Osteoarthritis

What is Osteoarthritis?

It is sometimes called degenerative joint disease or osteoarthrosis, and is the most common form of arthritis.

It occurs when the cartilage in your joints wears down over time.

It can affect any joint in your body, but it is common in hands, hips, knees and spine.

Usually it will just affect one joint, but in some cases such as with finger arthritis, several joints can be affected.

It slowly gets worse with time, and no cure exists. But there are treatments that can relieve the pain and help you remain active. Taking the correct steps to actively manage your osteoarthritis may help you gain control over your pain.

What are the Symptoms of Osteoarthritis?

Arthritic symptoms often develop slowly and worsen over time. The most common signs and symptoms of include:

• Pain in a joint during or after use, or after a period of inactivity.


• Tenderness in the joint when you apply light pressure.


• Stiffness in a joint, that may be most noticeable when you wake up in the morning or after a period of inactivity.


• Loss of flexibility may make it difficult to use the joint.


• Grating sensation when you use the joint.


• Bone spurs which appear as hard lumps, may form around the affected joint.


• Swelling in some cases.

What are Some Causes of Osteoarthritis?

It occurs when the cartilage that cushions the ends of bones in your joints deteriorates over time. The smooth surface of the cartilage becomes rough, causing irritation.

Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone, causing the ends of your bones to become damaged and your joints to become painful.

It isn't clear what causes osteoarthritis in most cases. Researchers suspect that it's a combination of factors, including being overweight, the aging process, joint injury or stress, heredity, and muscle weakness.

What are Some Treatments for Osteoarthritis?

There is no known cure, but treatments can help reduce pain and maintain joint mobility so that you can go about your daily activities. While medications and joint replacement surgery are key components of treatment for osteoarthritis, your doctor will likely recommend that you try all other possible solutions before you consider those options.

Initial Treatment Options For Mild Osteoarthritis

For pain that is bothersome, but not enough to have a major impact on your daily activities, your doctor may recommend that you:

• Rest: If you're experiencing pain or inflammation in your joint, rest it for 12 to 24 hours. Try to find activities that don't require you to use your joint repetitively. Try taking a 10-minute break every hour if possible.


• Exercise: With your doctor's approval, get regular exercise when you feel up to it. Stick with gentle exercises, such as walking, biking or swimming.

  Exercise can increase your endurance and strengthen the muscles around your joint, making your joint more stable. Avoid exercising tender, injured or swollen joints.

  If you feel new joint pain, stop. New pain that lasts more than two hours after you exercise probably means you've overdone it.

• Lose weight: Being overweight increases the stress on your weight-bearing joints, such as your knees and your hips. Even a small amount of weight loss can relieve some pressure and reduce your pain tremendously.

  Aim to lose 1 or 2 pounds a week, at most. Talk to your doctor about healthy ways to lose weight Here are some weight loss tips. Most people who combine changes in their diet with increased exercise receive better results.

• Use Heat and Cold to Manage Pain: Both heat and cold can relieve pain in your joint. Heat relieves stiffness and cold can relieve muscle spasms. Apply heat for 20 minutes several times a day.

  Cool the pain in your joints with cold treatments such as ice packs for 20 minutes several times a day. Don't use cold treatments if you have poor circulation or numbness.

• Apply Over-The-Counter Pain Creams: Creams and gels that are available at the drugstore may provide temporary relief. Some creams numb the pain by creating a hot or cool sensation.

  Other creams contain medications such as aspirin-like compounds that are absorbed into your skin. Pain creams work better on joints that are close to the surface of your skin such as your knees and fingers.

• Physical Therapy: Ask your doctor for a referral to a physical therapist. They can work with you to create an individualized home exercise program that will strengthen the muscles around your joint, increase your range of motion and reduce your pain.
• Find Ways To Avoid Stressing Your Joints: Try to find ways to go about your day without stressing your joints. An occupational therapist can help you discover ways to do everyday tasks or do your job without putting extra stress on your already painful joint.

  For instance, a toothbrush with a large grip could make brushing your teeth a lot easier if you have finger osteoarthritis. A special seat in your shower could help relieve the pain of standing if you have knee osteoarthritis. A thicker pen may be more comfortable to write with.

• Try Braces or Shoe Inserts: Consider trying special splints, braces, shoe inserts or other medical devices that can help reduce your pain. These devices can immobilize or support your joint to help you keep pressure off it.

Moderate Osteoarthritis Treatment Options

Pain that persists despite initial treatment may require medications in addition to initial treatment options. Don't assume that taking a medication is all you need.

In order to get the most from your treatment, continue exercising when possible and resting when you need to. If you're overweight, continue working to lose weight.

Medications that may be useful for moderate arthritis include:

• Acetaminophen: Tylenol and other pain relievers can relieve pain, but they don't reduce inflammation. Acetaminopen has been known to work better with people who have mild to moderate pain.
• NSAIDs: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin and others) and naproxen sodium (Aleve).

