Osteoarthritis (OA) is the most common chronic (long-lasting) joint condition.
A joint is where two bones come together. The ends of these bones are covered with protective tissue called cartilage. With OA, this cartilage breaks down, causing the bones within the joint to rub together. This can cause pain, stiffness, and other symptoms.
OA occurs most often in older people, although it can occur in adults of any age. OA is also called degenerative joint disease, degenerative arthritis, and wear-and-tear arthritis.
A leading cause of disability, OA affects more than in the United States. Here’s everything you need to know about OA, from treatment to prevention and more.
OA is caused by joint damage. This damage can accumulate over time, which is why age is one of the main causes of the joint damage leading to osteoarthritis. The older you are, the more wear and tear you’ve had on your joints.
Other causes of joint damage include past injury, such as:
- torn cartilage
- dislocated joints
- ligament injuries
They also include joint malformation, obesity, and poor posture. Certain risk factors, such as family history and gender, increase your risk of osteoarthritis.
Cartilage is a tough, rubbery substance that’s flexible and softer than bone. Its job is to protect the ends of bones within a joint and allow them to move easily against each other.
When cartilage breaks down, these bone surfaces become pitted and rough. This can cause pain within the joint, and irritation in surrounding tissues. Damaged cartilage can’t repair itself. This is because cartilage doesn’t contain any blood vessels.
When cartilage wears away completely, the cushioning buffer that it provides disappears, allowing for bone-on-bone contact. This can cause intense pain and other symptoms associated with OA.
OA can occur in any joint. However, the most commonly affected areas of the body include the:
The most common symptoms of osteoarthritis include:
- tenderness (discomfort when pressing on the area with your fingers)
As OA becomes more advanced, the pain associated with it may become more intense. Over time, swelling in the joint and surrounding area may also occur. Recognizing the early symptoms of OA can help you to better manage the condition.
OA is a progressive condition with five stages, from 0 to 4. The first stage (0) represents a normal joint. Stage 4 represents severe OA. Not everyone who has OA will progress all the way to stage 4. The condition often stabilizes long before reaching this stage.
People with severe OA have extensive or complete loss of cartilage in one or more joints. The bone-on-bone friction associated with this can cause severe symptoms such as:
- Increased swelling and inflammation. The amount of synovial fluid within the joint may increase. Normally, this fluid helps reduce friction during movement. However, in larger amounts, it can cause joint swelling. Fragments of broken-off cartilage may also float within the synovial fluid, increasing pain and swelling.
- Increased pain. You may feel pain during activities, but also when you’re at rest. You may feel an increase in your pain level as the day progresses, or more swelling in your joints if you’ve used them a lot throughout the day.
- Decreased range of motion. You may not be able to move as well, due to stiffness or pain in your joints. This can make it harder to enjoy the day-to-day activities that used to come easily.
- Joint instability. Your joints may become less stable. For instance, if you have severe OA in your knees, you may experience locking (sudden lack of movement). You may also experience buckling (when your knee gives out), which can cause falls and injury.
- Other symptoms. As a joint continues to wear down, muscle weakness, bone spurs, and joint deformity may also occur.
The joint damage caused by severe OA isn’t reversible, but treatment can help reduce symptoms.
OA and rheumatoid arthritis (RA) share the same symptoms but are very different conditions. OA is a degenerative condition, which means that it increases in severity over time. RA, on the other hand, is an autoimmune disorder.
People with RA have immune systems that mistake the soft lining around joints to be a threat to the body, causing it to attack that area. This soft lining, which includes the synovial fluid, is called the synovium. As the immune system launches its assault, fluid buildup within the joint occurs, causing stiffness, pain, swelling, and inflammation.
If you’re not sure which form of arthritis you have, your best bet is to talk to your doctor. But you can also do your own research.
OA is often a slow-developing disease that can be hard to diagnose until it starts to cause painful or debilitating symptoms. Early OA is often diagnosed after an accident or other incident that causes a fracture requiring an X-ray.
In addition to X-rays, your doctor may use an MRI scan to diagnose OA. This imaging test uses radio waves and a magnetic field to create images of bone and soft tissue.
Other diagnostic tests include a blood test to rule out other conditions that cause joint pain, such as RA. A joint fluid analysis can also be used to determine whether gout or infection is the underlying cause of inflammation.
OA treatment is centered upon symptom management. The type of treatment that will help you the most will largely be determined by the severity of your symptoms and their location. Often, lifestyle changes, over-the-counter (OTC) medication, and home remedies will be enough to provide you with relief from pain, stiffness, and swelling.
At-home treatments and lifestyle changes for OA include:
Physical activity strengthens the muscles around your joints and may help relieve stiffness. Aim for at least 20 to 30 minutes of physical movement, at least every other day. Choose gentle, low-impact activities, such as walking or swimming. Tai chi and yoga can also improve joint flexibility and help with pain management.
Being overweight can put strain on your joints and cause pain. Shedding excess pounds helps relieve this pressure and reduces pain. A healthy weight can also lower your risk of other health problems, such as diabetes and heart disease.
Resting your muscles can reduce swelling and inflammation. Be kind to yourself and don’t overdo it. Getting enough sleep at night can also help you to manage pain more effectively.
Heat and cold therapy
You can experiment with heat or cold therapy to relieve muscle pain and stiffness. Apply a cold or hot compress to sore joints for 15 to 20 minutes several times a day.
These practices can help take the edge off of your symptoms and improve your quality of life.
Gentle stretching exercises can be very helpful for people with OA, especially if you have stiffness or pain in your knees, hips, or back. Stretching can help improve mobility and range of motion.
As with any exercise plan, check with your doctor before beginning, to make sure it’s the right course of action for you.
