Information - Osteoarthritis
Osteoarthritis (OA) is the most common form of arthritis. It's also known as degenerative joint disease or “wear and tear” arthritis. As the body attempts to strengthen the joint damaged by osteoarthritis, it tries to repair itself by growing new bone. However, this leads to the formation of bumps of new bone growth surrounding the joint, which causes joint stiffness and pain.
In patients with osteoarthritis, the cartilage within a joint breaks down, causing changes in the underlying bone. Over time, a patient experiences worsening joint pain, swelling and stiffness. Some people are able to function well, while others find it difficult to do daily tasks.
The most commonly affected joints include the:
- Hands (most often the ends of the fingers and base/ends of the thumbs)
- Lower back
Who Gets Osteoarthritis?
Osteoarthritis is most common in people who are 50 years or older. It's more common in women than in men. Other risk factors for OA include:
- Being overweight or obese
- Joint injury
- Excessive use of a joint
Although the reason is not well understood, osteoarthritis can run in families, especially when it affects joints in the hands.
Diagnosis of Osteoarthritis
While you may work with a rheumatologist to manage your osteoarthritis, your family physician may be the one to diagnose it by taking your medical history, doing a physical assessment and sending you for blood tests and x-rays.
Because there are about 100 different types of osteoarthritis, it can be difficult to distinguish this disease from other forms of arthritis. Blood tests can help rule out other conditions.
The changes in joints caused by osteoarthritis can often be identified in x-ray images.
Symptoms of Osteoarthritis
Depending on the severity of your osteoarthritis, you may experience a range of symptoms. Some people maintain good mobility and flexibility, while others find it difficult to perform daily tasks.
The most commonly affected joints are the knees and the hips, although other joints can also be affected, including the base of the big toe or thumb, the end joints or middle joints of fingers or the neck and low back.
For many people, osteoarthritis begins with one or a few joints, and symptoms begin slowly. OA symptoms can include:
- Joint stiffness that generally lasts less than 30 minutes, especially in the morning or after periods of rest.
- Swelling in the joint.
- Decreased range of motion.
- Pain when using the joint, which may be worse at night. In some patients, joint pain may get better with rest.
- Inability to properly move the joint, or feeling like the joint is "loose".
Treatments for Osteoarthritis
When it comes to treating osteoarthritis, the earlier the better, because once a joint is damaged, the damage can't be reversed. It's important to keep joints moving in order to stay mobile and decrease joint pain.
In many cases, physicians will use a multimodal approach that combines different treatments to treat osteoarthritis.
In most cases, the medications used for osteoarthritis help control pain. Medications used to treat OA include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. There are about 20 different NSAIDs available.
- Analgesics and opioids (pain killers). Non-prescription analgesic medications such as acetaminophen can help control pain in some patients, and are safe to use long-term.
- Opioids. If your osteoarthritis isn't well controlled with NSAIDs or analgesics, stronger opioids such as morphine or oxycodone may be prescribed. However, patients must use them with caution because they can cause dependence.
- Corticosteroid injections directly into the joint for pain and swelling. While they can be effective for some patients, they're generally limited to three or four per joint per year.
Other osteoarthritis treatments include:
- Physiotherapy. Exercises and stretches can help you maintain mobility and prevent further joint damage.
- Weight loss. Even losing as few as 10 pounds can relieve OA pain in weight-bearing joints.
- In severe cases, surgery can be an option to help people improve mobility and restore functioning. Generally, surgery involves replacing a damaged joint with an artificial joint (usually the hip or knee).
Print this Action Plan and check off items that you want to discuss with your healthcare provider
Osteoarthritis is most common in the joints of the knees, hips, hands, fingers, neck and spine, although it can affect any joint in the body.
Osteoarthritis symptoms include pain, stiffness and swelling in joints, especially when getting up in the morning. If your OA is severe, you may feel pain for the entire day, or lose your ability to use the joint.
Even five or ten pounds of weight loss significantly reduces the strain across a weight-bearing joint, and can improve pain and reduce the need for joint replacement in the future.
Many individuals will not have any osteoarthritis symptoms. Others will have quite severe symptoms.
OA medications include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, acetaminophen and pain medications such as opioids.