What is osteoarthritis?
Osteoarthritis is a painful problem with the joints. Healthy joints help your body move, bend, and twist. Knees glide up and down stairs without creaking or crunching. Hips move you along on a walk without a complaint. But when you have arthritis, such simple, everyday movements can hurt. Using the stairs can be painful. Walking a few steps, opening a door, and even combing your hair can be hard.
Arthritis is mainly a disease of the spine, hip, hand, knee, and foot. But it can happen in other joints too. A joint is where two bones connect. And you have them all over your body.
Arthritis is most common in older people. Even though you can't cure arthritis, there are many treatments that can help with your pain and make it easier for you to move. And you can do things to keep the damage from getting worse.
What causes osteoarthritis?
The simplest way to describe arthritis is that it's wear and tear on the cartilage of your joints. Your joints have cushioning inside them called cartilage. This tissue is firm, thick, and slippery. It covers and protects the ends of bones where they meet to form a joint.
With arthritis, there are changes in the cartilage that cause it to break down. When it breaks down, the bones rub together and cause damage and pain. Experts don't know why this breakdown in cartilage happens. But aging, joint injury, being overweight, and genetics may be a part of the reason.
What are the symptoms?
How is osteoarthritis diagnosed?
Your doctor will check that your pain is not caused by another problem. He or she will ask questions about your symptoms, such as:
If your joints are tender and swollen and the muscles are weak, this will also help your doctor confirm whether you have arthritis. You may also have X-rays to check your joints for damage. Your doctor may want to do blood tests or other tests to see if there are other causes for your pain.
How is it treated?
There are many treatments for arthritis, but what works for someone else may not help you. Work with your doctor to find what is best for you. Often a mix of things helps the most.
Your treatment may include:
There are also some things you can do at home to help relieve your symptoms. For example, there are devices and tools that can take the stress and weight off of your joints and make it easier for you to hold objects, open and close things, and walk. Doorknob covers, tape, braces, splints, and canes may help.
You might also try changing activities or the way you do things to reduce the stress on the joint that hurts and allow you to move better. For example, walk instead of jog. Or use a sewing machine to make a quilt instead of making it by hand.
Frequently Asked Questions
Learning about osteoarthritis:
Living with osteoarthritis:
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Osteoarthritis occurs when changes in cartilage cause the cartilage to break down faster than the body can produce it. When cartilage breaks down, the bones rub together and cause damage and pain. Experts don't know why this happens. But things like aging, joint injury, being overweight, and genetics may increase your risk.
In some cases, arthritis is caused by other conditions that damage cartilage.
For more information, see the What Increases Your Risk section of this topic.
Symptoms of osteoarthritis can range from mild to severe.
They may include:
Arthritis of the spine can also narrow the openings that make space for the spinal cord and for the nerves that branch off the spinal cord (spinal nerves). This is called spinal stenosis. It can lead to pressure on the spinal cord or spinal nerves. This pressure can cause pain, weakness, or numbness.
Some medical conditions can cause symptoms similar to osteoarthritis.
One Man's Story:
"I thought the stiffness and pain in my hip was just from the stress I was putting on my muscles. But when I changed my exercise routine or stopped working out, the pain was still there ... The pain would come and go. It wasn't a sharp pain, but a kind of ache that would keep me awake a lot. I could never stay in one position for very long."—Steve
Osteoarthritis occurs when the cartilage that cushions your joints breaks down and wears away. When this happens, the bones rub together and cause damage and pain. In most cases, it takes years for cartilage to break down.
It's hard to know how fast arthritis may progress. You may not have any symptoms for years, until the bones and tissues become damaged. Or symptoms may come and go, stay the same, or get worse over time.
Arthritis can cause problems in any joint in the body. But in most cases, you'll have symptoms in only one or two joints or groups of joints. Arthritis may cause problems in your hands, hips, knees, or feet, and sometimes in your spine. At first, you may only feel pain when you're active. As the disease gets worse, you may also feel pain when you're at rest.
If you have arthritis in your fingers, the joints at the tip or middle part of your fingers may get bigger and form bumps. These are known as Heberden's and Bouchard's nodes.
