OSTEOARTHRITIS

Osteoarthritis (OA) is the most common form of arthritis in the United States, affecting an estimated 21 million adults. OA begins with the breakdown of joint cartilage, resulting in pain and stiffness. OA commonly affects the joints of the fingers, knees, hips, and spine. Other joints affected less frequently include the wrists, elbows, shoulders, and ankles. When OA is found in a less frequently affected joint, there is usually a history of injury or unusual stress to that joint. Work-related repetitive injury and physical trauma may contribute to the development of OA. If you have a strenuous job that requires repetitive bending, kneeling, or squatting, for example, you may be at high risk for OA of the knee.

Risk Factors

Factors that may increase your risk of developing osteoarthritis include: Age: Age is the strongest risk factor for OA. Although OA can start in young adulthood*often due to joint injury*it usually occurs in older people. By 2030, 20% of Americans*about 70 million people*will be age 65 or older and will be at risk for OA. Female Gender: Before age 45, OA occurs more frequently in men; although after age 45, OA is more common in women. OA of the hand is particularly common among women. Joint injury or overuse caused by physical labor or sports: Traumatic injury to a joint increases your risk of developing OA in that joint. Joints that are used repeatedly in certain jobs may be more likely to develop OA because of injury or overuse. Obesity: The chances of getting OA generally increase with the amount of weight joints have to bear. In the knee, which is a major weight-bearing joint, being overweight during midlife or the later years is the strongest risk factor for developing OA. Joint alignment: People with joints that move or fit together incorrectly, such as in bowlegs, dislocated hips, or double-jointedness, are more likely to develop OA in those joints. Hereditary gene defect: A defect in one of the genes responsible for a cartilage component called collagen can cause deterioration of cartilage. Certain diseases: Some diseases, such as rheumatoid arthritis, change the normal structure and function of cartilage and may increase your risk of developing OA.

What are the symptoms of osteoarthritis?The most common symptoms of OA include: Steady or intermittent pain in a joint. Stiffness after periods of inactivity, such as sleeping or sitting. Swelling or tenderness in 1 or more joints. Crunching feeling or sound of bone rubbing on bone (called crepitus) when the joint is used. OA usually comes on slowly. Early in the disease, joints may ache after physical work or exercise. If you are experiencing symptoms such as joint pain and stiffness, see a doctor to find out if you have OA. Early diagnosis is important so you can begin treatment that can help to relieve pain, improve mobility, and minimize disability.

Where do symptoms of osteoarthritis typically appear? Although OA can occur in any joint, most often it occurs in the following areas: Fingers: OA of the fingers is often hereditary, meaning it runs in families. Fingers may ache or be stiff and numb. The base of the thumb joint is commonly affected. Fingers can become enlarged and gnarled. Small, bony knobs (called Heberden's nodes) may also appear on the end joints of the fingers. Similar knobs (called Bouchard's nodes) can appear on the middle joints of the fingers. More women than men have OA of their fingers. Women become especially susceptible to OA after menopause. Knees: Because knees are primary weight-bearing joints, they are very commonly affected by OA. They may be stiff, swollen, and painful, making it hard to walk, climb, and get in and out of chairs and bathtubs. If OA of the knee is not treated, it can lead to disability. Hip: OA in the hip can cause pain, stiffness, and severe disability. In addition to your hip, you may feel the pain in your groin, inner thigh, or knees. This can lead to difficulty moving, bending, and walking. Spine: OA of the spine can cause stiffness and pain in the neck or in the lower back, as well as weakness or numbness in your arms or legs.

What causes osteoarthritis?

Although the exact cause of OA is not known, some scientists believe that joint damage begins in response to physical stress (such as an injury or repetitive movement). Also known as "wear and tear," this stress can erode the cartilage that normally encases the ends of the bones in a joint. Cartilage serves to cushion the bones and to help the joint move smoothly and easily.

As cartilage breaks down, the ends of the bones thicken and the joint may lose its normal shape. With further cartilage breakdown, the ends of the bones may begin to rub together causing pain. In addition, damaged joint tissue can cause the release of certain substances called prostaglandins, which can also contribute to the pain and swelling characteristic of the disease.

How is osteoarthritis diagnosed?

If you experience swelling or stiffness in your joints for more than 2 weeks, you should see your doctor. It is important to find out if you have arthritis and, if so, what type. Early diagnosis and treatment can help minimize pain and disability. If your doctor determines that you have OA, he or she can work with you to develop a pain management and treatment plan.

When you see your doctor for the first time regarding your symptoms, he or she will ask questions about when and how the condition started. The doctor will probably give you a physical examination to check your general health and to examine the joints that are bothering you. You may also need other tests to help confirm the diagnosis of OA and determine the extent and severity of joint damage.

Tests that your doctor may perform include:

X-rays: X-rays can help the doctor determine whether you have OA or RA. A series of X-rays obtained over time can show how rapidly joint damage is progressing. X-rays of the affected joints can show cartilage loss, bone damage, and bone spurs.

Joint aspiration: If your doctor is still uncertain about the diagnosis or suspects that you may have an infection, he or she may perform joint aspiration. In this procedure, your doctor withdraws and examines synovial fluid from affected joints using a needle.

How is osteoarthritis treated?

There's no known cure for osteoarthritis, but treatments can help to reduce pain and maintain joint movement. Your doctor may recommend a combination of treatments that may include medication, self-care, physical therapy and occupational therapy. In some cases, surgical procedures may be necessary.

Medications

Medications are used to treat the pain and mild inflammation of osteoarthritis and to improve your joints' functioning. They include both topical medications and oral medications. Over-the-counter (OTC) medications may be sufficient to treat milder osteoarthritis, but stronger prescription medications also are available. Some types of medications include: Topical pain relievers

Acetaminophen

COX-2 inhibitors

Tramadol

Intra-articular injections

Antidepressants

NSAIDs (Non-steroidal anti-inflammatory drugs)

Surgical or other procedures

Surgical procedures can help relieve disability and pain caused by osteoarthritis.

Joint replacement

Fragment removal

Repositioning bones

Fusing bones

Complementary and alternative medicine Common forms of complementary and alternative medicine for treatment of osteoarthritis include:
Acupuncture
Copper jewelry
Homeopathy
Magnets
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