What is Osteoarthritis?
Arthritis is the name for a set of conditions that cause inflammation in the joints.
Osteoarthritis occurs when the cartilage that normally cushions the ends of the bones in your joints gets worn away and the bones begin to rub against each other ("osteo" means bone). Osteoarthritis, also called degenerative joint disease or osteoarthrosis, is by far the most common form of arthritis.
Osteoarthritis usually affects only one joint in your body, although it can affect more. The most commonly affected joints are your hands, hips, knees, and spine, but osteoarthritis can affect any joint. While there is no cure for the condition, there are treatments that can help manage the pain and loss of mobility that often accompany the disease.
Around 12 percent of the U.S. population (nearly 21 million Americans) has osteoarthritis. The disease gets more common as people get older and occurs most frequently in people who are overweight and those whose jobs or lifestyles place a lot of stress on particular joints. Younger people can developoOsteoarthritis too, but it is often due to a joint injury, abnormal joint anatomy, or a genetic defect in joint cartilage.
The symptoms of osteoarthritis often start out mild and get worse. This is because joint damage is frequently made worse by use of the joint and it is difficult to stop using a joint entirely. In some people the joint damage progresses quickly, but for most people it develops gradually over years. The symptoms of osteoarthritis may be mild with little effect on your day-to-day life or they may cause significant pain and disability.
The most commonly reported symptoms are pain and stiffness in the joint, which tend to be worse during or after use of the joint, especially early in the course of the disease. Later on, the pain may be present even when the joint is not used.
Other common symptoms of osteoarthritis include:
- joint tenderness
- loss of flexibility
- grating sensation when the joint is used
- bone spurs (hard lumps formed around the affected joint)
The joints most commonly affected by OA are:
- lower back
The symptoms you experience depend somewhat on which joint is affected. Osteoarthritis rarely affects the jaw, shoulder, elbows, wrists, or ankles unless you have had an injury to one of those sites or you have a lifestyle that places a lot of stress on that particular joint.
Causes of Osteoarthritis
In all of your body's joints, a smooth layer of cartilage covers the ends of each bone in the joint. This cartilage cushions the ends of bones, absorbing shock and preventing the bones from rubbing against each other. Over time and with repeated use, this cartilage can deteriorate, resulting in osteoarthritis. The smooth surface of the cartilage becomes rough, causing irritation and inflammation. If the cartilage wears away entirely in spots, the bones will rub against each other and incur damage. Over time, the pressure on the bone stimulates it to grow resulting in raised processes called bone spurs that can limit mobility and cause a lot of pain.
What causes the cartilage to deteriorate? Researchers suspect it is a combination of factors including excess weight that puts stress on joints, joint overuse, joint injury or stress, family history, and the aging process. While aging does not cause osteoarthritis, it is definitely a factor in developing the disease.
Anyone can get osteoarthritis, but the disease is uncommon in people under the age of 40.
Some of the main risk factors for OA include:
- Older age: Osteoarthritis becomes much more common as people age.
- Female sex: Osteoarthritis is more common in women, although under the age of 45 it is actually more common in men.
- Overweight/obesity: Carrying excess weight increases stress on the back and legs. There is some evidence suggesting that osteoarthritis in the hands is also more common in obese people.
- Physical job stress: osteoarthritis is more common in people whose jobs place a lot of stress on their joints.
- Joint deformities: People born with malformed joints or defective cartilage are at increased risk of osteoarthritis.
- Joint injuries: Osteoarthritis is more common in people who have had joint injuries from sports or an accident.
- Other diseases: Certain bone and joint diseases may increase the risk of osteoarthritis such as gout and Paget's disease.
- Heredity: People with relatives who have osteoarthritis may be at increased risk of the disease.
- Pain or stiffness in a joint, usually the hip, knee, foot, spine, or fingers.
- Pain that is aggravated by activity and relieved by rest.
- Swelling that may include the area around a joint.
- Symptoms that last longer than two weeks.
- Grating or crunching sound of bones rubbing together when the joint is moved.
- Limited mobility in the affected joint.
If you experience several of these symptoms, see your doctor to find out if you have osteoarthritis.
What to expect at the doctor: The doctor will perform a physical examination including a thorough check of the joint or joints that are causing pain. He or she will be looking for signs that might indicate osteoarthritis including bumps, enlargement of the bones, restricted motion, fluid build up, weakened muscles, and joint instability. The doctor will also ask you questions about your pain to get a better idea of what is causing it. If necessary, he or she may also recommend tests to help diagnose osteoarthritis.
Treatment can be very effective. Successful treatment usually involves a combination of exercise, lifestyle modifications, pain relief measures, and medications. In advanced cases of osteoarthritis, surgery may be necessary to restore movement to the joint.
Exercise is one of the best ways to treat OA pain. When performed properly, exercise can reduce joint pain and improve mobility, as well as helping improve mood and overall fitness. Improving muscle strength can also make the affected joint more stable. The type of exercise that is best depends on the site and severity of your osteoarthritis symptoms. Your doctor or physical therapist can show you the types of exercises that are appropriate for you. Examples of some helpful activities include walking and swimming.
Lifestyle modifications you can make to help improve the symptoms of OA involve reducing the impact of the factors in your life that contribute to or exacerbate your joint pain. If you are overweight, losing weight is a great way to take some of the stress off of the weight-bearing joints of the lower body. A doctor, nutritionist, or dietitian can help you with a plan to lose weight and maintain a healthy weight.
If you work in a job that places stress on your affected joint, you may want to consider changing jobs or finding alternative ways to complete your tasks. Also, it is important to take breaks and rest your joints periodically, no matter what your job. Using splints, braces, or other supports from time to time can provide a way to give joints a temporary break from use.
There are several non-drug pain relief measures that can help to relieve acute pain without medication:
- Applying heat or cold to the joint. Generally, heat (often applied with hot packs or hot water bottles) helps improve circulation to the joint and ease pain and stiffness while cold (applied with ice bags) helps to reduce pain and swelling caused by inflammation.
- Massage is another way to relieve joint pain. A massage therapist who is trained in how to treat arthritis can increase blood flow to the joint and improve pain by lightly massaging the muscles that surround the joint.
- A treatment called TENS (for transcutaneous electrical nerve stimulation) stimulates nerves in the region of the joint through the surface of the skin (transcutaneously) and can prevent them from sending pain signals.
There are also several medication options for dealing with the pain of osteoarthritis. For short-term relief of acute inflammation and stiffness, over-the-counter drugs like acetaminophen and the non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, and celecoxib can be used. Another commonly used drug is prescription pain reliever tramadol (Ultram), while mild narcotics such as codeine or hydrocodone may also provide some relief when NSAIDs aren't enough.
Since the root cause of osteoarthritis is unknown, there is no known way to prevent its occurrence. However, you can reduce your risk factors if you have them.
If you are overweight, lose weight and if you have a job or hobby that places a lot of stress on your joints, you can take measures to reduce that stress. It is still unclear how exercise affects the development of osteoarthritis; some studies suggest that certain activities contribute to the development of osteoarthritis while other studies conclude that exercise can help prevent osteoarthritis from occurring.
If you have pain, swelling, or stiffness in a joint or joints that lasts for more than two weeks, make an appointment with your doctor. The sooner you are diagnosed with osteoarthritis, the sooner you can start treatment to prevent further joint damage from occurring.