. Hyaluronic acid is a component similar to that found in joint fluid.
- Realigning bones: If osteoarthritis has caused more damage to one side of your knee than the other, an osteotomy may be beneficial. A surgeon performs a knee osteotomy by cutting across the bone above or below the knee and then removing or adding a wedge of bone. This moves your weight away from the worn-out part of your knee.
- Joint replacement: Your surgeon will remove your damaged joint surfaces and replace them with plastic and metal parts during joint replacement surgery. Infections and blood clots are two surgical risks. Artificial joints can wear out or become loose over time, necessitating replacement.
CONCLUSION
Osteoarthritis is a chronic condition with no known cure. However, with treatment, the outlook is bright.
Don't dismiss the signs of chronic joint pain and stiffness. The sooner you see a doctor, the sooner you can get a diagnosis, start treatment, and improve your quality of life.