Osteoarthritis

Osteoarthritis is a degenerative joint disease that affects the cartilage in your knees, hips and other joints. Cartilage is the shock-absorbing material between bones in your joints. It helps keep bones from rubbing together and allows for smooth movement.

Osteoarthritis most often affects weight-bearing joints — such as the hips, knees, spine and hands — but can also affect joints of the fingers, toes and neck.

As you age, your body produces less synovial fluid, which provides nutrients to the cartilage in your joints. Over time, this lack of fluid can cause cartilage breakdown or thinning. In addition, overuse can cause microscopic damage to joint tissue, which leads to inflammation that causes further breakdown of your joint cartilage.

You may develop osteoarthritis from an injury, overuse or repetitive stress on a joint due to activities such as running or dancing. Osteoarthritis also sometimes runs in families — though not all cases are hereditary — so having a parent who has osteoarthritis increases your risk of developing it as well.

What causes osteoarthritis?

Osteoarthritis is caused by wear and tear over time, but it can also be caused by injury or obesity.

The cartilage in your joints is smooth and slippery, so it allows your bones to move easily without damaging each other. But as you age, your body produces less of a natural lubricant called synovial fluid that keeps the joints moving smoothly and protects them from friction. As a result, the cartilage breaks down faster than it can be replaced naturally by the body.

Over time, this can lead to osteoarthritis in any joint in your body — from your fingers to your hips — including:

Knees: This is the most common place for osteoarthritis to develop because of all the stress on them from walking and running.

Who develops osteoarthritis?

Osteoarthritis is a common condition that affects people of all ages. It’s most common in older people and those who are overweight.

Osteoarthritis is most likely to develop in people aged over 50, but it can begin much earlier. The risk of developing osteoarthritis increases with age, as the cartilage in your joints wears down over time. This wear and tear happens gradually, but the rate at which it progresses varies from person to person.

It’s estimated that around half of women and two-thirds of men will show signs of osteoarthritis by the age of 70.

Doctors don’t know exactly why some people develop osteoarthritis, but research has shown that genetics play a role.

Osteoarthritis can run in families. Having a parent or sibling with the condition increases your risk of developing it by about 50%. If you have rheumatoid arthritis (RA), you’re at greater risk for osteoarthritis than someone without RA.

Osteoarthritis symptoms

Symptoms of osteoarthritis include:

Joint pain and stiffness. The pain may be more pronounced when you wake up and ease with activity.

Loss of cartilage (the rubbery tissue that covers the ends of bones). With less cartilage to cushion the joint, bones rub together, causing pain and swelling.

Bony overgrowth (bone spurs). Bone spurs develop around the edges of joints where there’s little or no cartilage left. They’re made up of bone tissue that replaces normal joint cartilage as it wears away from too much use or injury over time.

How do they test for osteoarthritis?

Medical history. Your doctor will ask about your pain, stiffness and other symptoms, as well as your general health and medical history.

Physical exam. The doctor will examine your joints and muscles to see how they move and feel. He or she will also check the strength in your hands and feet, which may be affected by osteoarthritis of the knees, hips or spine.

X-rays. X-rays are used to look at the joints of your fingers and toes, wrists, elbows and shoulders. They may also be taken of your knees, hips or spine to see if there is damage from osteoarthritis in these areas. X-rays are not as good at showing damage on the inside of a joint (bone) compared with CT scans (see below).

Blood tests. Blood tests can show whether you have an inflammatory disease such as rheumatoid arthritis that can cause similar symptoms as those of osteoarthritis but may require different treatments than those used for osteoarthritis alone.

Osteoarthritis treatment

Osteoarthritis treatment usually involves medication, exercise and physical therapy. You may need to try several treatments before you find one that works for you. Medications for osteoarthritis include:

Nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen (Advil, Motrin IB), naproxen sodium (Aleve), celecoxib (Celebrex), diclofenac sodium (Voltaren) and meloxicam (Mobic). These drugs can help relieve pain and reduce inflammation. But using them can cause side effects such as stomach bleeding or ulcers, heartburn and diarrhea. They may also cause blood pressure problems or kidney problems if taken long term.

Capsaicin cream or patch. Capsaicin stimulates pain receptors in the skin, which helps reduce pain signals coming through nerves into the spinal cord and brain. The over-the-counter cream is applied directly to the joint for 30 minutes three times a day for about four weeks before its effectiveness begins to wear off; it’s available at most drugstores without a prescription. The patch is applied like a nicotine patch to deliver small amounts of capsaicin directly to the joint for up to 12 hours.

Do you need physical therapist for osteoarthritis?

There is a great deal of confusion about the role of physical therapists in the treatment of osteoarthritis (OA) of the hip or knee. Some physicians mistakenly believe that physical therapy is not useful for OA, while others are under the impression that it can be harmful. In reality, physical therapy is an important component of treatment for patients with OA.

Physical therapists have expertise in treating conditions that affect joints and surrounding tissues. Physical therapists have been trained to assess and treat patients who have OA and other musculoskeletal conditions affecting their joints.