Osteoarthritis: Symptoms, Causes, and Treatment

What is Osteoarthritis?

Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of your bones wears down over time. While osteoarthritis can damage any joint, it most commonly affects joints in your hands, knees, hips, and spine.

Osteoarthritis is often referred to as a "wear and tear" disease, but it's more than just the result of aging. It's a complex process involving the entire joint, including the cartilage, joint lining, ligaments, and underlying bone. The disease develops slowly and worsens over time, leading to pain, stiffness, and reduced mobility.

Source: Mayo Clinic

Common Causes

While the exact cause of osteoarthritis is unknown, several factors can increase your risk of developing the condition:

• Aging: The risk of osteoarthritis increases with age, as the cartilage becomes less able to repair itself.
• Joint injury or overuse: Injuries, such as those sustained during sports or from an accident, can increase the risk of osteoarthritis. Overusing a joint through repetitive movements can also lead to OA.
• Obesity: Carrying extra body weight puts added stress on weight-bearing joints, such as the knees and hips, increasing the risk of OA.
• Genetics: Some people inherit a tendency to develop osteoarthritis.
• Gender: Women are more likely to develop osteoarthritis, especially after menopause.
• Bone deformities: Some people are born with malformed joints or defective cartilage, which can increase the risk of OA.
• Certain metabolic diseases: Conditions like diabetes and hemochromatosis (a condition where your body has too much iron) can increase the risk of OA.
• Other types of arthritis: People with rheumatoid arthritis, the second most common type of arthritis, are more likely to develop osteoarthritis.

Source: Arthritis Foundation

Associated Symptoms

Osteoarthritis symptoms often develop slowly and worsen over time. The most common symptoms include:

• Pain: Affected joints might hurt during or after movement.
• Stiffness: Joint stiffness may be most noticeable upon awakening or after being inactive.
• Tenderness: Your joint might feel tender when you apply light pressure to or near it.
• Loss of flexibility: You might not be able to move your joint through its full range of motion.
• Grating sensation: You might feel a grating sensation when you use the joint, and you might hear popping or crackling.
• Bone spurs: These extra bits of bone, which feel like hard lumps, can form around the affected joint.
• Swelling: This might be caused by soft tissue inflammation around the joint.

Source: NHS

When to See a Doctor

If you have joint pain or stiffness that doesn't go away, make an appointment with your doctor. While there's no cure for osteoarthritis, treatments can help reduce pain and maintain joint movement. It's especially important to see a doctor if:

• Your pain is severe and interferes with your daily activities.
• You experience sudden, unexplained joint pain.
• Your joint pain is accompanied by swelling, redness, or warmth around the joint.
• You have difficulty moving the joint or putting weight on it.

Source: CDC

Diagnosis

Your doctor will likely perform a physical exam and review your symptoms and medical history. They may also recommend the following tests:

• Imaging tests:
  • X-rays: Cartilage doesn't show up on X-ray images, but cartilage loss is revealed by a narrowing of the space between the bones in your joint. An X-ray can also show bone spurs around a joint.
  • MRI: An MRI uses radio waves and a strong magnetic field to produce detailed images of bone and soft tissues, including cartilage. It's not commonly needed to diagnose osteoarthritis but can help provide more information in complex cases.
• Lab tests:
  • Blood tests: While there's no blood test for osteoarthritis, certain tests can help rule out other causes of joint pain, such as rheumatoid arthritis.
  • Joint fluid analysis: Your doctor might use a needle to draw fluid from the affected joint. Examining and testing the fluid from your joint can determine if there's inflammation and if your pain is caused by gout or an infection.

Source: Mayo Clinic

Treatment Options

Osteoarthritis treatment focuses on relieving symptoms and improving joint function. You might not need treatment if your symptoms are mild. However, if symptoms are affecting your quality of life, treatments can help.

Medications

Medications that can help relieve osteoarthritis symptoms, primarily pain, include:

• Acetaminophen: This can relieve pain but doesn't reduce inflammation. It's generally well-tolerated but can cause liver damage if taken in excess.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These include over-the-counter options like ibuprofen and naproxen sodium, as well as prescription-strength NSAIDs. They can relieve pain and reduce inflammation but may cause stomach upset, cardiovascular problems, bleeding, and liver and kidney damage.
• Duloxetine (Cymbalta): This antidepressant is also approved to treat chronic pain, including osteoarthritis pain.

