Osteoarthritis is the most common joint disorder. The chronic disease causes the cushioning (cartilage) between the bone joints to wear away, leading to pain and stiffness. It can also cause new pieces of bone, called bone spurs, to grow around the joints.
Most of the time, the cause of osteoarthritis (OA) is unknown. It is primarily related to aging. However, metabolic, genetic, chemical, and mechanical factors can play a role in its development.
The symptoms of osteoarthritis usually appear in middle age and are present in almost everyone by the age of 70. Before the age of 55, the condition occurs equally in both sexes. However, after 55 it is more common in women.
The cartilage of the affected joint becomes rough and wears down (degenerates). As the disease gets worse, the cartilage disappears and the bone rubs on bone. Bony spurs usually develop around the joint.
OA is classified as primary or secondary. Primary OA occurs without any type of injury or identifiable cause. Secondary OA is osteoarthritis due to another disease or underlying condition. The most common causes of secondary OA are metabolic conditions, such as acromegaly, problems with anatomy (for example, being bow-legged), injury, or inflammatory disorders like septic arthritis.
Note: There may be no symptoms.
A physical exam can show limited range of motion, grating of a joint with motion, joint swelling, and tenderness.
An x-ray of affected joints will show loss of the joint space, and in advanced cases, wearing down of the ends of the bone and bone spurs.
The goals of treatment are to relieve pain, maintain or improve joint mobility, increase the strength of the joints, and minimize the disabling affects of the disease. The specific treatment depends on which joints are involved.
MEDICATIONS
The most common medications used to treat osteoarthritis are nonsteroidal, anti-inflammatory drugs (NSAIDs). They are pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen (Motrin, Advil, Nuprin), and naproxen (Aleve, Naprosyn, Naprelan, Anaprox).
Although NSAIDs work well, long-term use of these drugs can cause stomach problems, such as ulcers and bleeding. In April 2005, the FDA asked manufacturers of NSAIDs to include a warning label on their product that alerts users of an increased risk for cardiovascular events (heart attacks and strokes) and gastrointestinal bleeding.
Other medications used to treat OA include:
LIFESTYLE CHANGES
Exercise helps maintain joint and overall mobility. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.
Heat and cold treatments, protection of the joints, the use of self-help devices and rest are all recommended.
Good nutrition and careful weight control are also important. Weight loss for overweight individuals will reduce the strain placed on the knee and ankle joints.
PHYSICAL THERAPY
Physical therapy can be useful to improve muscle strength and the motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3-6 weeks, then it will likely will not work at all.
BRACES
Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; while others allow some movement. You should use a brace only when your doctor or therapist recommends one. The incorrect use of a brace can cause joint damage, stiffness, and pain.
SURGERY
Surgery to replace or repair damaged joints may be needed in severe, debilitating cases. Surgical options include:
For additional information and support, see arthritis resources.
Movement may become very limited. Treatment generally improves function. OA is the leading cause of disability in industrialized nations.
Call your health care provider if you have symptoms of osteoarthritis.
Weight loss can reduce the risk of developing knee osteoarthritis in overweight women.
Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB, Kelley's Textbook of Rheumatology, 7th ed. St. Louis, MO; W.B. Saunders; 2005.
US Food and Drug Administration. FDA Announces Series of Changes to the Class of Marketed Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Rockville, MD: National Press Office; April 7, 2005. Press Release P05-16.
US Food and Drug Administration. FDA Issues Public Health Advisory Recommending Limited Use of Cox-2 Inhibitors. Rockville, MD: National Press Office; December 23, 2004. Talk Paper T04-61.