Osteoarthritis

Osteoarthritis

Overview

What is arthritis?

Arthritis is inflammation (swelling) of the joints. It causes pain and usually also limits movement of the joints that are affected. There are many kinds of arthritis.

What is osteoarthritis?

Osteoarthritis (say: “oss-tee-oh-arth-rye-tis”) is the most common kind of arthritis. Osteoarthritis (also called degenerative joint disease) can affect any joint in your body and causes the cushion layer between your bones (called the cartilage) to wear away.

Causes & Risk Factors

What causes osteoarthritis?

The exact cause isn't known. Osteoarthritis may be hereditary, which means it runs in families. Osteoarthritis seems to be related to the wear and tear put on joints over the years in most people. But wear and tear alone don't cause osteoarthritis.

What happens when a joint is affected?

Normally, a smooth layer of cartilage acts as a pad between the bones of a joint. Cartilage helps the joint move easily and comfortably. In some people, the cartilage thins as the joints are used. This is the start of osteoarthritis. Over time, the cartilage wears away and the bones may rub against one another.

Bones may even start to grow too thick on the ends where they meet to make a joint, and bits of cartilage may loosen and get in the way of movement. This can cause pain, joint swelling and stiffness.

Who gets osteoarthritis?

Osteoarthritis is more common in older people because they have been using their joints longer. Using the joints to do the same task over and over or simply using them over time can make osteoarthritis worse.

Younger people can also get osteoarthritis. Athletes are at risk because they use their joints so much. People who have jobs that require the same movement over and over are also at risk. Injuries to a joint can increase the risk of arthritis in the joint later on. Excess weight also can accelerate arthritis in the knees, hips and spine.

Diagnosis & Tests

How can my doctor tell if I have osteoarthritis?

Your doctor will ask you questions about your pain. He or she will probably ask you if your joint pain gets worse with activity and better with rest. Your doctor will examine you to see if you have trouble moving your joint. Your doctor may also order an X-ray of the joint that is causing you problems to see what is causing the pain. Blood tests can help rule out other forms of arthritis.

Treatment

Is there a treatment?

No cure for osteoarthritis has been found. But the right plan can help you stay active, protect your joints from damage, limit injury and control pain. Your doctor will help you create the right plan for you.

Will my arthritis get worse?

Osteoarthritis does tend to get worse over time. But you can do many things to help yourself.

It's important to stay as active as possible. When joints hurt, people tend not to use them and the muscles get weak. This can cause the joint to work less effectively and it can make it harder to get around. This causes more pain and the cycle begins again. Talk to your doctor about ways to control your pain so that you can stay active and avoid this problem.

Tips on staying active

  • Lose weight if you're overweight.
  • Exercise regularly for short periods.
  • Go to a physical therapist if you can.
  • Use canes and other special devices to protect your joints.
  • Avoid lifting heavy things.
  • Avoid overusing your joints.
  • Don't pull on objects to move them -- push them instead.
  • Take your medicine the way your doctor suggests.
  • Use heat and/or cold to reduce pain or stiffness.

Will medicine help?

Over-the-counter medicines are medicines you can buy without a doctor's prescription. Some of these, such as nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce inflammation, or pain relievers can help you feel better. NSAIDs include aspirin, ibuprofen (one brand name: Motrin) and naproxen (one brand name: Aleve). Acetaminophen (one brand name: Tylenol) is a common pain reliever. Your doctor can also prescribe medicine for you, such as prescription pain relievers or prescription NSAIDs used to treat certain types of arthritis. NSAIDs can help by reducing inflammation, swelling and pain in the joints, but not everyone can take them.

Medicine should be used wisely. You only need the amount that makes you feel good enough to keep moving. Using too much medicine may increase the risk of side effects.

Can special devices really help?

Yes. Special devices (see box below) and different ways of doing things can help people who have arthritis stay independent for as long as possible. These devices help protect your joints and keep you moving.

For example, if you learn to use a cane the right way, you can help reduce the amount of pressure your weight puts on your hip joint when you walk by up to 60%. Talk to your doctor if you think a special device may help your arthritis.

Special devices for people who have arthritis

  • Canes, walkers and splints
  • Shoe inserts, wedges or pads
  • Special fasteners (such as Velcro) on clothing
  • Large grips for tools and utensils (wrap foam or fabric around items with narrow handles, like pens)
  • Wall-mounted jar openers
  • Electric appliances, such as can openers and knives
  • Mobile shower heads
  • Bath seats and grab bars for the bathtub

Will special exercises really help?

Yes. Exercise keeps your muscles strong and helps you stay flexible. Exercises that don't strain your joints are best. To avoid pain and injury, choose exercises that can be done in small amounts with rest time in between. Dancing, weight lifting and bike riding are good exercises for people who have arthritis.

Try tightening your muscles and then relaxing them a number of times. You can do this with all of your major muscle groups. You could also try an "aquacise" program available through your local swimming pool or community center. These programs involve special movements in the pool, with much of your body's weight held up by water.

Talk to your doctor before starting a new exercise program.

Should I use heat to ease pain?

Using heat may reduce your pain and stiffness. Heat can be applied through warm baths, hot towels, hot water bottles or heating pads. Try alternating heat with ice packs.

Other Organizations

Questions to Ask Your Doctor

  • I'm an athlete. Am I at risk for osteoarthritis?
  • I'm only __ years of age. Could I really have osteoarthritis at my age?
  • Is it safe for me to exercise? What kind of exercise should I do?
  • What medicines can help relieve my pain?
  • Is it safe for me to take a pain reliever every day?
  • Would I benefit from a weight-loss plan?
  • Could alternative therapies, such as yoga or acupuncture, help relieve my pain?
  • Will I need surgery?

Bibliography

Intra-articular Hyaluronic Acid Injections for Knee Osteoarthritis by DY Wen, M.D. (American Family Physician August 01, 2000, http://www.aafp.org/afp/20000801/565.html)

Shoulder Osteoarthritis: Diagnosis and Management by Peter J. Millett, MD, Reuben Gobezie, MD, and Robert E. Boykin, MD (American Family Physician September 01, 2008, http://www.aafp.org/afp/20080901/605.html)

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