Therapy

• Physical therapy: A physical therapist can work with you to create an individualized exercise program that will strengthen the muscles around your joint, increase your range of motion, and reduce pain.
• Occupational therapy: An occupational therapist can help you discover ways to do everyday tasks without putting extra stress on your already painful joint. They can also teach you how to use assistive devices to reduce pain.
• Transcutaneous electrical nerve stimulation (TENS): This uses a low-voltage electrical current to relieve pain. It's not clear yet how well TENS works for osteoarthritis, but it might be worth trying if other treatments haven't helped.

Surgical and other procedures

• Cortisone injections: Injections of corticosteroid medications may relieve pain in your joint. During this procedure, your doctor numbs the area around your joint, then places a needle into the space within your joint and injects medication. The number of cortisone injections you can receive each year is generally limited to three or four injections, because the medication can worsen joint damage over time.
• Lubrication injections: Injections of hyaluronic acid might offer pain relief by providing some cushioning in your knee, though some research suggests these injections offer no more relief than a placebo. Hyaluronic acid is similar to a component normally found in your joint fluid.
• Realigning bones: If osteoarthritis has damaged one side of your knee more than the other, an osteotomy might be helpful. In a knee osteotomy, a surgeon cuts across the bone either above or below the knee and then removes or adds a wedge of bone. This shifts your body weight away from the worn-out part of your knee.
• Joint replacement: In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surfaces and replaces them with plastic and metal parts. Surgical risks include infections and blood clots. Artificial joints can wear out or come loose and may need to eventually be replaced.

Lifestyle and home remedies

• Exercise: Low-impact exercises, such as walking, cycling, or swimming, can increase your endurance and strengthen the muscles around your joint, making your joint more stable. Try to avoid exercises that put stress on your painful joints, such as running or jumping.
• Lose weight: If you're overweight or obese, losing weight can reduce stress on your weight-bearing joints and limit future joint injury.
• Use heat and cold: Both heat and cold can relieve pain in your joint. Heat also relieves stiffness, and cold can relieve muscle spasms and pain.
• Use assistive devices: Assistive devices can make it easier to go about your day without stressing your painful joint. A cane can take weight off your knee or hip as you walk. Carrying things in a backpack or using a walker or scooter can also help.

Source: Mayo Clinic

Prevention Tips

While you can't always prevent osteoarthritis, you can take steps to reduce your risk:

• Maintain a healthy weight: Extra weight puts more stress on weight-bearing joints, such as your hips and knees. Even a small amount of weight loss can relieve some pressure and reduce your risk of osteoarthritis.
• Control your blood sugar: High blood sugar levels can increase your risk of osteoarthritis, as well as make the condition worse. Managing your blood sugar can help reduce your risk.
• Get active: Regular, low-impact exercise can help keep your joints healthy. Aim for at least 150 minutes of moderate-intensity aerobic activity each week, such as walking, cycling, or swimming.
• Stretch: Gentle stretching can help improve your range of motion and reduce your risk of injury.
• Avoid injury: Try to avoid activities that put excessive stress on your joints. If you do suffer an injury, see your doctor and follow their recommendations for recovery to avoid further damage.
• Protect your joints: Use proper techniques when lifting, carrying, or performing other tasks to avoid putting unnecessary stress on your joints.

Source: Arthritis Foundation

Emergency Warning Signs

While osteoarthritis is generally not a medical emergency, there are certain warning signs that require immediate medical attention:

• Sudden, severe joint pain: If you experience sudden, severe pain in a joint, especially if it's accompanied by swelling, redness, or warmth, seek medical attention immediately. This could be a sign of a fracture, infection, or other serious condition.
• Inability to move the joint: If you're unable to move a joint or put weight on it, see a doctor right away.
• Joint deformity: If a joint appears deformed or out of place, seek immediate medical attention.
• Fever: If you have a fever along with joint pain and swelling, it could be a sign of an infection or other serious condition that requires prompt treatment.

If you experience any of these emergency warning signs, go to the nearest emergency room or call your local emergency number immediately.

Source: NHS