There are a number of different types of OA medications that can help provide relief from pain or swelling. They include:
- Oral analgesics. Tylenol (acetaminophen) and other pain relievers reduce pain but not swelling.
- Topical analgesics. These OTC products are available as creams, gels, and patches. They help to numb the joint area and can provide pain relief, especially for mild arthritis pain.
- NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs such as Advil (ibuprofen) and Aleve (naproxen) reduce swelling as well as pain.
- Cymbalta. Your doctor may prescribe the antidepressant Cymbalta (duloxetine) for you off-label to help provide OA pain relief.
- Corticosteroids. These prescription medications are available in oral form. They may also be given by injection directly into a joint.
Your doctor may recommend you try OTC solutions as a first line of defense.
Alternative treatments and supplements may help to relieve symptoms such as inflammation and joint pain. Some supplements or herbs that may help include:
Other alternative treatment options include:
You should discuss with your doctor any herbs or supplements you’re considering before you use them. This will help ensure that they’re safe and effective, and won’t interfere with other medications you’re taking.
There’s no downside to eating healthy, but if you have OA, diet and nutrition are especially important.
First off, you’ll want to keep your weight in a normal range to reduce unnecessary pressure on your joints.
There’s also research suggesting that some types of OA, such as osteoarthritis of the knee, respond positively to a diet high in flavonoids, which are nutrients found in fruits and vegetables. Also, the antioxidants found in many fruits and vegetables may also help combat the free radicals produced by inflammation. Free radicals are molecules that can cause cell damage.
A high-quality diet may help provide relief from OA symptoms by reducing inflammation and swelling. Eating foods high in the following can be highly beneficial:
- vitamin C
- vitamin D
- omega-3 fatty acids
Increasing your intake of foods with anti-inflammatory properties will help, too.
Osteoarthritis can affect one or several areas of your hands. These areas often include the tips of the fingers, the middle knuckle of each finger, the joint connecting the thumb and the wrist, and the wrist itself. The joints that are affected largely determine the symptoms that occur. These symptoms often include:
- trouble moving your fingers
- reduced range of motion
- crunching sound when you move your fingers
- trouble gripping or holding onto objects
Women are more prone to OA in the hand than men, and usually get it at a younger age. Hand OA can have a big impact on your ability to do the tasks associated with day-to-day living. However, treatments ranging from lifestyle changes to surgery can help.
OA can occur in one or both hips. In this way it differs from RA, which usually occurs in both hips at the same time.
Hip OA is a slowly degenerative condition. Many people find that they’re able to combat their symptoms for many years by using medication, exercise, and physical therapy. Supports, such as canes, can also help.
If the condition worsens, steroid injections, other medications, or surgery can help provide relief. Alternative therapies can also help, and new technologies are on the horizon.
Like hip OA, knee OA can occur in one or both knees. Age, genetics, and knee injury may all play a role in knee OA.
Athletes who concentrate solely on one sport that creates extensive, repetitive motion, such as running or tennis, may be at increased risk of OA. Likewise, if you pursue only one type of physical activity, this may overuse some muscles and underuse others, causing weakness and instability in the knee joint. Varying your activities helps to work different muscle groups, allowing all the muscles around your knee to be strengthened.
Treatment for knee OA depends on the stage of the condition.
Wearing a brace around your knee can be an excellent nonsurgical treatment for knee OA. Braces can reduce swelling and pressure. They can also increase stability in your knee by shifting your weight away from the damaged part of your knee. This allows for greater mobility.
There are several types of knee braces. Some may be custom fitted for you, and others are available OTC. Your doctor may recommend that you try different kinds of braces for different activities.
The cervical spine is located in the neck and contains facet joints. These joints help to maintain flexibility in the spine, allowing for a full range of motion. When the cartilage around the facet joints starts to wear away, cervical OA results.
Cervical OA doesn’t always cause symptoms. If it does, symptoms can range from mild to severe and include:
- pain in your shoulder blade, down your arm, or in your fingers
- muscle weakness
- stiffness in your neck
- headache, mostly in the back of your head
- tingling or numbness down your arms or legs
Occasionally, more serious symptoms can occur, such as loss of bladder or bowel control, or loss of balance.
If you have back pain, you may have spinal osteoarthritis. This condition affects the facet joints located in the lower back and buttocks. Age and spine trauma are both potential factors in spinal OA. Women are more likely than men to get this condition. People who are overweight, or whose jobs require squatting and sitting, may also be at increased risk.
Spinal OA’s symptoms can vary in severity. They include:
- stiffness or tenderness in the joints in your back
- weakness, numbness, or tingling in your arms or legs
- reduced range of motion
It’s important to pay attention to these symptoms. If left untreated, spinal OA can worsen, causing more severe symptoms and disability.
You may have risk factors for OA that you can’t control, such as heredity, age, and gender. But other risk factors can be controlled, and managing them can help reduce your risk of OA.
The following tips can help you manage the risk factors under your control:
- Support your body. If you’re an athlete or an avid exerciser, make sure you care for your body. Wear athletic supports and shoes that reduce impact on your knees. Also make sure to vary your sports, so that all of your muscles get a workout, not just the same muscles every time.
- Watch your weight. Keep your body mass index (BMI) in the appropriate range for your height and gender.
- Keep a healthy diet. Eat a range of healthy foods, with a focus on fresh vegetables and fruits.
- Get enough rest. Give your body ample opportunities to rest and to sleep.
If you have diabetes, controlling your blood sugar can also help manage your risk of OA.
OA is a chronic condition that doesn’t have a cure, but with treatment, the outlook is positive. Don’t ignore symptoms of chronic joint pain and stiffness. The sooner you speak with your doctor, the sooner you can receive a diagnosis, begin treatment, and improve your quality of life.