Even though there is no cure for arthritis, most people can manage their symptoms with medicine and lifestyle changes. But in a few people, arthritis may get so bad that they decide to have surgery to replace the worn joint or to fuse the bones together so that the joint won't bend.
Learn about the complications of arthritis.
Things that can increase your risk for osteoarthritis are called risk factors. Some risk factors, such as your age or family history, can't be changed or prevented.
You may be able to reduce other risk factors by making lifestyle changes or taking medicine.
Risk factors you may be able to change or prevent include:
Risk factors you can't change include:
Some medical problems have symptoms that are similar to osteoarthritis, so it's important that you get the right diagnosis. Call your doctor if you have:
If you have mild joint pain and stiffness, try home treatment first. If you don't feel better in 6 weeks, or if you have other symptoms, call your doctor.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
In most cases, your doctor can tell you if you have osteoarthritis and recommend treatment based on your symptoms and by doing a physical examination. Your doctor may also do some other tests to be sure that the diagnosis is correct or to rule out other other conditions that have similar symptoms.
These tests may include:
Other tests may include a urine test and one or more blood tests, such as:
Even though there is no cure for osteoarthritis, treatment can help reduce your symptoms and make it possible for you to lead a full and active life.
The goals of treatment are to:
Treatment is based on:
In most cases, people who have mild to moderate arthritis can manage their symptoms for many years with a treatment plan that may include:
Some people with arthritis also feel down or depressed. They may describe this as feeling "depressed," "unhappy," "short-tempered," "blue," or "down in the dumps." If you feel like this most of the time, tell your doctor. Treating these symptoms may help you feel better and make it easier for you to do your daily tasks.
If the pain and stiffness from arthritis don't get better or they get worse, your doctor may recommend:
If your pain is very bad, you may decide to have surgery to replace the joint. Or you may decide to have some other kind of surgery that can help keep your joints moving well and prevent your arthritis from getting worse.
Some types of surgery include:
For help deciding whether to have joint replacement surgery, see:
You can take steps to help prevent osteoarthritis. If you already have arthritis, these same steps may keep it from getting worse.
When you have osteoarthritis, you may find it hard to do your daily tasks. Your joints may ache or feel stiff, and they may hurt when you move. You can do some things at home to feel better.
One Woman's Story:
"Gardening books and magazines always have wonderful ideas and innovations that you can use. For instance, I've cut off sections of the rubber insulation that is used to cover water pipes and slipped them over any of the garden tools that I'm going to use, because it gives me a little more cushion and a little extra width for my tools."—Bev
Living with arthritis can be stressful. At times you may feel overwhelmed, tired, and angry. And you may worry about what your life may be like as your condition gets worse. These feelings are normal. But there are a lot of ways to cope with arthritis. For example, ask for help when you need it, keep a positive attitude, and join a support group.
If you are caring for someone who has arthritis, be sure to take time to care for yourself and find ways to manage stress. Being a caregiver isn't easy. But it can be rewarding, especially when you know that your care makes a positive difference in someone's life.
For more information on coping and support, see the topics:
Medicine can help reduce your symptoms of osteoarthritis and allow you to do your daily activities.
The goal of medicine is to:
The type of medicine depends on how bad your pain is. For instance:
Medicines used to treat arthritis include:
Here are a few things to think about:
Medicines that work for some people don't work for others. Be sure to let your doctor know if the medicine you're taking doesn't help. You may need to try several kinds of medicines to find one that works for you.
Here are a few things to think about:
In most cases, people can manage their osteoarthritis symptoms with medicine and lifestyle changes. But surgery may be an option if:
One Man's Story:
"I wasn't sure about having surgery since I was so young. I had heard that an artificial hip could give out in 10 to 20 years ... But when the medicine I was taking stopped working, I figured I had gone as far as I could go with this, and decided to go ahead with the surgery ... It's a strange feeling to be able to walk without a limp and to walk up and down stairs without grabbing on to the railing."—Steve
Types of surgery for arthritis include:
A newer procedure for arthritis of the knee uses a small cup shaped like a "C." It's placed in the joint space of the inner knee and acts as a cushion for the joint. It may help delay surgery to replace the knee.
