Osteoarthritis

Osteoarthritis is the most common form of arthritis. It is redness, soreness, and swelling (inflammation) affecting the cartilage. Cartilage acts as a cushion, covering the ends of bones where they meet to form a joint.

CAUSES

Over time, the cartilage begins to wear away. This causes bone to rub on bone. This produces pain and stiffness in the affected joints. Factors that contribute to this problem are:

  • Excessive body weight.

  • Age.

  • Overuse of joints.

SYMPTOMS

  • People with osteoarthritis usually experience joint pain, swelling, or stiffness.

  • Over time, the joint may lose its normal shape.

  • Small deposits of bone (osteophytes) may grow on the edges of the joint.

  • Bits of bone or cartilage can break off and float inside the joint space. This may cause more pain and damage.

  • Osteoarthritis can lead to depression, anxiety, feelings of helplessness, and limitations on daily activities.

The most commonly affected joints are in the:

  • Ends of the fingers.

  • Thumbs.

  • Neck.

  • Lower back.

  • Knees.

  • Hips.

DIAGNOSIS

Diagnosis is mostly based on your symptoms and exam. Tests may be helpful, including:

  • X-rays of the affected joint.

  • A computerized magnetic scan (MRI).

  • Blood tests to rule out other types of arthritis.

  • Joint fluid tests. This involves using a needle to draw fluid from the joint and examining the fluid under a microscope.

TREATMENT

Goals of treatment are to control pain, improve joint function, maintain a normal body weight, and maintain a healthy lifestyle. Treatment approaches may include:

  • A prescribed exercise program with rest and joint relief.

  • Weight control with nutritional education.

  • Pain relief techniques such as:

  • Properly applied heat and cold.

  • Electric pulses delivered to nerve endings under the skin (transcutaneous electrical nerve stimulation, TENS).

  • Massage.

  • Certain supplements. Ask your caregiver before using any supplements, especially in combination with prescribed drugs.

  • Medicines to control pain, such as:

  • Acetaminophen.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen.

  • Narcotic or central-acting agents, such as tramadol. This drug carries a risk of addiction and is generally prescribed for short-term use.

  • Corticosteroids. These can be given orally or as injection. This is a short-term treatment, not recommended for routine use.

  • Surgery to reposition the bones and relieve pain (osteotomy) or to remove loose pieces of bone and cartilage. Joint replacement may be needed in advanced states of osteoarthritis.

HOME CARE INSTRUCTIONS

Your caregiver can recommend specific types of exercise. These may include:

  • Strengthening exercises. These are done to strengthen the muscles that support joints affected by arthritis. They can be performed with weights or with exercise bands to add resistance.

  • Aerobic activities. These are exercises, such as brisk walking or low-impact aerobics, that get your heart pumping. They can help keep your lungs and circulatory system in shape.

  • Range-of-motion activities. These keep your joints limber.

  • Balance and agility exercises. These help you maintain daily living skills.

Learning about your condition and being actively involved in your care will help improve the course of your osteoarthritis.

SEEK MEDICAL CARE IF:

  • You feel hot or your skin turns red.

  • You develop a rash in addition to your joint pain.

  • You have an oral temperature above 102° F (38.9° C).

FOR MORE INFORMATION

National Institute of Arthritis and Musculoskeletal and Skin Diseases: www.niams.nih.gov

National Institute on Aging: www.nia.nih.gov

American College of Rheumatology: www.rheumatology.org