Osteoarthritis is the most common joint disorder. It is due to aging and wear and tear on a joint.
When cartilage breaks down and wears away, bones rub together. This often causes the pain, swelling, and stiffness of osteoarthritis. As the condition worsens, bony spurs or extra bone may form around the joint. The ligaments and muscles around the joint may become weaker and stiffer.
Before age 55, osteoarthritis occurs equally in men and women. After age 55, it is more common in women.
Other factors can also lead to osteoarthritis, including:
- Osteoarthritis tends to run in families.
- Being overweight increases the risk for osteoarthritis in the hip, knee, ankle, and foot joints. This is because extra weight causes more wear and tear.
- Fractures or other joint injuries can lead to osteoarthritis later in life. This includes injuries to the cartilage and ligaments in your joints.
- Jobs that involve kneeling or squatting for more than an hour a day, or involve lifting, climbing stairs, or walking increase the risk for osteoarthritis.
- Playing sports that involve direct impact on the joint (football), twisting (basketball or soccer), or throwing also increase the risk for osteoarthritis.
Medical conditions that can lead to osteoarthritis include:
- Bleeding disorders that cause bleeding in the joint, such as hemophilia
- Disorders that block the blood supply near a joint and lead to bone death (avascular necrosis)
- Other types of arthritis, such as chronic gout, pseudogout, or rheumatoid arthritis
Osteoarthritis Symptoms
Symptoms of osteoarthritis 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 osteoarthritis, 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 osteoarthritis 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 osteoarthritis gets worse, you may have pain even when you are resting.
Osteoarthritis 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 osteoarthritis.
An x-ray will likely show:
- Loss of the joint space
- Wearing down of the ends of the bone
- Bone spurs
Osteoarthritis Treatment
Osteoarthritis cannot be cured. It will most likely get worse over time. However, symptoms can be controlled.
Surgery is an option, but other treatments can improve the pain. Although these treatments cannot make the arthritis go away, they can often delay surgery.
Medicines
Over-the-counter pain relievers can help with osteroarthritis symptoms. You can buy these medicines without a prescription.
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 osteoarthritis 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.
Surgery
Severe cases of osteoarthritis 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)