Osteoarthritis, sometimes called degenerative joint disease or osteoarthrosis, is the most common form of arthritis. Osteoarthritis occurs when cartilage in your joints wears down over time. Osteoarthritis can affect any joint in your body, though it most commonly affects joints in the hands, hips, knees and spine. Osteoarthritis typically affects just one joint, though in some cases, such as with finger arthritis, several joints can be affected.
Osteoarthritis occurs when the cartilage that cushions the ends of bones in the joints deteriorates over time. The smooth surface of the cartilage becomes rough, causing irritation. Eventually, if the cartilage wears down completely, what remains is bone rubbing on bone causing the ends of your bones to become damaged and the joints to become painful.
It isn't clear what causes osteoarthritis in most cases. Researchers suspect that it's a combination of factors, including being overweight, the aging process, joint injury or stress, heredity, and muscle weakness.
Signs and Symptoms
Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:
- Pain in a joint during or after use, or after a period of inactivity
- Tenderness in the joint when you apply light pressure
- Stiffness in a joint, that may be most noticeable when you wake up in the morning or after a period of inactivity
- Loss of flexibility may make it difficult to use the joint
- Grating sensation when you use the joint
- Bone spurs, which appear as hard lumps, may form around the affected joint
- Swelling in some cases
Osteoarthritis symptoms most commonly affect the hands, hips, knees and spine.
One of the most beneficial ways to manage OA is to get moving. While it may be hard to think of exercise when the joints hurt, moving is considered an important part of the treatment plan. Studies show that simple activities like walking around the neighborhood or taking a fun, easy exercise class can reduce pain and help maintain (or attain) a healthy weight.
Strengthening exercises build muscles around OA-affected joints, easing the burden on those joints and reducing pain. Range-of-motion exercise helps maintain and improve joint flexibility and reduce stiffness. Aerobic exercise helps to improve stamina and energy levels and also help to reduce excess weight. Talk to a doctor before starting an exercise program.
The U.S. Department of Health and Human Services recommends that everyone, including those with arthritis, get 150 minutes of moderate exercise per week.
Excess weight adds additional stress to weight-bearing joints, such as the hips, knees, feet and back. Losing weight can help people with OA reduce pain and limit further joint damage. The basic rule for losing weight is to eat fewer calories and increase physical activity.
Slow, gentle stretching of joints may improve flexibility, lessen stiffness and reduce pain. Exercises such as yoga and tai chi are great ways to manage stiffness.
Pain and Anti-inflammatory Medications
Medicines for osteoarthritis are available as pills, syrups, creams or lotions, or they are injected into a joint. They include:
Analgesics. These are pain relievers and include acetaminophen, opioids (narcotics) and an atypical opioid called tramadol. They are available over-the-counter or by prescription.
Nonsteroidal anti-inflammatory drugs (NSAIDs). These are the most commonly used drugs to ease inflammation and related pain. NSAIDs include aspirin, ibuprofen, naproxen and celecoxib. They are available over-the-counter or by prescription.
- Corticosteroids. Corticosteroids are powerful anti-inflammatory medicines. They are taken by mouth or injected directly into a joint at a doctor’s office.
- Hyaluronic acid. Hyaluronic acid occurs naturally in joint fluid, acting as a shock absorber and lubricant. However, the acid appears to break down in people with osteoarthritis. The injections are done in a doctor’s office.
Physical and Occupational Therapy
Physical and occupational therapists can provide a range of treatment options for pain management including:
- Ways to properly use joints
- Heat and cold therapies
- Range of motion and flexibility exercises
- Assistive devices
Assistive devices can help with function and mobility. These include items, such as like scooters, canes, walkers, splints, shoe orthotics or helpful tools, such as jar openers, long-handled shoe horns or steering wheel grips. Many devices can be found at pharmacies and medical supply stores. But some items, such as custom knee braces and shoe wedges are prescribed by a doctor and are typically fitted by a physical or occupational therapist.
Natural and Alternative Therapies
Many people with OA use natural or alternative therapies to address symptoms and improve their overall well-being. These include nutritional supplements, acupuncture or acupressure, massage, relaxation techniques and hydrotherapy, among others.
Surgery is generally reserved for severe osteoarthritis that isn't relieved by other treatments. You may consider surgery if your osteoarthritis makes it very difficult to go about your daily tasks. Surgical treatments include:
- Joint replacement. In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surfaces and replaces them with plastic and metal devices called prostheses. The hip and knee joints are the most commonly replaced joints. But today implants can replace your shoulder, elbow, finger or ankle joints. How long your new joint will last depends on how you use it. Some knee and hip joints can last 20 years. Joint replacement surgery can help you resume an active, pain-free lifestyle. In smaller hand joints, it can also improve appearance and comfort and may improve your joint's mobility. Joint replacement surgery carries a small risk of infection and bleeding. Artificial joints can wear or come loose, and may need to eventually be replaced.
- Cleaning up the area around the joint (debridement). Your surgeon may recommend removing loose pieces of cartilage and bone from around your joint to relieve your pain. Debridement is most useful if you're experiencing a locking sensation from a torn cartilage or loose debris in your knee joint. Debridement is typically done arthroscopically, meaning only small incisions are made in your body. A tiny video camera is inserted through the incision to allow your surgeon to see inside your joint. The surgeon uses special surgical tools to clean out any debris pieces from your joint.
- Realigning bones. Surgery to realign bones may relieve pain. These types of procedures are typically used when joint replacement surgery isn't an option, such as in younger people with osteoarthritis. During a procedure called an osteotomy, the surgeon cuts across the bone either above or below the knee to realign the leg. Osteotomy can reduce knee pain by transferring the force of the joint away from the worn-out part of the knee.
- Fusing bones. Surgeons also can permanently fuse bones in a joint (arthrodesis) to increase stability and reduce pain. The fused joint, such as an ankle, can then bear weight without pain, but has no flexibility. Arthrodesis may be an option if you experience severe pain in your joint, but can't undergo joint replacement
Many studies have demonstrated that a positive outlook can boost the immune system and increase a person's ability to handle pain.