What is osteoarthritis?
Osteoarthritis affects over 32.5 million adults in the United States. It is the most common form of arthritis as well as the most common and chronic joint condition. It occurs when the protective cartilage cushions at the end of your bones wear down over time. This most commonly affects joints in your hands, fingertips, knees, hips, and spine. Osteoarthritis is also known as wear-and-tear arthritis, degenerative joint disease, and degenerative arthritis.
Cartilage is a firm but slippery tissue that allows nearly frictionless movement of joints. If this cartilage wears down completely, bone will rub against bone instead, causing pain as the bone surfaces become pitted and rough. The damaged cartilage cannot repair itself because cartilage has no blood vessels.
Osteoarthritis affects not only the cartilage, but the entire joint, causing changes in the bone as well as deterioration of the joint’s connective tissues. It also causes inflammation of the joint lining.
While damage to the joints can’t be reversed, the pain can be managed. Some ways to help combat the condition include staying a healthy weight, staying active, and various treatments to improve pain and joint function.
What are the signs and symptoms of osteoarthritis?
Osteoarthritis symptoms usually start slowly and get worse over time. These symptoms include:
- Increased pain
- Stiffness, especially after awakening or after activity
- Loss of flexibility and decreased range of motion
- Grating sensation
- Bone spurs
- Swelling and inflammation
There are four stages of osteoarthritis: minor, mild, moderate and severe.
In the minor stage, there is some small amount of wear-and-tear in the joints, there is typically little or no pain in the affected area.
In the mild stage, X-Rays show bone spur growths, which can happen when bones meet each other in the joint. The area becomes stiff and uncomfortable after long sedentary periods.
In moderate osteoarthritis, cartilage starts to erode and narrow the gap between joint and bone. The inflamed joint causes discomfort during daily activity.
Lastly, in severe osteoarthritis the cartilage is almost completely gone in the joint, causing an inflammatory response. The bone spurs have often multiplied, causing excruciating pain.
How is osteoarthritis diagnosed?
First, your doctor will provide a physical exam where he or she checks your affected joint for tenderness, swelling, redness and flexibility.
Your doctor may order imaging tests to get a picture of the joint, including X-rays or an MRI (magnetic resonance imaging).
Analyzing your blood or joint fluid can help confirm the diagnosis, so your healthcare provider may order blood test or joint fluid tests.
How is osteoarthritis treated?
While osteoarthritis can’t be reversed, there are treatments that can help reduce pain and help with mobility.
Medications that can help treat osteoarthritis and the pain associated with the condition include:
- Acetaminophen. Acetaminophen—such as Tylenol—has been shown to help some people with osteoarthritis who have mild to moderate pain.
- NSAIDs. Nonsteroidal anti-inflammatory drugs, or NSAIDs, can also relieve osteoarthritis pain. Examples include Advil, Motrin IB, and Aleve.
- Duloxetine (Cymbalta). Normally used as an antidepressant, Duloxetine is also approved to help treat chronic pain.
There are three types of therapy that can help those living with osteoarthritis.
- Physical therapy. Physical therapy can help you with exercises to strengthen the muscles around your joint, increase your flexibility and reduce pain. If you’re not able to see a physical therapist, gentle exercises like swimming or walking can help as well.
- Occupational therapy. An occupational therapist can help you resume everyday activities. For example, occupational therapy is useful if you have osteoarthritis in your hands and are having trouble brushing your teeth. Your therapist may suggest you use a toothbrush with a larger grip.
- Transcutaneous electrical nerve stimulation (TENS). TENS uses a low-voltage electrical current to relieve pain, and it can provide short-term relief for some people with knee and hip osteoarthritis.
If other types of treatments don’t help, your healthcare provider might suggest surgery.
- Cortisone injections. These injections are made directly into your joint, and might relieve pain for a few weeks. However, the number of cortisone injections you can receive each year is generally limited to three or four, because the medication can worsen joint damage over time.
- Lubrication injections. Lubrication injections consist of hyaluronic acid. These injections provide relief because the hyaluronic acid can provide some cushioning in your knee.
- Realigning bones. During this type of surgery, your healthcare provider performs what is known as an osteotomy—a procedure in which a surgeon removes, or sometimes adds, a wedge of bone near a damaged joint. This shifts your body weight away from the worn-out part of your knee.
- Joint replacement. During joint replacement surgery, a surgeon will remove part of your damaged joint and replace it with plastic and metal parts.
Lifestyle changes and home remedies can also make a major impact on your quality of life while living with osteoarthritis. These changes include:
- Losing weight
- Low-impact exercise, such as swimming
- Movement therapies, such as tai chi or yoga
- Heat and cold therapies, to relieve the pain and swelling in the joint
- Capsaicin, a chili pepper extract applied over an arthritic joint that provides relief for some people
- Braces or shoe inserts that support your foot and help take some pressure off the affected joint
- Assistive devices such as a cane
While osteoarthritis may cause chronic pain, it’s by no means an unmanageable condition. Make sure you speak to your doctor if you worry that you are exhibiting the signs and symptoms of this condition and discuss your treatment plans with a medical professional.
- Osteoarthritis (OA) | Arthritis. (n.d.). Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/basics/osteoarthritis.htm
- Konstantakos, E., MD. (n.d.). What Is Cartilage? Arthritis Health. https://www.arthritis-health.com/types/joint-anatomy/what-cartilage.
- Woodard, J. C., Becker, H. N., & Poulos, P. W., Jr (1987). Articular cartilage blood vessels in swine osteochondrosis. Veterinary pathology, 24(2), 118–123. https://doi.org/10.1177/030098588702400203.
- Knee osteotomy. (2020, July 30). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/knee-osteotomy/about/pac-20394514.