  Stronger versions of these NSAIDs and others are available by prescription. NSAIDs have some risks of side effects that increase when used at high dosages for long-term treatment.

  Side effects may include: ringing in your ears, gastric ulcers, cardiovascular problems, gastrointestinal bleeding, and liver and kidney damage.

  NSAIDS and Alcohol: Consuming alcohol or taking corticosteroids while using NSAIDs also increases your risk of gastrointestinal bleeding. Many people choose to try natural supplements, due to NSAIDs side effects.

• Cortisone Shots: Injections of corticosteroid medications may relieve pain in your joint. During this procedure your doctor numbs the area around your joint and then inserts a needle into the space within your joint and injects medication.

  It isn't clear how or why corticosteroid injections work in people with osteoarthritis. Your doctor may limit the number of injections you can have each year, since too many corticosteroid injections may cause joint damage.

• Visco-Supplementation: Injections of hyaluronic acid derivatives (Hyalgan, Synvisc) may offer pain relief by providing some cushioning in your knee. These treatments are made from rooster combs and are very similar to a component normally found in your joint fluid.

  Visco Supplementation is only approved for knee osteoarthritis, though researchers are studying its use in other joints. Injections are typically given weekly over several weeks. Pain relief may only last for a few months.

  Possible risks include infection, swelling and joint pain. People who are sensitive to birds, feathers or eggs shouldn't undergo visco-supplementation treatments.

Surgery For Osteoarthritis

Surgery is generally reserved for severe osteoarthritis that can't be relieved by other treatments. You might consider surgery if your osteoarthritis makes it very difficult to perform your daily activities.

Surgical treatment include:

• Joint Replacement: In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surfaces and replaces them with plastic and metal devices called prostheses; most commonly replaced on hip and knee joints. But today, implants can replace your shoulder, elbow, finger or ankle joints.

  How long your new joint will last depends on how you use it. Some knee and hip joints can last 20 years. Joint replacement surgery can help you resume an active, pain-free lifestyle. In smaller hand joints, it can also improve appearance and comfort and may improve your joint's mobility.

  Joint replacement surgery carries a small risk of infection and bleeding. Artificial joints can wear or come loose, and may need to eventually be replaced.

• Debridement: Your surgeon may recommend removing loose pieces of cartilage and bone from around your joint to relieve your pain. Debridement is most useful if you're experiencing a locking sensation from a torn cartilage or loose debris in your knee joint.

  Debridement is typically done arthroscopically, meaning only small incisions are made in your body. A tiny video camera is inserted through the incision to allow your surgeon to see inside your joint. The surgeon uses special surgical tools to clean out any pieces of debris from your joint which may be "grinding" on the bone.

• Fusing Bones (Arthrodesis): Surgeons also can permanently fuse bones in a joint to increase stability and reduce pain. The fused joint, such as an ankle, can then bear weight without pain, but has no flexibility.

  Arthrodesis may be an option if you experience severe pain in your joint, but can't undergo joint replacement surgery.

• Realigning Bones: Surgery to realign bones may relieve pain. These types of procedures are typically used when joint replacement surgery isn't an option, such as in younger people with osteoarthritis.

  During a procedure called an osteotomy, the surgeon cuts across the bone either above or below the knee to realign the leg. Osteotomy can reduce knee pain by transferring the force of the joint away from the worn-out part of the knee.

What are Some Lifestyle and Home Remedies?

Osteoarthritis pain may flare up from time to time. To try to prevent and cope with these flares in pain and stiffness, try self-care techniques. Try to:

• Eat a Healthy Diet: Help your body to heal. A healthy diet emphasizing fruits and vegetables that are high inantioxidants and whole grains can help you control your weight and maintain your overall optimal health, allowing you to be able to deal better with your arthritis.

  However, there's no special diet effective for treating arthritis. Researchers are finding out that antioxidant-rich foods can help decrease inflammation in your joints can decrease pain.

  Chronic Inflammation: Chronic inflammation has been linked to both rheumatoid arthritis and osteoarthritis, and new research also links chronic-inflammation to allergies, asthma, diabetes, digestive disorders, heart disease, hormonal imbalances, and osteoporosis.

• Assistive Mobility Devices: Assistive devices can make it a lot easier to go about your daily activities without stressing your painful joint.

  Cane: A cane may take weight off your knee or hip as you walk.

  Gripping and Grabbing Tools: Gripping and grabbing tools might make it easier to work in the kitchen if you have osteoarthritis in your fingers. Your doctor or occupational therapist might have ideas about what kind of assistive devices might be helpful to you.

  Health catalogs and medical supply stores may also be places that you can look for ideas for special assistive devices to decrease joint friction.

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