Maybe it starts with a little soreness in your knees in the morning. Perhaps your hands feel stiff when the weather gets bad, or you notice your hip aches when you stand up from sitting. These types of joint pain become common as we get older and may be caused by osteoarthritis. Here’s what you should know.
What Is Osteoarthritis?
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Osteoarthritis is a type of arthritis often referred to as a “wear and tear” disease due to cartilage deterioration in the joints. Cartilage lines the inner surfaces of the joint where two bones meet and move. This cartilage is a resilient, flexible material that protects the bones from shock, damage, and wear. It also prevents the bone surfaces from coming into direct contact with one another.
Over time, cartilage gradually wears thin (or completely away) in the joint. Severe degeneration or loss of cartilage may lead to direct bone-on-bone contact. When this happens, there is a decrease in the normal range of motion and function of the joint—and the potential for pain.
This loss of cartilage is also associated with inflammation. Inflammation release molecules that can further damage the tissues in and around the joint. Damaged cartilage may also impact or damage the sac of synovial fluid around your joint. Synovial fluid helps joints to glide smoothly against each other, too. When this is compromised, this source of protection and cushioning within some joints is gone.
Osteoarthritis is most common in high-use joints in the body. These include:
- Finger joints
- Toe joints
- Knee joints
- Hip joints
- Spinal joints (including facet joints)
Most people experience osteoarthritis as a gradual increase in pain and decreased joint mobility over time. As the condition progresses, you might experience loss of flexibility, more pain, and even damage in the joint. Osteoarthritis is a chronic, progressive disorder, which means it is not technically “curable” and will get steadily worse over time.
Unlike other types of arthritis that can involve other tissues, osteoarthritis is normally confined to joints. This condition occurs most often in adults over 60, but younger people can develop osteoarthritis as well. When this happens, it is usually related to a prior joint injury or damage.
What Are Common Osteoarthritis Causes?
Although osteoarthritis is a result of age-related wear and tear, there are other causes and risk factors.
For most people and regardless of cause, osteoarthritis often has a mild onset and then intensifies slowly over time. Age-related degeneration is just a fact of life. Certain structures of our bodies just begin to wear as we use them.
But there are variables or attributes are associated with an increased risk of osteoarthritis. Some of these risk factors include:
- Increased bodyweight
- Prior injury or damage to joints (especially for early-onset osteoarthritis)
- Structural joint abnormalities
- Joint disorders
- Genetic factors concerning cartilage formation
- Occupational hazards that increase stress on joints (e.g. repetitive athletic movements or motions at work)
Some of these risk factors can be controlled, while others are simply a function of age.
Do I Have Osteoarthritis?
Symptoms of osteoarthritis can vary and are as individual as each person who suffers from it. The most common osteoarthritis symptoms include:
- Reduced flexibility
- Reduced range of motion in the affected joint(s)
- Joint pain
Some people experience heat and swelling in the affected joint, too.
Symptoms are not always constant. They may begin as a dull ache that gets worse, but they many also go away for periods of time.
Another possible symptom of osteoarthritis is Heberden’s nodes. This is additional tissue that forms around the joints of the fingers and toes. These may be clearly visible through the skin and appear as a swelling of the bone at the end of the digit. Heberden’s nodes are also responsible for reduced mobility and possible pain of the affected joint.
Diagnosing osteoarthritis starts with a physical exam that looks for pain, swelling, and loss of joint mobility. Although cartilage is not visible on an X-ray, this can be a good tool to look for narrowing in the joints (one sign of osteoarthritis). Likewise, an MRI will not, on its own, diagnose osteoarthritis but can track the health of soft tissue in and around your joint.
To rule out rheumatoid arthritis and other conditions, your doctor may also run blood tests or do a joint fluid analysis.
Osteoarthritis Treatments To Find Relief
There are no outright cures for osteoarthritis available. Because of this, osteoarthritis treatment focuses on symptom relief and prevention of damage or acceleration.
Always talk to your doctor to find the right mix of treatment approaches. You’ll likely incorporate a number of therapies to help you find relief.
Complementary therapies can help ease your osteoarthritis pain—or at least help with your response to it.
Movement is often recommended to restore motion, flexibility, and function to the joint. This may include physical therapy and whole-body, low-impact exercise like yoga or walking. Regular movement is one of the best treatments for stiff, sore joints.
Making changes to your diet can also help relieve the symptoms of osteoarthritis. Switching to healthier foods and balanced eating patterns can help manage weight and reduce pressure on your joints (especially the knees and hips). Increasing your intake of fresh vegetables and fruits and adding fish rich in omega-3 fatty acids does correspond with improvements in early-stage osteoarthritis.
Biofeedback training, a system of relaxation and coping techniques in response to pain or other symptoms, can help improve some cases of osteoarthritis symptoms. This therapy trains people to notice their physical response to pain in order to mentally work through it. Biofeedback training may be conducted in the clinic and then practiced at home.
Finally, a large review of studies regarding acupuncture for knee osteoarthritis found that pain decreased and mobility improved after treatment. Acupuncture may also benefit osteoarthritis in other joints.
Non-steroidal anti-inflammatory drugs (NSAIDs) are typically recommended for new-onset or mild osteoarthritis. These medications can be purchased over-the-counter (stronger doses by prescription). They include aspirin, ibuprofen, and naproxen sodium. NSAIDs reduce inflammation and the pain that comes with it.
Corticosteroids are the next step in medications. The oral version of this anti-inflammatory drug is a prescription drug that helps as osteoarthritis progresses from mild to moderate.
As pain progresses, there are other treatments to consider. For moderate to severe pain associated with osteoarthritis, joint injections can help. These include the injection of corticosteroids and local anesthetic to reduce inflammation and ease pain. These are available for many different joints but are most effective in the weight-bearing joints (e.g., hip joint injections and knee joint injections). Watch a knee joint injection in the following video!
While there is conflict in the research about the effectiveness of these injections for every patients, most doctors agree that many of their patients find relief.
Additionally, these joint injections may be repeated according to a regular schedule, depending