Osteoarthritis (OA)

What is osteoarthritis?

Arthritis is a condition that causes pain and inflammation in joints. Osteoarthritis (OA) is the most common type. It's a long-term (chronic), degenerative joint disease. Degenerative means that it gets worse over time. It affects mostly middle-aged and older adults. OA causes the breakdown of joint cartilage. It can occur in any joint. But it most often affects the hands, knees, hips, or spine.

What causes osteoarthritis?

OA can be called primary or secondary. Primary OA has no known cause. Secondary OA is caused by another disease. Or by an infection, injury, or deformity. OA starts with the breakdown of cartilage in the joint. The bone ends may thicken and form bony growths as the cartilage wears down. These growths are called bone spurs. They can limit joint movement. Bits of bone and cartilage may float in the joint space. Fluid-filled cysts may form in the bone. These can also limit joint movement.

Who is at risk for osteoarthritis?

The risk factors of OA include:

• Heredity. Some genetic problems may lead to OA. These include slight joint defects. Or joints that are too loose.

• Extra weight. Being overweight can put stress on joints like the knees over time.

• Injury or overuse. Severe injury to a joint, such as the knee, can lead to OA. Injury may also result from overuse. Or from misuse over time.

What are the symptoms of osteoarthritis?

The most common symptom of OA is pain after overuse or inactivity of a joint. Symptoms often happen slowly over years. Symptoms can vary for each person. They may include:

• Joint pain

• Joint stiffness. This often happens after sleep or inactivity.

• Less movement in the joint over time

• A grinding feeling in the joint when moved. This is because the cartilage wears away (in later stages).

Some of the symptoms can be caused by other health problems. Always see your healthcare provider for a diagnosis.

How is osteoarthritis diagnosed?

The process starts with a health history and a physical exam. You may also have X-rays. This test uses a small amount of radiation. This is to create images of bone and other body tissues.

How is osteoarthritis treated?

Treatment will depend 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 to improve joint movement. Treatment may include:

• Exercise. Regular exercise may help ease pain and other symptoms. This may include stretching and strength exercises.

• Heat treatment. Treating the joint with heat may help ease pain.

• Physical and occupational therapy. These types of therapy may help ease joint pain, improve joint flexibility, and reduce joint strain. You may use splints and other assistive devices. Physical therapists will make certain canes, walkers, and other assistive devices are fitted correctly for your height and posture.

• Weight maintenance. Keeping a healthy weight, or losing weight if needed, may help to prevent or ease symptoms.

• Medicines. These may include pain relievers and anti-inflammatory medicines. You might take these by mouth as a pill. Or you may rub them on your skin in a cream.

• Injections of a lubricant into the joints. These liquids mimic normal joint fluid.

• Joint surgery. If other treatments don't work, you may need surgery to fix or replace a joint that has severe damage.

Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are possible complications of osteoarthritis?

OA can result in disability. That's because it causes joints to get worse over time. It can cause pain and movement problems. These can make you less able to do normal daily activities and tasks.

Living with osteoarthritis

There is no cure for OA. But it's still important to help keep joints working. Doing so can ease pain and inflammation. Work on a treatment plan with your provider. The plan may include medicine and therapy. Work on lifestyle changes that can improve your quality of life. These may include:

• Losing weight. Extra weight puts more stress on weight-bearing joints like the hips and knees.

• Exercising. Some exercises may help ease joint pain and stiffness. These include swimming, walking, low-impact aerobic exercise, and range-of-motion exercises. Stretching exercises may also help keep the joints flexible.

• Balancing activity and rest. To reduce stress on your joints, switch 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. Be sure they are correctly fitted for your height and posture.

• Using adaptive equipment. Reachers and grabbers allow you to extend your reach and reduce straining. Dressing aids can help you get dressed more easily.

• Managing use of medicines. Long-term use of some anti-inflammatory medicines can lead to stomach bleeding. Work with your provider to create a plan to reduce this risk while still managing your pain.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know.

Key points about osteoarthritis

• Osteoarthritis is a chronic joint disease. It affects mostly middle-aged and older adults.

• It starts with the breakdown of joint cartilage.

• Risk factors include heredity, obesity, injury, and overuse.

• Common symptoms include pain, stiffness. And limited movement of joints.

• Treatment may include medicines, exercise, heat, and joint injections. Surgery may be needed to fix or replace a severely damaged joint.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

• Write down the name of a new diagnosis, and any new medicines, treatments, or tests at the visit. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended. And know what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after hours and on weekends.