Osteoarthritis (degenerative joint disease) is an illness in which joints get inflamed, painful and stiff. It usually affects the knees, hips, hands, and spine. These joints contain cartilage, the substance that cushions the spot where two bones meet. As osteoarthritis develops, cartilage loses the ability to cushion the joint and bones rub together. In advanced disease, cartilage completely deteriorates (degenerates).
Osteoarthritis cannot be cured, but keeping to a normal weight and exercising regularly may help delay the start of the disease and improve flexibility. Avoid strenuous activities and contact sports.
The causes are aging, injury, trauma, obesity, and other factors. Osteoarthritis is very common when people reach their 70s. It affects both men and women, but women more than men.
Osteoarthritis develops slowly. Pain may be the first symptom. It usually gets worse with exercise and stops during rest. Over time, movement is limited and affected joints are less flexible. Stiffness occurs in the morning but goes away after moving around and joints warm up. As osteoarthritis gets worse, joints become tender and lose their ability to bend. People may have a grating feeling when moving.
The health care provider makes a diagnosis from the symptoms and physical examination. The health care provider may also take joint x-rays to confirm the diagnosis and if surgical treatment is being considered.
Treatment goals are to control pain and prevent more joint degeneration. The kind of treatment depends on the severity of the changes in the joints and lifestyle. Acetaminophen may control symptoms of mild disease. Nonsteroidal antiinflammatory drugs (NSAIDs) may be prescribed for more severe pain. Using heat and cold may help relieve some symptoms. Heating pads or warm soaks may help early morning stiffness. Cold packs reduce swelling and inflammation and are very useful after physical activity.
For a more severe form of osteoarthritis, the health care provider may prescribe physical therapy to help maintain use of the joints. Low-impact exercises such as swimming and cycling are good for maintaining muscle strength and flexibility. Lifestyle changes to keep to a healthy weight are very important. Injections of cortisone and other substances into the joints may also be used for mobility. Viscosupplementation involves injecting the substance called hyaluronic acid, which is a natural part of the fluid that lubricates joints. These treatments can be very expensive and may not work well. Assistive devices such as canes or braces may be used to minimize stress on knees.
Surgery is used for severe disease that isn’t helped by other treatments. It can include joint replacement, cleaning up the area inside near the joint, and fusing bones.
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