Introduction to osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis. It has been estimated that more than 27 million Americans have the condition, which primarily affects people who are 60 years of age or older.

OA is called “wear-and-tear” arthritis. It typically comes with aging and results from joints being used over time. With OA of the knee, the cartilage — cushiony material between the bones of the knee joint — wears away, and bone begins to rub against bone. This friction causes irritation, which can be very painful. In some cases, a grinding noise occurs when the joint moves.

Osteoarthritis most often involves the joints that bear most of your body weight (weight-bearing joints), such as the knees or hips. In many cases, only one joint hurts. OA can also occur in any other joint, such as the middle and lower spine or the joints in the hands and fingers.

It has been estimated by the Center for Disease Control that nearly 1 in every 2 people develop symptoms of OA of the knee by age 85. The symptoms may vary from person to person. For most, the joint damage occurs gradually over many years, and as it does, the pain usually increases. But it also may progress quickly. In some people, OA is relatively mild and does not interfere much with daily life. Others may experience significant pain and disability.


How is osteoarthritis diagnosed?

To make a diagnosis, your health care provider will:

  • Ask about your medical history. Be prepared to tell your provider about your level of pain, symptoms, and any other medical issues. One of the most common early signs of osteoarthritis is stiffness in the morning that lasts 20 to 30 minutes, and gets better throughout the course of the day.
  • Perform a physical exam. To assess the condition of your joints, your health care provider will examine them and have you move them. You might be asked to walk around the room to determine if the knee and/or hip joints are affected. Your provider may also check the flexibility and alignment of your neck and spine to see if those are affected as well.  It’s important to remember that your neck and spine have joints, too.
  •  Order laboratory tests and X-rays to confirm the diagnosis, if needed. Blood laboratory tests typically are not useful in diagnosing OA; however, they may be important in distinguishing OA from other types of arthritis. Your health care provider will also likely order X-rays to find out if there’s damage to bone or cartilage, to determine how severe it is, and to rule out other conditions. Signs that OA is affecting your bones include the appearance of bony growths (“spurs”) and decreased space between the joints.


Four goals of osteoarthritis treatment

There’s no known cure for OA, since, as mentioned, it’s usually the result of wear and tear. But you can take steps to reduce its effects and slow its progression. A medical plan for treating OA will help you to:

  • Control pain – If pain prevents activity, it could worsen stiffness that often occurs.  Additionally, overall quality of life may be decreased with poorly controlled OA pain.
  • Maintain or improve joint function – Activity is often one of the best “treatments” for OA.
  • Maintain a normal body weight (especially if weight-bearing joints are affected) – Being overweight can make symptoms of OA worse.
  • Achieve an overall healthy lifestyle – This is often useful for all types of pain conditions.  A healthy lifestyle can create a healthy body.


How is osteoarthritis treated?

Although each person’s treatment plan is different, common treatments for OA usually involve a combination of the following approaches:

  • Exercise: Studies indicate that moving your body can alleviate OA symptoms and maintain or even, in some cases, improve flexibility. A wide range of activities — strengthening, aerobic, balance, and range of motion — have been found to help. Talk to your provider about what’s best for you.
  • Weight control: Losing weight can reduce the stress on your weight-bearing joints. Your provider or a nutritionist can help you assess your diet and put together a healthy, manageable eating plan.
  • Rest: Scheduling breaks and getting plenty of rest can take some of the pressure off your joints. At the same time, OA pain can make it difficult to relax. Consult your provider if your OA symptoms interfere with rest.
  • Non-medication pain relief: There are a number of ways to treat OA pain without medication, such as massage, acupuncture, and hot and cold therapy. Ask your health care provider about which methods might be most effective for your symptoms.
  • Pain medication: Your health care provider may recommend an over-the-counter and/or prescription medicine to help control your pain. Talk to your health care provider or pharmacist about possible side effects and how any medication may affect other OA treatments, or other medications you take for other reasons.
  • Surgery: Depending on the join affected, joint replacement can alleviate pain and improve flexibility, function, and your overall quality of life. Most often, your health care provider will offer surgery only when other treatments no longer work and/or your pain and mobility are getting worse, severely impacting your quality of life.  This point is often different for everyone, and will be an individualized decision.