Osteoarthritis (OA) is a slowly progressive joint disease usually seen in those 40 and older. It is caused by a breakdown of the joint cartilage and is the most common type of arthritis. OA can occur along with other types of arthritis. While there is no available way to reverse joint damage due to OA, many studies are under way. They are researching new medicines, tools to detect the disease at an earlier stage and ways to grow cartilage to replace damaged cartilage (known as tissue engineering).
OA symptoms can range from mild to severe. They include:
- Pain that can feel achy, burning or sharp and that may come and go. Constant pain may indicate the disease is worsening.
- Stiffness, especially while sitting and first thing in the morning.
- Muscle weakness, especially with OA of the knee.
- Swelling of the joints, which makes them feel tender and sore.
- Deformed joints especially as the disease worsens.
- Limited range of motion and an inability to use the joint. Over time those with OA may become unable to completely bend, flex or extend the affected joints.
- Cracking and creaking of the joints, although these sounds can also occur in normal joints.
- Spinal stenosis, a narrowing of the spinal cord pathway caused by arthritis of the spine.
Osteoarthritis typically develops over time. Possible risk factors are:
- Being overweight or obese
- Joint trauma or repetitive use
- Improperly formed joints
- A genetic defect in joint cartilage
- Stresses on the joints from some jobs and sports
The following steps can help prevent osteoarthritis. In patients who already have the disease, these actions can help stop its progression:
- Maintain a healthy weight or lose weight if necessary. Excess weight stresses the large joints such as the knees and hips.
- Stay active. Without exercise, the body’s muscles and joints will weaken. Light-to-moderate exercise also helps reduce joint pain for many people.
- Avoid tasks and exercises that cause pain or swelling of the joints. Rely on the largest joints and strongest muscles rather than the smaller, weaker ones.
Osteoarthritis can occur in any joint, but is most often present in the hands, knees, hips and spine. There is no single test for the disease but warning signs include:
- Joint stiffness after getting out of bed or sitting for a long period
- Swelling or tenderness in one or more joints
- A crunching sensation or the sound of bone rubbing on bone
Tools and Tests
Your Wellstar rheumatologist will use the following to make a diagnosis and to rule out other possibilities:
- Medical history
- A physical exam
- Blood tests and other tests, including an examination of the fluid in the joints
- Imaging studies in some cases to detect the extent of the disease and to eliminate other joint problems
The goal of osteoarthritis treatment is to reduce joint pain and improve function. Depending on your symptoms and other factors, your physician will discuss options including physical measures, medication, surgery and supplements.
These involve exercise, weight control, rest and joint care as well as alternatives like massage, acupuncture and chiropractic manipulation to temporarily relieve pain. Alternative treatments can be costly and may require ongoing repeated treatments. Be sure to talk first with your doctor.
Options to treat OA include topical drugs (applied to the surface of the skin), oral agents (taken by mouth) and injections. Topical drugs include capsaicin cream, lidocaine and diclofenac gel. Oral pain relievers include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs). Stronger drugs like narcotics may be required for more serous pain. Some patients get relief with corticosteroids (steroids) or a lubricant known as HA derivatives.
Arthroscopy (a minimally invasive way to examine or treat the internal structure of a joint) or joint replacement are considered when a joint has suffered serious damage or when the patient is in significant pain and experiencing loss of function. Your doctor will help you decide if surgery is the right choice for your condition and symptoms.
While a variety of over-the-counter nutritional supplements are available for osteoarthritis, the safety and effectiveness of most of them are not supported by research. Commonly used supplements are glucosamine/chondroitin sulfate, calcium and vitamin D, and omega-3 fatty acids. Before reaching for these, discuss them with your physician to fully understand the risks and benefits.
Ongoing Care for Osteoarthritis
There is no cure for this most common form of arthritis. But many patients, in collaboration with their physicians, successfully manage the symptoms and their effect on lifestyle. They take steps starting with self-education to better understand the disease. And they develop a positive attitude that helps them focus on strengths rather than weaknesses, reduce stress and cope with the emotional aspect of having a chronic disease.
Other successful strategies include:
- Breaking down activities into smaller tasks that are easier to manage
- Balancing rest with activity
- Getting regular exercise and following a healthy diet
- Maintaining a healthy weight or losing weight if necessary to reduce stress on the joints
- Biologics approved for treatment of other rheumatic diseases
- Focusing on the things they can do rather than on the things they can no longer do
- Attending arthritis support groups or informally sharing ideas with others who have the disease
- Making simple changes, such as supporting the back and neck during sleep and avoiding high-impact activity