If you're in poor health or have certain health problems, you may not be able to have surgery. Your doctor can help you decide if surgery is right for you.
Here are some things to think about if you're thinking about surgery:
For help deciding whether to have joint replacement surgery, see:
In the days or weeks before your surgery, talk to your doctor about what you need to do to get ready for your return home. For example, you may need to arrange for someone to drive you home and to help you after your surgery. Or you may need to make changes to your home, such as removing small rugs, to help you move around.
Nearly 4 out of 10 people use some form of complementary and alternative medicine to treat certain health problems, including osteoarthritis.8 Some people use these treatments along with or, in some cases, in place of standard care to help relieve their arthritis symptoms.
Some of these treatments may help you move more easily and deal with the stress and pain of arthritis. But in some cases, not much is known about how safe they are or how well they may work.
Be sure to tell your doctor if you're using a complementary or alternative therapy or if you're thinking about trying one. He or she can discuss the possible benefits and potential side effects of these treatments and whether any of these treatments may interfere with your standard care. For example, some diet supplements and herbal medicines may cause problems if you take them with another medicine.
Complementary and alternative medicines that some people may use for arthritis include:
Other treatments to consider
One Woman's Story:
"After I have a massage and acupuncture, I feel like a new person. I encourage people to find out what treatments others have tried and what things have worked for them. I'm a believer in other people's ideas. Obviously, what works for one person may not work for another, but unless you try it, you'll never know if it'll help."—Bev
There are many treatments for arthritis, but what works for someone else may not work for you. You may need to try several different treatments to find what works for you.
Experts are testing new medicines and methods that they hope will one day help prevent, reduce, or repair cartilage damage. For example, they're looking at cartilage transplants and the use of stem cells to grow new cartilage. So far, therapies to repair cartilage have only been studied in younger people with small, well-defined holes in their knee cartilage. This isn't a common problem for most older adults who have arthritis of the knee.
|American College of Rheumatology|
|2200 Lake Boulevard NE|
|Atlanta, GA 30319|
The American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP, a division of ACR) are professional organizations of rheumatologists and associated health professionals who are dedicated to healing, preventing disability from, and curing the many types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members of the ACR are physicians; members of the ARHP include research scientists, nurses, physical and occupational therapists, psychologists, and social workers. Both the ACR and the ARHP provide professional education for their members.
The ACR website offers patient information fact sheets about rheumatic diseases, about medicines used to treat rheumatic diseases, and about care professionals.
|P.O. Box 7669|
|Atlanta, GA 30309|
The Arthritis Foundation provides grants to help find a cure, prevention methods, and better treatment options for arthritis. It also provides a large number of community-based services nationwide to make living with arthritis easier, including self-help courses; water- and land-based exercise classes; support groups; home study groups; instructional videotapes; public forums; free educational brochures and booklets; the national, bimonthly consumer magazine Arthritis Today; and continuing education courses and publications for health professionals.
|Arthritis Society of Canada|
|393 University Avenue|
|Toronto, ON M5G 1E6|
The Arthritis Society provides funding for arthritis research and offers information on patient care, public education, and self-management of arthritis.
|Canadian Orthopaedic Association|
|4150 St. Catherine Street West|
|Westmount, QC H3Z 2Y5|
|U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health|
|1 AMS Circle|
|Bethesda, MD 20892-3675|
|Phone:||1-877-22-NIAMS (1-877-226-4267) toll-free|
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is a governmental institute that serves the public and health professionals by providing information, locating other information sources, and participating in a national federal database of health information. NIAMS supports research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases and supports the training of scientists to carry out this research.
The NIAMS website provides health information referrals to the NIAMS Clearinghouse, which has information packages about diseases.
- Messier SP, et al. (2005). Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis and Rheumatism, 52(7): 2026–2032.
- Messier SP, et al. (2004). Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: The arthritis, diet, and activity promotion trial. Arthritis and Rheumatism, 50(5): 1501–1510.
