Osteoarthritis is a disease that causes the breakdown of the cartilage in joints. It also called degenerative arthritis or degenerative joint disease (DJD). Cartilage is the joint's cushion. It covers the ends of bones and allows free movement. If joint cartilage becomes rough, frays, or wears away, the joint surface loses its smoothness. The rough surfaces grind against each other. As a result, the joint becomes irritated, inflamed, and swollen. Sometimes the irritation causes abnormal bone growths, called spurs. As the cartilage keeps wearing away, patches of bone get exposed. Advanced osteoarthritis often is called “bone-on-bone†arthritis.
The disease most often affects the feet, knees, hips, and fingers. The shoulders are affected less often. Osteoarthritis usually affects only one or maybe a few joints at one time.
The exact cause of osteoarthritis is not known, but too much wear on joints is an important factor. Cartilage is a tissue that cannot repair itself very well. Obesity, bad posture, old injuries, and overuse can all cause extra wear on joints.
Age is the strongest risk factor. Over 80% of people over age 75 have osteoarthritis. Osteoarthritis is about twice as common in women over age 50 than in men.
Heredity also appears to play a role. A family history of osteoarthritis can double your risk of having osteoarthritis.
The way you move and use your joints in some sports can increase your risk of having osteoarthritis. Heavy pressure within the joint damages the cartilage surface of the joint, especially if it is often repeated. Moderate running, exercise walking outdoors or on a treadmill, or bicycle riding cause only mild to moderate joint pressures and do not lead to cartilage damage.
The joints start to be affected by early adulthood. Osteoarthritis slowly gets worse as you get older. Although there may be signs of it on X-rays even when you are young, you may not have any symptoms. Symptoms of arthritis are usually first noticed after the age of 60. However, they can happen earlier or later than this.
The symptoms of osteoarthritis include:
Pain in and around a joint is the main symptom of osteoarthritis. The pain of osteoarthritis comes on with activity and persists after you stop the activity. The stiffness of osteoarthritis wears off quickly (usually within 15 to 30 minutes) once you get moving in the morning.
Your healthcare provider will ask about your symptoms, review your medical history, and examine you.
Tests may include:
You may have other types of scans or procedures, such as a CT scan, MRI, ultrasound scan, or arthroscopy, for complications caused by the disease or other injuries. These tests are most useful when your healthcare provider thinks something else, as well as arthritis, is causing your problems. For example, arthroscopy is a way your healthcare provider can look inside your joints. A thin scope can be put into the knee, hip, shoulder, ankle, or elbow. Your provider can see the joint surface with the scope and find areas of roughness or loss of cartilage.
The goal of treatment is to keep the joint working by reducing strain on the joint and by relieving pain, stiffness, and swelling.
Medicine
Medicine can control pain and reduce inflammation.
Most of the time, acetaminophen is the best medicine for pain relief. It has fewer side effects than other pain relievers when used for a long time.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, can help relieve pain and swelling. NSAIDs may be bought with or without a prescription. NSAIDs may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason. Talk with your healthcare provider to learn more about taking NSAIDs.
Shots of anesthetic (numbing medicine), steroid medicine, or extracts of cartilage are other medicines that might be used to treat the arthritis.
Weight loss
If you are overweight, losing weight will help. It helps lower strain on your joints. Studies show that the more weight you can lose, the better your joints will feel. Eating fewer calories and increasing your physical activity can help you lose weight.
Canes, walkers, wheelchairs, and motorized scooters also help take the weight off affected joints and reduce pain.
Other treatments
Rubbing anti-inflammatory or deep-heat creams over a painful joint can give short-term relief. Putting an ice pack on the joint once or twice a day can also help relieve pain. Hot paraffin baths can help symptoms in the hands and feet.
Although the evidence is not conclusive, some people seem to benefit from the natural remedies glucosamine and chondroitin sulfate. Yoga and acupuncture may help reduce pain and stiffness in the joints.
Splints offer protection from overuse of joints. Physical therapy helps relieve pain and muscle spasms. It also helps you keep range of motion. Regular gentle exercise is very important to help you control osteoarthritis.
If you have an injury that may be adding to the arthritic pain, like a torn cartilage in the knee or a strained ligament, the injury should be treated.
Sometimes severely damaged joints may be surgically replaced.
There is no cure for osteoarthritis. It is a lifelong problem that can get worse over time. Avoiding repeated injury to your joints can help, but damaged cartilage cannot repair itself.
No one yet knows how to prevent osteoarthritis, but you can help reduce symptoms by following these guidelines:
Walk a little each day if you can. Be sure to wear comfortable, well-cushioned walking shoes. If you cannot walk easily, you can exercise while sitting down or in a pool. The water in a warm swimming pool can help support your weight while you exercise, and the warmth helps joint movement.
