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Osteoarthritis

Osteoarthritis is the most common form of arthritis, the inflammation or swelling of one or more joints. More than 100 conditions affect the joints, tissues around the joint, and other connective tissues. Learn more about the different conditions.

 

OA is often referred to as degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, knees, and spine when the cartilage within a joint begins to break down and the underlying bone begins to change. OA can cause pain, stiffness, and swelling and, in some cases, reduced function and disability.


Symptoms

OA usually develops slowly and gets worse over time. Symptoms include:

  • Pain in joints during or after movement

  • Stiffness, most noticeable upon awakening or after being inactive

  • Tenderness when light pressure is applied to or near the joint 

  • Loss of flexibility

  • Grating sensation when using the joint, including popping or crackling sounds

  • Bone spurs, extra bits of bone that feel like hard lumps and form around the affected joint

  • Swelling of the soft tissue around the joint


Risk Factors

There are many factors that can cause OA, some of which can be controlled. 

  • Joint injury, overuse, and repetitive stress on the joint 

  • Age increases the risk 

  • Women are more likely to develop OA than men, especially after age 50

  • Obesity, since extra weight puts more stress on joints, particularly the hips and knees

  • Genetics

  • Osteoarthritis in another body location

  • Bone deformities such as malformed joints or defective cartilage

  • Certain metabolic diseases such as diabetes and hemochromatosis


Complications

OA worsens over time and can result in chronic pain, sleep disturbances, and depression. Joint pain and stiffness can become severe enough to make daily tasks difficult.


Diagnosis

It’s recommended to visit a rheumatologist, a doctor specializing in arthritis and other related conditions, for a diagnosis. Find one here. In addition to a physical exam and review of symptoms, a diagnosis may include: 

  • Imaging tests such as X-rays and MRIs to obtain pictures of the affected joint. X-rays can show cartilage loss and bone spurs, while  MRIs provide more detailed information for use in complex cases. 

  • Lab tests such as blood tests and joint fluid analysis that can help confirm the diagnosis by ruling out other causes of joint pain, including infection. 


Treatment

There is no cure for OA since damage to the joints cannot be reversed. Treatment focuses on managing symptoms and pain and may include:

  • Physical therapy with muscle strengthening exercises to increase flexibility

  • Occupational therapy to identify new ways to do everyday tasks 

  • Over-the-counter pain relievers like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve), as well as NSAIDs gels, applied to the skin over the affected joint. (not to exceed the recommended dose)

  • Prescription drugs including stronger NSAIDs and Duloxetine (Cymbalta), an antidepressant also approved to treat chronic pain.

  • Transcutaneous electrical nerve stimulation (TENS), the use of low-voltage electrical current to relieve pain for short-term relief of knee and hip OA.

  • Cortisone injections to relieve pain for a few weeks, although medication can worsen joint damage over time.

  • Realigning bones such as an osteotomy, where a surgeon cuts across the bone either above or below the knee, and then removes or adds a wedge of bone. 

  • Joint replacement when a surgeon removes damaged joint surfaces and replaces them with plastic and metal parts.


Lifestyle Changes and Self Care

There are many ways to help manage the symptoms and severity of OA including:

  • Low-impact exercises such as walking, bicycling or water aerobics to strengthen the muscles around the joint

  • Weight loss

  • Movement therapies like tai chi and yoga 

  • Heat and cold. Heat, especially moist heat, can help muscles relax and ease pain. Cold can relieve muscle aches after exercise and decrease muscle spasms.

  • Supportive devices including braces, shoe inserts, or canes

  • Tools and aids to assist with daily tasks

  • Capsaicin, a chili pepper extract, applied to the skin over an arthritic joint might help, although some people cannot tolerate the irritation. 

  • Omega-3 fatty acids found in fatty fish and fish oil supplements, might help relieve pain and improve function.

  • Attend regular healthcare appointments and discuss treatment with a doctor, including any supplements and OTC medications. 

 


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