What Is Osteoarthritis?

Osteoarthritis is the most common joint condition that occurs when the cartilage (the connective tissue surrounding the bones) around a joint gradually breaks down over time. When the cartilage breaks down, the remaining cartilage and bones rub together, causing symptoms such as joint pain, swelling, and stiffness in the knees, hips, neck, and hands.

Researchers don’t know what exactly causes osteoarthritis, but risk factors like age, previous joint injury, and joint overuse may increase your risk of developing the condition. At this time, there is no cure for osteoarthritis. But, drug and non-drug treatment options are available to help you better manage your symptoms. Your exact treatment plan will depend on the severity of your condition and the symptoms you are experiencing.

Symptoms

Osteoarthritis is a degenerative (progressively declining) joint condition that often begins slowly, affecting one or a few joints at first. Most people living with osteoarthritis start having symptoms after 40 years old. Although symptoms may vary person to person, common symptoms include:

• Pain that worsens with activity and is relieved by rest
• Stiffness, especially in the morning
• Swelling or fluid retention
• Popping, clicking, or cracking sounds when you bend your joints
• Changes in joint shape
• Loss of mobility or flexibility
• Muscle weakness

Symptoms of osteoarthritis commonly appear in the fingers, feet, knees, hip, and spine. Joints that are less likely to be affected by osteoarthritis symptoms are the elbows, wrists, shoulders, and ankles.

Causes

Your cartilage is a firm, rubbery tissue that cushions and protects your bones at the joints. A joint is where two bones meet or make contact. When a person develops osteoarthritis, the cartilage breaks down and wears away over time. As a result, the remaining pieces of cartilage or bones rub together, leading to painful symptoms.

Researchers aren’t sure what exactly causes osteoarthritis. But, they have found that some factors increase your risk of developing the condition. Most people with osteoarthritis have one or more of the following risk factors:

• Age: Osteoarthritis can happen at any age, but your chance of developing the condition increases around 55 years or older. 
• Sex: Women are two to three times more likely to develop osteoarthritis than men.
• Obesity: Extra weight can add stress to your hips and knees.
• Genetics: Your risk for osteoarthritis increases if you have a family history of the condition.
• Occupation: Working certain jobs like dock work, carpentry, farm work, and construction may increase your risk of developing symptoms.
• Injury: Having a previous injury or trauma to your joints increases the risk of osteoarthritis in those joints in the future.
• Congenital conditions: Being born with a condition such as scoliosis or hip dysplasia can also increase your risk.

Diagnosis

There is no single test that can diagnose osteoarthritis alone. That said, your healthcare provider will take a thorough medical history to learn about your symptoms and order a number of tests to help confirm a diagnosis.

During your appointment, you can expect your provider to ask you questions such as:

• What symptoms are you experiencing?
• When did the joint pain begin?
• Do you have a family history of a joint disease?
• Have you ever had a joint injury or broken a bone?
  
• Does the pain happen only with activity or also with rest?
• Is the pain continuous or does it come and go?
• Does anything make the pain better?

The information from these questions can help your provider guide the next steps. In this case, they may order one or more of the following tests to confirm a diagnosis or rule out other health conditions:

• Physical exam: Assesses your general health, reflexes, and joints
• X-rays: Checks for bone damage and bone spurs
• Magnetic resonance imaging (MRI): Shows signs of soft tissue damage in and around the joints
• Blood tests: Helps rule out other conditions (like gout or rheumatoid arthritis) that cause symptoms similar to osteoarthritis
• Synovial (joint) fluid analysis: Uses a sample of your joint fluid to look for infections or other illnesses that may be causing your symptoms

Treatments

There is no cure for osteoarthritis, but drugs and non-drug therapies can help you manage your condition. Your healthcare provider will create a treatment plan based on your medical history, the severity of your symptoms, and your specific needs. The goals of treatment are to:

• Reduce joint pain
• Improve joint function and mobility
• Maintain your quality of life
• Prevent osteoarthritis-related disability or complications

Non-drug Therapies

Non-drug therapies are the first treatments that your provider will recommend. These therapies include:

• Physical therapy and exercise programs that include range-of-motion, stretching, and strengthening exercises
• Use of braces, splints, and orthotics to reduce joint pain
• Assistive devices such as canes, walkers, raised toilet seats, and shower bars which can make daily activities more accessible
• Weight loss (if needed) to reduce stress on your joints

Drug Therapies

Generally, your provider will prescribe medication in conjunction with non-drug therapies. They may recommend one of the following drug therapies:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Topical or oral medications such as Advil (ibuprofen), Aleve (naproxen), and Celebrex (celecoxib) can relieve pain and reduce inflammation
• Acetaminophen: Medications such as Tylenol may improve symptoms
• Glucocorticoid injections: Steroid injections into the joint can provide short-term pain relief
• Neuropathic agents: Medicines such as Lyrica (pregabalin) or Yentreve (duloxetine) that may help reduce nerve pain

Surgery

If you have severe joint damage because of your condition, surgery may be an option for you. This is especially true if drug and non-drug therapies have not improved your symptoms and your joint damage is limiting your daily activities. Surgery options include:

• Arthroscopic surgery to remove torn or damaged cartilage
• Realignment surgery to relieve stress on the bone or joint
• Joint fusion
• Partial or total joint replacement

How to Prevent Osteoarthritis Flares

If you are living with osteoarthritis, you may experience a period of time when your symptoms are more intense. These moments of increased pain, stiffness, and swelling are known as flares or flare-ups.

It’s not possible to prevent osteoarthritis altogether. However, there are some things you can do to reduce the pain associated with osteoarthritis flare-ups, such as:

• Practicing muscle relaxation and stress reduction techniques
• Learning how to exercise safely
• Pacing your daily tasks with light activity and planned rest breaks
• Protecting your joints from injury 
• Limiting repetitive movements that may aggravate your joints 

Complications 

People living with osteoarthritis may experience complications as their condition progresses. In addition to ongoing pain, other complications may include:

• Increased risk of falls
• Difficulty walking or moving around
• Decreased range of motion of the joint
• Injury or damage to nerve roots in the spine (a condition known as radiculopathies)

Complications caused by osteoarthritis can lead to challenges with everyday activities like completing household chores or keeping up with personal hygiene. With treatment, your ability to complete everyday tasks can improve over time.

Living With Osteoarthritis 

Osteoarthritis is a progressive joint disorder that affects everyone differently based on which joints are affected and the severity of your symptoms. Some people with mild osteoarthritis may not be affected by their symptoms at all, while others may experience severe disability. That's why treatment options for osteoarthritis can vary.

Living with osteoarthritis can feel limiting, difficult, and draining. It's important to follow your treatment plan and implement lifestyle changes when you can, such as:

• Alternating hot and cold compresses to relieve joint pain
• Using assistive devices to help move around safely
• Engaging in gentle, low-impact exercises such as walking, tai chi, or swimming
• Finding support groups that can offer tips on how to cope with osteoarthritis
• Asking your loved ones for physical and emotional support when you need it