Osteoarthritis

What is osteoarthritis?

Osteoarthritis is a disease that causes the breakdown of the cartilage in joints. It also called degenerative arthritis. 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 and inflamed. 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.

Osteoarthritis is 3 times more common in women than in men. It usually begins after the age of 60. By age 60, most people have some osteoarthritis, although it may be too mild to cause symptoms.

How does it occur?

Osteoarthritis is caused by excessive wear on joints. Obesity, bad posture, old injuries, and overuse can all cause extra wear on joints. Heredity also appears to play a role.

What are the symptoms?

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
• deformity of the joint.

How is it diagnosed?

Your health care provider will review your medical history and examine you. You may also have blood tests and x-rays. A sample of fluid in the joint may be taken with a needle to confirm 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.

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) are other drugs used to treat pain. Aspirin, ibuprofen, and naproxen are NSAIDs that you may buy with or without a prescription. Adults over the age of 65 should not take NSAIDs for more than 5 days without their health care 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. While they may help arthritis symptoms, COX-2 inhibitors have been linked to a greater risk of heart attacks and stroke. Talk with your health care provider about this.

Rubbing anti-inflammatory or deep-heat creams over the arthritic joint can provide short-term relief. Putting an ice pack on the joint once or twice a day can also help relieve pain.

Nutritional supplements such as glucosamine and ginger may help relieve pain. Yoga and acupuncture may help reduce pain and stiffness in the joints.

Your health care 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, by increasing your physical activity, or both. This helps reduce strain on the joint.

Canes and splints offer protection. Physical therapy helps relieve pain and muscle spasms, and maintains joint range of motion. Regular gentle exercise is very important to help you control osteoarthritis.

Sometimes severely damaged hips and knees 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 health care 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 go swimming. The water in a warm swimming pool can help support your weight while you exercise, and the warmth helps improve joint movement.
• Protect your joints by doing warm-up exercises before strenuous activity.
• Use a knee pad to protect your knees when you are kneeling.
• Take the medicine your health care provider recommends for controlling your osteoarthritis.
• Keep your body healthy by eating a healthy, varied, low-fat diet.
• Follow your health care provider's recommendations for weight control.