Osteoarthritis is the most common kind of arthritis. It can occur in any joint and is a long-term condition that gets worse over time.
“Joints are surrounded by cartilage that acts as a kind of cushion between the bones, which is especially important when we move,” said Dr. Eric Bowman, an orthopedic surgeon with Vanderbilt Orthopaedics. “Osteoarthritis causes this cartilage to break down, which can cause bone-on-bone rubbing and a number of problems, ultimately resulting in pain and limited mobility.”
As the cartilage in a joint wears down, the bone ends may thicken and form bony growths. These are called bone spurs. Bone spurs can limit joint movement. Fluid-filled cysts may also form in the bone. Bits of bone and cartilage may break off and float in the joint space. These can also limit joint movement.
Causes of osteoarthritis
Osteoarthritis typically worsens with age, mostly affects people who are middle age and older.
“You may hear your doctor refer to your osteoarthritis as ‘primary’ or ‘secondary,” Bowman said. “Secondary osteoarthritis is caused by another disease, such as infection or injury. Primary osteoarthritis is more common. Primary osteoarthritis is likely a combination of genetic factors and wear and tear on the body over time.”
Risk factors for osteoarthritis include:
- Heredity. Some genetic factors may lead to osteoarthritis. These are inherited and likely predispose someone to arthritis.
- Extra weight. Being overweight can put additional stress on joints, such as the knees, over time.
- Injury. Severe injury to a joint, including fracture or trauma, can lead to secondary osteoarthritis.
- Overuse of the joint, especially high-impact repetitive use over time.
Symptoms of osteoarthritis
The most common sign of osteoarthritis is pain after overuse of a joint. Symptoms usually increase slowly over years but may cause more sudden flare-ups.
“Symptoms can occur a bit differently in each person, but typically people say things like, ‘I notice that my joints are really stiff first thing in the morning or after I have been sitting on the couch for too long,’” Bowman said. “Other people may start to notice pain in the joints after long sessions of their favorite sport or physical activity.”
Symptoms may include:
- Joint pain.
- Joint stiffness, especially after sleep or inactivity.
- Reduced movement in the joint over time.
- A grinding feeling in the joint when moved, as the cartilage wears away.
Diagnosing osteoarthritis requires a health history, a physical exam and most likely X-rays. “Many of the symptoms of osteoarthritis can be caused by other conditions too, so it’s important to visit your health care provider to get an accurate diagnosis,” Bowman said.
Treatments for osteoarthritis
Treatment depends on your symptoms, age and general health. It will also depend on how severe the condition is. “The goal of treatment is to ease joint pain and stiffness and improve joint movement,” Bowman said. “Your doctor can work with you to consider what activities are most important to you, and how to slow the progression of your symptoms and keep you active as long as possible.”
Treatment may include:
- Exercise. Regular exercise may help ease pain and other symptoms. This may include stretching and strength exercises.
- Heat and ice. Treating the joint with heat may help with mobility and ease pain. Ice may help with pain and inflammation.
- Physical and occupational therapy. Therapy may help ease joint pain by improving joint flexibility and reducing joint strain. You may use assistive devices for hip or knee arthritis. Placing objects on lower surfaces may help reduce shoulder symptoms.
- Weight maintenance. Being a healthy weight may help to prevent or ease symptoms. Low-impact exercises such as a stationary bike, elliptical, swimming or walking in the pool is strongly recommended. Higher impact exercises may worsen osteoarthritis symptoms.
- Medication. These may include acetaminophen and anti-inflammatory medicines. You might take these in pill form or as a cream to rub into the skin.
- Injections. There are several types of injections that can provide pain relief and better motion in a joint. A cortisone (steroid) injection can provide relief for several months. There may be other injection options available that you can discuss with your doctor.
- Surgery. Many joints can be replaced if symptoms are no longer responding to other treatments.
Living with osteoarthritis
Because osteoarthritis causes joints to get worse over time, it can cause disability. It can cause pain and movement problems, making you less able to do normal activities and tasks.
“Although there is no cure for osteoarthritis, it’s important to help keep joints working,” Bowman said. “Working with your doctor to create a treatment plan can ease your pain and inflammation and keep you mobile longer.”
Your health care provider can also make suggestions for how to adjust your life in ways that can improve your comfort level and functioning. These changes may include:
- Losing weight. Extra weight puts more stress on weight-bearing joints, such as the hips and knees – up to six times your body weight while squatting, for example.
- Exercising. Some exercises may help ease joint pain and stiffness. The focus should be on low-impact exercises (no jumping or running) that work the thigh muscles, such as cycling or using an elliptical machine. Swimming, walking, low-impact aerobic exercise and range-of-motion exercises, and gentle stretches, may also help keep the joints flexible.
- Balancing activity and rest. To reduce stress on your joints, alternate between activity and rest. This can help protect your joints and ease your symptoms.
- Using assistive devices. Canes, crutches and walkers can help to keep stress off certain joints and improve balance.
- Using adaptive equipment. Tools that help you reach and grab items let you extend your reach and reduce straining. Dressing aids can help you get dressed more easily.
- Managing medications. Anti-inflammatories can help with symptoms. However, long-term use of some anti-inflammatory medicines can lead to stomach bleeding and kidney problems. Work with your health care provider to create a plan to reduce this risk.
