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What is osteoarthritis?

Osteoarthritis is a form of arthritis. It is characterized by deteriorating cartilage in joints, leading to pain and swelling. Unlike some other forms of arthritis, such as rheumatoid arthritis, osteoarthritis is a condition associated with wear and tear on the joints over time. It affects over 32 million US adults.

Types of osteoarthritis

Osteoarthritis is a complex condition that can manifest in various ways and is classified into two primary types:

  • Primary osteoarthritis

    This form of osteoarthritis is the most common and is primarily attributed to the natural aging process. As we grow older, the cartilage that cushions the ends of our bones can wear down gradually. Primary osteoarthritis tends to affect weight-bearing joints, such as the hips, knees and the spine. However, arthritis can also occur in the shoulder and is often associated with the rotator cuff. It is more common in individuals over 65, and while aging is the primary factor, genetics and joint abnormalities can also contribute to its development.

  • Secondary osteoarthritis
    Secondary osteoarthritis is typically the result of an underlying condition or joint injury. These factors can accelerate the breakdown of cartilage and lead to osteoarthritis at a younger age. Secondary osteoarthritis can affect any joint in the body and often occurs because of joint injuries, genetic predisposition, metabolic diseases or conditions such as rheumatoid arthritis. Understanding the specific cause of secondary osteoarthritis is crucial for effective treatment and management.

Osteoarthritis symptoms

Osteoarthritis has various symptoms, which may differ from person to person. The most common signs and symptoms of osteoarthritis include:

  • Joint pain
  • Stiffness
  • Reduced range of motion
  • Crepitus (grinding, clicking or popping in the joint)
  • Bone spurs
  • Swelling
  • Joint tenderness

These symptoms can vary in intensity and may come and go. They are often exacerbated by physical activity and relieved by rest. If you are experiencing any of these symptoms, call your doctor for a proper diagnosis and to discuss suitable treatment options.

When to see a doctor

If you experience persistent joint pain, stiffness or swelling or have difficulty performing daily activities due to osteoarthritis symptoms, it's time to visit your doctor. Seeking medical attention early can lead to an accurate diagnosis and the development of a suitable treatment plan.

healthy joint vs joint with osteoarthritis illustration

What causes osteoarthritis?

Osteoarthritis is a condition marked by the gradual deterioration of the protective cartilage that surrounds the ends of bones in your joints. This durable, smooth cartilage enables easy and painless joint movements. However, as it undergoes wear and tear over time, it can lead to discomfort.

This condition is categorized as either primary or secondary osteoarthritis. The cause of primary osteoarthritis remains unknown, while secondary osteoarthritis is linked to other conditions, infections, injuries or deformities.

Regardless of classification, the initial stage of osteoarthritis always starts with the breakdown of joint cartilage. This degeneration can trigger the thickening of bone ends and bony growths known as spurs that may impact joint movement. Bone and cartilage fragments may float within the joint space and fluid-filled cysts can form in the bone, limiting joint mobility.

Risk factors for osteoarthritis

Understanding the risk factors associated with osteoporosis is crucial in preventing its onset and managing its effects. A combination of genetic, lifestyle and health-related factors influences the condition. By recognizing these risk factors, individuals can proactively work towards stronger bone health.

Osteoarthritis is often the result of a combination of these risk factors. Additionally, it can affect any joint in the body, including the hands, spine and feet. Understanding these risk factors is essential for preventing and effectively managing osteoarthritis.

  • Age

    As we grow older, the protective cartilage that cushions the ends of our bones naturally wears down, which makes the joints more susceptible to damage and degeneration.

  • Gender

    Osteoarthritis tends to affect both men and women, but it is more common in women, especially after post-menopause, due to hormonal changes.

  • Excess weight

    Being overweight or obese places stress on weight-bearing joints, such as the hips and knees, accelerating the wear and tear of joint cartilage.

  • Tendon injury

    Previous tendon injuries can lead to joint imbalance and eventually arthritis, particularly in the shoulder’s rotator cuff.

  • Joint injury

    Previous joint injuries, including fractures, ligament tears and dislocations, can increase the likelihood of developing osteoarthritis in the affected joint. Even injuries that occurred years ago can contribute to the condition.

  • Joint abnormalities

    Conditions where joints do not form or align correctly, such as hip dysplasia or structural abnormalities, can predispose individuals to osteoarthritis.

  • Genetics

    Genetic factors may contribute to a person's susceptibility to osteoarthritis. Family history can play a role in the development of the condition.

  • Other medical conditions

    Certain medical conditions, such as diabetes, gout and rheumatoid arthritis, are associated with an increased risk of osteoarthritis.

X-ray image of knee joints highlighted with osteoarthritis

How is osteoarthritis diagnosed?

Diagnosing osteoarthritis typically involves a combination of clinical evaluation, medical history, physical examination and imaging tests. Here's an overview of the diagnostic process:

  • Medical history and physical exam

    Your doctor will start by gathering information about your symptoms, including when they began, their duration and any factors that make the pain or stiffness better or worse. You'll also discuss your medical history, including any previous joint injuries or conditions that may be contributing to your symptoms.

    A thorough physical examination will assess the affected joint's range of motion, visible swelling or deformities and joint tenderness. Your doctor will also check for crepitus (a crackling or popping sound) when the joint is moved.

