Causes

Risk Factors

Symptoms

Osteoarthritis

(Degenerative Joint Disease; Arthritis, Osteo-)

by Editorial Staff and Contributors

Definition

Cartilage is smooth tissue that covers the bone in a joint. Osteoarthritis (OA) is the wearing down of cartilage over time. OA can cause pain and limit movement.

Joints Affected by Osteoarthritis

Causes TOP

Cartilage acts as a cushion for the bones. It also helps bones move smoothly over each other. High impact, stress, and pressure on the joint can wear down the cartilage. The damage worsens over time. For some, the cartilage may completely wear away. This leaves the bone surfaces bare which causes pain and trouble moving.

Wear and tear of the joint is a part of aging. Injuries to the joint, weak muscles, or other health problems can speed up and worsen the damage.

Risk Factors TOP

OA is more common in older adults. Other factors that may increase your chance of OA include:

Excess body weight
Family history of OA
Having an injury or surgery to the cartilage
Having a job or doing physical activities that put stress on the joints
Certain endocrine, metabolic, or neuropathic disorders
Avascular necrosis—death of bone from lack of blood flow

Symptoms TOP

OA is most common in larger joints that support weight such as the spine, hips, and knees. It is also common in active joints like the hand and feet. Common symptoms include:

Mild to severe pain in a joint, especially after overuse or long periods of rest
Creaking or grating sound in the joint
Swelling, stiffness, and problems moving the joint, especially in the morning
Decreased stiffness after starting activity

Diagnosis TOP

You will be asked about your symptoms and past health. A physical exam will be done. The doctor can often diagnose OA based on your symptoms.

Other tests are not always needed. The doctor may do more tests if your symptoms are not typical. They can help to rule out other issues like a new injury. Test options may include:

X-ray —damage from OA can be seen on x-ray
Blood tests—to look for signs of infection or markers of joint disease
MRI scan —to rule out injuries
Ultrasound

Treatment TOP

OA cannot be cured. Treatment is focused on:

Reducing joint pain and inflammation
Improving joint function
Slowing future damage

Treatment may change over time. Options may include:

Weight Loss

Extra weight can increase pressure on the joints. This may speed up wear and tear. The closer you are to your ideal weight, the better it will be. If you are overweight, losing any weight can lessen the stress on your joints. A dietitian can help you make meal plans.

Exercise and Therapy

Muscles affect how the joints line up and how they move. It can also affect how much stress is placed on your joints. Strong muscles can decrease the wear and tear with each movement. They can help to slow the progress of OA.

Strong muscles related to the joint may also decrease OA pain and make movement easier. Low impact may be a good way to start. For example, swimming and water aerobics improve muscle health with less impact on the joints. Ask a doctor or an exercise specialist for help to create a program that works for you.

OA can make everyday tasks difficult. Physical or occupational therapy can provide new steps or devices to help you such as:

Shoes with shock-absorbing insoles
Splints or braces to align joints and distribute weight
Elastic supports
Canes, crutches, walkers, and orthopedic shoes
Home tools, such as handrails and grips or raised seats, including toilet seats

Other therapy options include:

Transcutaneous electrical nerve stimulation (TENS)—electrical pulses that can reduce pain signals
Manual therapy—such as massage therapy to improve muscle balance and joint alignment

Medications TOP

Medicines may help to manage pain or swelling. Options include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Topical pain medicines that are applied to the skin—capsacian is a common choice
Prescription pain medicines
Corticosteroid—may be by mouth or by injection
Viscosupplementation injection (hyaluronic acid)—to replace low levels and help cushion the joint

Heat and Ice TOP

Heat may help loosen stiff joints and help you move easier. Heat may be given through hot water bottles, warm soaks, paraffin, or heating pads.

Ice may help to decrease swelling and pain. It may be most useful after activity.

Alternative Treatments TOP

These therapies may be able to give you some relief. They work best when used in combo with treatments above. Let your doctor know about any treatment you may try to make sure all your efforts work together. Options that have shown some promise with OA include:

Surgery TOP

OA can sometimes cause severe limits. If it is making daily life hard, your doctor may recommend a surgery. Surgery may be done to:

Remove loose pieces of bone or cartilage from joints
Reposition bones to balance stress on the joint
Replace a damaged joint with an artificial one

Prevention TOP

To reduce your chance of OA:

Maintain a healthy weight.
Do regular exercise, such as walking, stretching, swimming, or yoga.
Limit repetitive motions. Avoid risky activities that may lead to joint injury. This is even more important after age 40.

RESOURCES:

American College of Rheumatology
http://www.rheumatology.org

The Arthritis Foundation
http://www.arthritis.org

CANADIAN RESOURCES:

The Arthritis Society
http://www.arthritis.ca

Seniors Canada
http://www.seniors.gc.ca

References:

Degenerative arthritis (list of topics). EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated May 21, 2014. Accessed May 11, 2016.

Hochberg MC, Altman RD, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-474.

Fernandes L, Hagen KB, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013;72(7):1125-1135.

Living with arthritis. Arthritis Foundation website. Available at:
...(Click grey area to select URL)
Accessed May 11, 2016.

Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Disorders website. Available at:
...(Click grey area to select URL)
Updated April 2015. Accessed May 11, 2016.

Sinusas, K. Osteoarthritis: Diagnosis and treatment. Am Fam Physician. 2012;85(1):49-56.

van den Berg WB. Pathophysiology of osteoarthritis. Joint Bone Spine. 2000;67:555-556.

10/21/2008 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2008;CD004376.

12/11/2009 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Rutjes WJ, Nuesch E, Sterchi R, et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst Rev. 2009;(4):CD002823.

10/15/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Wandel S, Jüni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010;341:c4675.

10/26/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

11/15/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
US Food and Drug Administration. FDA clears Cymbalta to treat chronic musculoskeletal pain. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm232708.htm. Updated November 4, 2010. Accessed May 11, 2016.

11/29/2010 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
French HP, Brennan A, White B, Cusack T. Manual therapy for osteoarthritis of the hip or knee: a systematic review. Man Ther. 2011;16(2):109-117.

7/15/2013 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Dilek B, Gözüm M, Sahin E, et al. Efficacy of paraffin bath therapy in hand osteoarthritis: a single-blinded randomized controlled trial. Arch Phys Med Rehabil. 2013 Apr;94(4):642-9.

6/18/2014 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
MQIC guideline on medical management of adults with osteoarthritis. Available at: http://www.guideline.gov/content.aspx?id=47806. Updated August 1, 2013. Accessed June 29, 2015.

9/3/2014 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Zhou ZY, Liu YK, et al. Body mass index and knee osteoarthritis risk: A dose-response meta-analysis. Obesity (Silver Spring). 2014 Jul [Epub ahead of print].

1/5/2018 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Krsticevic M, Jeric M, et al. Proliferative injection therapy for osteoarthritis: a systemic review. Int Orthop. 2017 Apr;41(4):671-679.

Last reviewed May 2018 by Warren A. Bodine, DO, CAQSM
Last Updated: 7/12/2018

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