Osteoarthritis

What is an Osteoarthritis

Osteoarthritis is a type of arthritis that affects tissue that covers the ends of bones in joints (cartilage). Cartilage acts as a cushion between the bones and helps them move smoothly.

Osteoarthritis results when cartilage in the joints gets worn down. Osteoarthritis is sometimes called “wear and tear” arthritis.

Osteoarthritis is the most common form of arthritis. It often occurs in older people. It is a condition that gets worse over time (a progressive condition). Joints that are most often affected by this condition are in:

• Fingers.
• Toes.
• Hips.
• Knees.
• Spine, including neck and lower back.

4 Interesting Facts of Osteoarthritis

1. Most common type of joint disease
2. Degenerative disorder involving breakdown of articular cartilage in synovial joints; also involves subchondral bone and synovium
3. Involves joint pain and stiffness, similar to osteonecrosis
4. Differentiated with plain radiography, the imaging method of choice; abnormalities found in the load-bearing areas of the affected joint (eg, joint space loss, subchondral bony sclerosis, cyst formation) differ from those in non–load-bearing areas

What are the causes?

This condition is caused by age-related wearing down of cartilage that covers the ends of bones.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Older age.
• Being overweight or obese.
• Overuse of joints, such as in athletes.
• Past injury of a joint.
• Past surgery on a joint.
• Family history of osteoarthritis.

What are the symptoms?

The main symptoms of this condition are pain, swelling, and stiffness in the joint. The joint may lose its shape over time. Small pieces of bone or cartilage may break off and float inside of the joint, which may cause more pain and damage to the joint. Small deposits of bone (osteophytes) may grow on the edges of the joint. Other symptoms may include:

• A grating or scraping feeling inside the joint when you move it.
• Popping or creaking sounds when you move.

Symptoms may affect one or more joints. Osteoarthritis in a major joint, such as your knee or hip, can make it painful to walk or exercise. If you have osteoarthritis in your hands, you might not be able to grip items, twist your hand, or control small movements of your hands and fingers (fine motor skills).

How is this diagnosed?

This condition may be diagnosed based on:

• Your medical history.
• A physical exam.
• Your symptoms.
• X-rays of the affected joint(s).
• Blood tests to rule out other types of arthritis.

How is this treated?

There is no cure for this condition, but treatment can help to control pain and improve joint function. Treatment plans may include:

• A prescribed exercise program that allows for rest and joint relief. You may work with a physical therapist.
• A weight control plan.
• Pain relief techniques, such as:
  • Applying heat and cold to the joint.
  • Electric pulses delivered to nerve endings under the skin (transcutaneous electrical nerve stimulation, or TENS).
  • Massage.
  • Certain nutritional supplements.
• NSAIDs or prescription medicines to help relieve pain.
• Medicine to help relieve pain and inflammation (corticosteroids). This can be given by mouth (orally) or as an injection.
• Assistive devices, such as a brace, wrap, splint, specialized glove, or cane.
• Surgery, such as:
  • An osteotomy. This is done to reposition the bones and relieve pain or to remove loose pieces of bone and cartilage.
  • Joint replacement surgery. You may need this surgery if you have very bad (advanced) osteoarthritis.

Follow these instructions at home:

Activity

• Rest your affected joints as directed by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• Exercise as directed. Your health care provider or physical therapist may recommend specific types of exercise, such as:
  • Strengthening exercises. These are done to strengthen the muscles that support joints that are 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 water aerobics, that get your heart pumping.
  • Range-of-motion activities. These keep your joints easy to move.
  • Balance and agility exercises.

Managing pain, stiffness, and swelling

• If directed, apply heat to the affected area as often as told by your health care provider. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.
  • If you have a removable assistive device, remove it as told by your health care provider.
  • Place a towel between your skin and the heat source. If your health care provider tells you to keep the assistive device on while you apply heat, place a towel between the assistive device and the heat source.
  • Leave the heat on for 20–30 minutes.
  • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.
• If directed, put ice on the affected joint:
  • If you have a removable assistive device, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag. If your health care provider tells you to keep the assistive device on during icing, place a towel between the assistive device and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Maintain a healthy weight. Follow instructions from your health care provider for weight control. These may include dietary restrictions.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Use assistive devices as directed by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Seek Additional 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  

Contact a health care provider if:

• Your skin turns red.
• You develop a rash.
• You have pain that gets worse.
• You have a fever along with joint or muscle aches.

Get help right away if:

• You lose a lot of weight.
• You suddenly lose your appetite.
• You have night sweats.

Summary

• Osteoarthritis is a type of arthritis that affects tissue covering the ends of bones in joints (cartilage).
• This condition is caused by age-related wearing down of cartilage that covers the ends of bones.
• The main symptom of this condition is pain, swelling, and stiffness in the joint.
• There is no cure for this condition, but treatment can help to control pain and improve joint function.