Osteoarthritis

What is osteoarthritis?

Osteoarthritis is a disease that causes the breakdown of the cartilage in joints. It also called degenerative arthritis or degenerative joint disease (DJD). Cartilage is the joint's cushion. It covers the ends of bones and allows free movement. If it becomes rough, frays, or wears away, bones grind against each other. As a result, the joint becomes irritated, inflamed, and swollen. Sometimes the irritation causes abnormal bone growths, called spurs, which increase swelling. The disease normally affects the feet, knees, lower back, hips, and fingers. Usually only one or maybe a few joints are affected at one time.

How does it occur?

The exact cause of osteoarthritis is not known, but excessive wear on joints is known to be an important factor. Obesity, bad posture, old injuries, and overuse can all cause extra wear on joints. Heredity also appears to play a role.

Osteoarthritis is more common in women than in men.

What are the symptoms?

Because wear and tear on the joints helps osteoarthritis develop, the joints start to be affected by early adulthood. Osteoarthritis gradually gets worse as you get older. Although there may be signs of it on X-rays of younger people, they may not have any symptoms. Symptoms of arthritis are usually first noticed after the age of 60. However, they can happen earlier or later than this.

The symptoms of osteoarthritis include:

• mild to severe pain in a joint, especially after overuse or long periods of inactivity, such as sitting for a long time
• creaking or grating sound in the joint
• swelling, stiffness, limited movement of the joint, especially in the mornings
• weakness in muscles around the sore joint from lack of use
• misshapen joint.

How is it diagnosed?

Your healthcare provider will review your medical history and examine you. You may also have blood tests and X-rays. A sample of fluid in a painful joint may be taken with a needle to check the diagnosis.

How is it treated?

The goal of treatment is to keep the joint working by reducing strain on the joint and by relieving pain, stiffness, and swelling.

Medicine can control pain and reduce inflammation. Most of the time, acetaminophen is the best medicine to use to relieve pain. It has fewer side effects than other pain relievers when used for a long time.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen can help relieve pain and inflammation. These NSAIDs may be bought with or without a prescription. Adults 65 years old and older should not take NSAIDs for more than 7 days without their healthcare provider's approval. NSAIDs help reduce pain and swelling but can cause kidney and stomach problems.

COX-2 inhibitors such as celecoxib (Celebrex) are prescription NSAIDs. COX-2 drugs may cause fewer stomach problems than other NSAIDs. COX-2 inhibitors can help arthritis symptoms, but they have been linked to a greater risk of heart attacks and stroke. Talk with your healthcare provider to learn more about taking NSAIDs.

Rubbing anti-inflammatory or deep-heat creams over an arthritic joint can provide short-term relief. Putting an ice pack on the joint once or twice a day can also help relieve pain. Hot paraffin baths can help symptoms in the hands and feet.

Although the evidence is not conclusive, some people seem to benefit from the natural remedies glucosamine and chondroitin sulfate. Yoga and acupuncture may help reduce pain and stiffness in the joints.

Your healthcare provider may inject steroids into the painful joint to help relieve pain.

If you are overweight, your provider may recommend that you lose weight. This may be done by eating fewer calories and increasing your physical activity. This helps reduce strain on the joint.

Canes, walkers, wheelchairs, and motorized scooters help take the weight off affected joints and reduce pain. Splints offer protection from overuse of joints. Physical therapy helps relieve pain and muscle spasms. It also helps you keep range of motion. Regular gentle exercise is very important to help you control osteoarthritis.

Sometimes severely damaged joints may be surgically replaced.

How long will the effects last?

There is no cure for osteoarthritis. Once you are diagnosed with it, you will have it for the rest of your life. It can worsen over time. Avoiding repeated injury to your joints can help, but damaged cartilage cannot repair itself.

How can I take care of myself?

No one yet knows how to prevent osteoarthritis, but you can help reduce symptoms by following these guidelines:

• Keep your joints in good working order. Stay fit. Do any exercises recommended by your healthcare provider or physical therapist for posture, muscle strength, and joint mobility. Daily moderate exercise is much better for your joints than occasional strenuous exercise. Walk a little each day if you can. Be sure to wear comfortable, well-cushioned walking shoes. Otherwise, you can exercise while sitting down or in a pool. The water in a warm swimming pool can help support your weight while you exercise, and the warmth helps joint movement.
• Protect your joints by doing warm-up and stretching exercises before strenuous activity.
• Use a knee pad to protect your knees when you are kneeling.
• Take the medicine your healthcare provider recommends for controlling your osteoarthritis.
• Keep your body healthy by eating a healthy, varied, low-fat diet.
• Follow your healthcare provider's recommendations for weight control.