Osteoarthritis

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Introduction

What is osteoarthritis?

Osteoarthritis is an ongoing, progressive disease that causes inflammation, pain, stiffness and swelling of joints. The joints of the body are the areas where two or more bones meet. The ends of the bones are protected by a durable tissue called cartilage, which helps bones to move easily without damaging bone tissue. In osteoarthritis, the cartilage breaks down, or becomes torn or thin, resulting in friction on the ends of the bones as they make contact. With time, this causes the classic symptoms of osteoarthritis, such as joint pain, stiffness, and swelling.

Osteoarthritis can also cause inflammation of the synovial membranes. Healthy synovial membranes line and protect the joints and allow smooth and free movement. When synovial membranes are inflamed, they become swollen, tender and warm, and are unable to move freely.

Osteoarthritis is also known as degenerative joint disease, because it can get worse with time and cause deterioration of joint function, difficulty moving, and even disability. Osteoarthritis cannot be cured, but early diagnosis and treatment can help to reduce symptoms and minimize complications.

Complications of osteoarthritis can be serious and include joint damage, deformity, and disability. Seek prompt medical care if you have symptoms of osteoarthritis, such as inflammation, pain, stiffness, and swelling of joints. Early diagnosis and treatment can minimize discomfort and reduce the risk of serious complications.

Symptoms

What are the symptoms of osteoarthritis?

The symptoms of osteoarthritis vary between individuals. At the onset of the disease, symptoms can be vague and develop slowly. Many people have no symptoms in the early stages of osteoarthritis.

Joint pain occurs as osteoarthritis progresses. Joint pain becomes more severe with time and can lead to difficulty moving, immobility, and disability. Certain types of activities may increase or aggravate joint pain. Joint pain is often worse after excessive exercise or periods of inactivity.

Symptoms of osteoarthritis include:

  • Altered joint alignment
  • Crunching, crackling, or grating sound or sensation in the affected joint
  • Difficulty moving and immobility due to joint pain and inflammation
  • Joint deformity in later stages of the disease
  • Joint inflammation and warmth
  • Joint pain, which may be aggravated by certain types of activities including excessive exercise or excessive inactivity
  • Joint stiffness
  • Joint swelling
  • Muscle weakness in the area of affected joints
Causes

What causes osteoarthritis?

Osteoarthritis is the breakdown of cartilage that normally cushions the ends of bones. Primary osteoarthritis is linked to age-related wear and tear on the joint with time, but the exact cause of the loss of cartilage is not completely understood. Osteoarthritis is not a normal part of aging. Certain risk factors affect the likelihood of an older person developing the condition.

In some cases, osteoarthritis is caused by a specific injury or exacerbated by obesity. Osteoarthritis is also related to genetics, since you are more likely to develop the condition if you have a family member with osteoarthritis.

What are the risk factors for osteoarthritis?

A number of factors may increase your chances of developing osteoarthritis. Not all people with risk factors will develop osteoarthritis, and not all people with osteoarthritis have risk factors. Risk factors include:

  • Acromegaly (disorder in which there is excessive growth hormone, which can affect the bones and joints)

  • Age older than 45 years

  • Certain blood and circulation disorders, such as hemophilia and avascular necrosis

  • Family history of osteoarthritis or bone deformities

  • Gout

  • Hemochromatosis (disorder in which there is too much iron, which can damage cartilage)

  • Joint injury including fractures, joint dislocations, ligament tears, and overuse injuries

  • Joint injury including fractures, joint dislocations, and overuse injuries

  • Obesity, which can put excessive pressure on the knees, hips, ankles and foot joints

  • Prolonged occupational or sports-related stress on joints

  • Rheumatoid arthritis

  • Weak muscles, particularly around the knees

Reducing your risk of osteoarthritis

You can lower your risk of developing osteoarthritis by :

  • Maintaining a healthy weight

  • Participating in a regular exercise program

  • Seeking regular medical care and following your treatment plan for joint injuries and such conditions as gout and rheumatoid arthritis

  • Wearing recommended gear that protects joints during contact sports and dangerous activities

Treatments

How is osteoarthritis treated?

Treatment plans for osteoarthritis use a multifaceted approach and are individualized to the stage and advancement of the disease, and your age, medical history, and coexisting diseases or conditions. There is no cure for osteoarthritis, but with early recognition and treatment, it is possible to minimize or delay joint damage and complications, such as chronic pain and disability.

Medications used to treat osteoarthritis include:

  • Acetaminophen (Tylenol), which relieves pain

  • Cortisone injection, which reduces inflammation

  • Glucosamine and chondroitin, which help strengthen damaged joint cartilage

  • Injection of a synovial fluid substitute, which helps lubricate joints and ease stiffness and movement

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and aspirin, which reduce inflammation

Other treatments used to treat osteoarthritis may include:

  • Heat and cold therapies to reduce inflammation and stiffness

  • Occupational therapy to help maximize function

  • Physical therapy, including range-of-motion exercises to help strengthen joints and delay the loss of joint function

  • Surgery to help improve joint pain, correct deformities, and increase function in seriously affected joints. Surgery may include a synovectomy, the removal of the joint lining. Joint replacements may also be performed in advanced cases. In these cases, a diseased joint is partially or completely replaced with a new, synthetic joint (prosthesis).

Complementary treatments

Some complementary treatments may help some people to better deal with osteoarthritis. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Acupuncture

  • Massage therapy

  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

  • Yoga

What are the potential complications of osteoarthritis?

In some cases, osteoarthritis can lead to serious complications. It is important to understand that osteoarthritis and its symptoms are not a normal part of the aging process and can be treated. You can minimize discomfort and reduce your risk of complications by following the treatment plan you and your health care provider develop specifically for you. Complications of osteoarthritis include:

  • Adverse effects of osteoarthritis treatment

  • Chronic pain

  • Difficulties with fine motor control of the hands

  • Immobility and disability

  • Increased risk for falls

  • Joint deterioration, deformity and destruction

  • Nerve compression in the spinal cord (pinched nerves)

  • Problems with posture, walking and balance

  • Weakness or abnormal sensations of the arms or legs

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 10
  1. Osteoarthritis. Merck Manual. https://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/joint-disorders/osteoarthritis-o...
  2. Osteoarthritis. Arthritis Foundation. http://www.arthritis.org/conditions-treatments/disease-center/osteoarthritis/
  3. Osteoarthritis. Medline Plus, a service of the National Library of Medicine National Institutes of Health. https://medlineplus.gov/osteoarthritis.html

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