What is osteoarthritis?

Osteoarthritis is a degenerative joint disease that primarily affects the joints of the spine, hips and knees. It is caused by the breakdown of cartilage, which acts as a cushion between bones where two or more bones meet.

Osteoarthritis can be highly debilitating and can affect people in many different ways. Some people may have no symptoms at all, while others may experience pain, stiffness and swelling in their joints. The symptoms tend to get worse over time and can be especially painful during cold weather or after physical activity. Many people with osteoarthritis also experience loss of movement in their joints as they get older, which can make it difficult to perform day-to-day tasks involving movement such as walking, climbing stairs and getting out of chairs.

The condition develops slowly over time due to wear-and-tear on the joints caused by everyday activities such as standing up after sitting for long periods of time or bending over repeatedly when picking up heavy objects such as groceries from the ground floor of a supermarket.

What causes osteoarthritis?

The exact cause of osteoarthritis isn’t known. But there are many theories about what might trigger it or make it worse.

Some factors that may contribute to osteoarthritis include:

Age – Most people with osteoarthritis are over 50 years old, but younger people can also get it. It’s more common as you get older, but it can happen at any age.

Genetics – Your genes may play a role in your risk of developing osteoarthritis. If you had surgery on your knee as a child or young adult, you’re more likely to develop arthritis later in life than someone who hasn’t had surgery on their knees at such an early age.

Obesity – Being overweight or obese increases your risk of developing osteoarthritis in weight-bearing joints such as the knees or hips (joints where you put weight on them when walking). You may need to lose some weight if this is contributing to your symptoms of osteoarthritis.

What is the difference between osteoarthritis and rheumatoid arthritis?

The pain and stiffness of osteoarthritis are caused by breakdown of the cartilage that cushions bones at joints. Cartilage is a tough, smooth tissue that protects bones from directly touching each other at joints.

Rheumatoid arthritis occurs when the body’s immune system attacks the synovium, which is the tissue that lines the joints. In rheumatoid arthritis, inflammation can eventually damage the joint cartilage.

Osteoarthritis and rheumatoid arthritis are distinct conditions with different causes and treatments.

In osteoarthritis, inflammation and destruction usually affect only one or a few joints at a time. Osteoarthritis usually affects weight-bearing joints such as knees, hips or fingers. It usually develops over many years and worsens with age.

In rheumatoid arthritis, inflammation can cause swelling throughout the entire joint — even those not affected by osteoarthritis — as well as damage to connective tissue in other parts of the body such as tendons (tissues connecting muscles with bones) and ligaments (tissues connecting bones). Rheumatoid arthritis can affect any joint in your body but often starts in your hands or feet.

Which joints are most commonly affected by arthritis?

Hands. This includes finger joints, but also the knuckles at the base of each finger and thumb. In severe cases, the entire joint can become swollen and stiff.

Knees. Arthritis in the knees is called osteoarthritis and is often caused by wear and tear on the joint over time. The pain is usually worse when you first start moving after being still for a while (for example, after sitting for a long time). It can also be worsened by weather changes and activity that puts more stress on the knee joint than usual (for example, running or weight-bearing exercises).

Ankles. Mild ankle arthritis may cause pain only when you’re walking uphill or downhill or if you’re wearing high heels or wedges. More severe ankle arthritis can cause pain in all directions and make walking difficult.

What are the symptoms of osteoarthritis?

The symptoms vary from person to person. Some people have mild symptoms and others have severe symptoms that stop them from doing everyday activities.

Osteoarthritis can affect any joint in your body, but most commonly affects your hands, fingers, hips and knees.

Some people with osteoarthritis may have no symptoms at all until they try to use their affected joints, after which they may experience:

Joint swelling (bursitis). This causes a dull ache around the joint or in the surrounding soft tissue (bursa). The bursa is a small fluid-filled sac that reduces friction between two bones or cartilage surfaces.

Pain when moving the affected joint – this is usually worse when you first move it and then eases off as you continue to use it for a few minutes.

Limited mobility in your affected joints – this can cause stiffness and pain when you try to move them through their full range of motion (ROM).

Other symptoms can include:

– Decreased range of motion

– Feeling like your hip or knee locks up when you bend or rotate it

– Joint swelling

How is osteoarthritis diagnosed?

The diagnosis of osteoarthritis is made on the basis of the patient’s medical history, physical examination, and X-rays. The physical examination includes tests to evaluate the range of motion and tenderness over the involved joints. Occasionally, other tests such as blood tests or joint fluid analysis may be needed to rule out other causes of joint pain or swelling.

The following tests may be used to rule out other conditions:

X-ray. This is an imaging test that uses small doses of radiation to produce images of internal tissues, bones, and organs onto film or a computer screen. X-rays can show the bones where arthritis has affected them, but they can’t show cartilage damage or changes in soft tissues like tendons and ligaments.

MRI (magnetic resonance imaging). This uses radio waves and strong magnets instead of x-rays to create detailed pictures of soft tissues and internal organs. MRI is often used when something unusual is suspected in the joints, such as infection or tumor (swollen tissue). A dye may be injected into your vein beforehand so that areas inside the joints can be seen more clearly on the images taken during the scan.

What tests are done for osteoarthritis?

The diagnosis of osteoarthritis is based on a physical examination and medical history. In some cases, additional tests may be necessary to confirm the diagnosis and to rule out other conditions that may have similar symptoms.

Blood tests. A blood test can help detect an infection, such as Lyme disease, in people with arthritis who live in areas where the disease is common.

How is osteoarthritis treated?

The treatment of osteoarthritis depends on the severity of symptoms and their cause. The first step is to try to prevent further damage by following a number of steps.

Avoid activities that cause pain or make it worse, such as climbing stairs, kneeling, squatting or prolonged walking.

Do gentle exercises and stretches for your joints, such as swimming and cycling.

Try using pads or supports for your joints if they are painful when you use them.

Use a cane or crutches if your knee pain is severe or you have trouble walking without a limp (if your hip or ankle also hurts).

If you have arthritis in your hands, wear gloves when doing tasks that will put stress on them – for example, gardening or opening jars. Gloves may also help protect against injury from falls that could result from weak hands and fingers.

What are the nonsurgical options for treating osteoarthritis pain?

Weight loss. Losing weight can help relieve the stress on your joints. It can reduce chronic inflammation, and it may also improve your ability to move and exercise.

Physical therapy. Physical therapists can teach you exercises that help maintain flexibility, strength and endurance. They can also direct you toward other treatments that can help manage your symptoms, such as aquatic therapy or yoga.

Pain relievers. Over-the-counter medications (such as ibuprofen) or prescription drugs (such as tramadol) can help relieve pain by reducing inflammation in your joints.

Exercise. Regular exercise increases blood flow to your joints and helps strengthen your muscles around them — both of which make it easier to move around without causing pain. Exercise also helps reduce depression and stress, which can make pain worse.

Heat therapy or cold packs. Applying heat or cold packs to your painful joints may temporarily relieve some of their stiffness and soreness.

When should I consider surgery?

If your symptoms are severe, surgery may be an option. You may be a candidate for surgery if:

• You have persistent pain that isn’t controlled by other treatments.
• Your back pain is causing significant changes in your quality of life.
• You have nerve pain that doesn’t respond to medication or physical therapy.
• Your spine has been damaged by an injury or disease process and needs stabilization to prevent further damage and mobility loss.