  • Imaging tests
    • X-ray: X-rays are commonly used to visualize the joint and assess the degree of joint damage. They can reveal the narrowing of joint space, bone spurs and other osteoarthritis-related structural changes.
    • Magnetic Resonance Imaging (MRI): In some cases, an MRI may be ordered to provide more detailed images of the joint, particularly when assessing soft tissues like cartilage and ligaments is needed. An MRI can help with an unclear diagnosis or evaluate the extent of the joint damage.
    • Computed Tomography (CT): CT scans can be more helpful than MRI to demonstrate bone abnormalities. Specialized scans can used to illustrate pathology in 3D and identify subtle rotator cuff tears.
  • Lab tests
    • Blood tests: While there is no specific blood test to diagnose osteoarthritis, blood tests may be performed to rule out other forms of arthritis, such as rheumatoid arthritis or to assess overall health.
    • Joint aspiration: Your healthcare provider may recommend joint aspiration, a procedure where a small sample of synovial fluid is withdrawn from the joint for analysis. This procedure can help rule out other causes of joint pain and may indicate the presence of inflammation.

What is the treatment for osteoarthritis?

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Osteoarthritis treatment is designed to alleviate pain, enhance joint function and improve the overall quality of life. Your care plan will be tailored to your specific needs, lifestyle, and the severity of the condition.

Medication

Medications play a central role in managing osteoarthritis symptoms. They include both over-the-counter and prescription pain relievers and anti-inflammatory drugs. Pain relievers, like acetaminophen, can effectively alleviate pain, while nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce both pain and inflammation. It's essential to use these medications under the guidance of a healthcare provider, as long-term use of NSAIDs can have side effects.

Exercise

Regular physical activity is a cornerstone of osteoarthritis management. It can contribute to:

  • Improved joint flexibility: Targeted exercises enhance the flexibility of affected joints and maintain their range of motion.
  • Strengthened muscles: Strengthening the muscles surrounding the joint provides additional support and reduces stress on the affected area.
  • Weight management: When combined with a balanced diet, exercise can support weight loss or help maintain a healthy weight. Maintaining a healthy weight reduces the load on weight-bearing joints, such as the knees and hips.

Weight loss and diet

Maintaining a healthy weight is crucial as osteoarthritis affects weight-bearing joints. A balanced diet supports weight management and promotes overall joint health.

Therapy

Therapies are vital components of osteoarthritis treatment:

  • Physical therapy: Therapists create customized exercise regimens to enhance joint mobility and strength. They may incorporate physical therapy techniques like manual therapy, ice or heat therapy, and ultrasound to alleviate discomfort and improve overall functionality.
  • Occupational therapy: Occupational therapists concentrate on assisting individuals in preserving their independence in everyday tasks. They can suggest using assistive devices like braces or splints and offer counsel on adaptive techniques as part of occupational therapy.
  • Transcutaneous electrical nerve stimulation (TENS): TENS therapy uses a battery-operated device that delivers low-voltage electrical currents to alleviate pain. It is often used for localized pain relief.
  • Complementary therapies: Integrative medicine, which includes approaches like acupuncture, yoga and mindfulness, can complement traditional treatments and help manage osteoarthritis symptoms.

Surgery

In cases where conservative treatments do not provide sufficient relief, surgical options may be considered:

  • Realigning bones: Osteotomy is a procedure that repositions bones to shift weight away from damaged areas of the joint.
  • Joint replacement: Arthroplasty, such as hip or knee arthroplasty, removes the deteriorated joint and replaces it with an artificial joint. Joint replacement effectively alleviates pain and enhances functionality.
  • Joint fusion: Arthrodesis is a procedure that fuses the bones on either side of the affected joint to eliminate motion at that joint. Joint fusion may be considered for smaller joints, such as the hand and foot.

Frequently asked questions

  • Can osteoarthritis be reversed?

    Osteoarthritis is a degenerative joint condition characterized by the gradual breakdown of joint cartilage. Currently, osteoarthritis cannot be completely reversed. However, various treatments and lifestyle modifications can effectively manage the symptoms, reduce pain and slow down the condition’s progression so you can lead an active, fulfilling life.

  • Can osteoarthritis cause numbness and tingling?

    Osteoarthritis primarily affects the joints and is not typically associated with numbness and tingling. These sensations are more commonly linked to nerve-related conditions. It's essential to consult a healthcare provider to differentiate between osteoarthritis and other conditions that may lead to numbness and tingling.

  • Will osteoarthritis spread?

    Osteoarthritis is localized in the affected joint or joints and does not spread to other body parts. However, if you have osteoarthritis in one joint, it is possible to develop the condition in other joints, especially if you have risk factors or a history of joint injuries.

  • Can osteoarthritis cause swelling?

    Yes, osteoarthritis can cause joint swelling. The inflammation associated with osteoarthritis can lead to the accumulation of excess synovial fluid within the joint and cause swelling. Swelling is a common symptom of osteoarthritis and can contribute to pain and reduced joint function.

  • Which is worse: osteoarthritis or osteoporosis?

    Osteoarthritis and osteoporosis are distinct conditions that affect different aspects of the musculoskeletal system. Comparing their severity is challenging because their impact can vary significantly from person to person.