- Messier SP, et al. (2000). Long-term exercise and its effect on balance in older, osteoarthritic adults: Results from the Fitness, Arthritis, and Seniors Trial (FAST). Journal of the American Geriatrics Society, 48(2): 131–138.
- McCarthy CJ, et al. (2004). Supplementing a home exercise programme with a class-based exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis. Rheumatology, 43(7): 880–886.
- Lozada CJ (2009). Management of osteoarthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 2, pp. 1563–1577. Philadelphia: Saunders Elsevier.
- Towheed TE, et al. (2006). Acetaminophen for osteoarthritis. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.
- Laupattarakasem W, et al. (2008). Arthroscopic debridement for knee osteoarthritis (Review). Cochrane Database of Systematic Reviews (3).
- Barnes PM, et al. (2008). Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Report #12. Hyattsville, MD: National Center for Health Statistics.
- Foster NE, et al. (2007). Acupuncture as an adjunct to exercise-based physiotherapy for osteoarthritis of the knee: Randomised controlled trial. BMJ. Published online August 15, 2007 (doi:10.1136/bmj.39280.509803.BE).
- Manheimer E, et al. (2007). Meta-analysis: Acupuncture for osteoarthritis of the knee. Annals of Internal Medicine, 146(12): 868–877.
Other Works Consulted
- American Academy of Orthopaedic Surgeons (2007). Activities after a knee replacement. Available online: http://orthoinfo.aaos.org/topic.cfm?topic=a00357.
- American Academy of Orthopaedic Surgeons (2008). Treatment of Osteoarthritis of the Knee (Non-arthroplasty): Full Guideline. Available online: http://www.aaos.org/Research/guidelines/OAKguideline.pdf.
- American Academy of Orthopaedic Surgeons (2009). Activities after hip replacement. Available online: http://orthoinfo.aaos.org/topic.cfm?topic=a00356.
- Boureau F, et al. (2004). The IPSO study: Ibuprofen, paracetamol study in osteoarthritis. A randomised comparative clinical study comparing the efficacy and safety of ibuprofen and paracetamol analgesic treatment of osteoarthritis of the knee or hip. Annals of the Rheumatic Diseases, 63(9): 1028–1034.
- Davis P, Juby A (2007). Osteoarthritis. In J Gray, ed., Therapeutic Choices, 5th ed., pp. 939–954. Ottawa: Canadian Pharmacists Association.
- Dunlop DD, et al. (2011). Physical activity levels and functional performance in the Osteoarthritis Initiative. Arthritis and Rheumatism, 63(1): 127–136.
- Felson DT, et al. (2004). The effect of body weight on progression of knee osteoarthritis is dependent on alignment. Arthritis and Rheumatism, 50(12): 3904–3909.
- Lin EHB, et al. (2003). Effect of improving depression care on pain and functional outcomes among older adults with arthritis: A randomized controlled trial. JAMA, 290(18): 2428–2434.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (2010). Handout on Health: Osteoarthritis. Available online: http://www.niams.nih.gov/Health_Info/Osteoarthritis/default.asp.
- Oesch PR, Bachmann S (2009). Introduction to physical medicine and rehabilitation. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 1, pp. 1023–1033. Philadelphia: Saunders Elsevier.
- Peak EL, et al. (2005). The role of patient restrictions in reducing the prevalence of early dislocation following total hip arthroplasty. Journal of Bone and Joint Surgery, 87-A(2): 847–853.
- Subcommittee on Osteoarthritis Guidelines, American College of Rheumatology (2000). Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis and Rheumatism, 43(9): 1905–1915.
- Zhang W, et al. (2004). Does paracetamol (acetaminophen) reduce the pain of osteoarthritis? A meta-analysis of randomised controlled trials. Annals of the Rheumatic Diseases, 63(8): 901–907.
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Primary Medical Reviewer||Andrew Swan, MD, CCFP, FCFP - Family Medicine|
|Specialist Medical Reviewer||Stanford M. Shoor, MD - Rheumatology|
|Last Revised||June 6, 2011|
Last Revised: April 6, 2012
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