Osteoarthritis

What is osteoarthritis?

Osteoarthritis is the most common type of arthritis (a condition that affects your joints). Healthcare providers sometimes refer to it as degenerative joint disease or OA. It happens when the cartilage that lines your joints is worn down over time and your bones rub against each other when you use your affected joints.

Usually, the ends of bones in your joints are capped in a layer of tough, smooth cartilage. Cartilage is like a two-in-one shock absorber and lubricant — it helps the bones in your joints move past each other smoothly and safely. If you have osteoarthritis, the cartilage in your affected joints wears away over time. Eventually, your bones rub against each other when you move your joints.

Osteoarthritis can affect any of your joints, but most commonly develops in your:

• Hands.
• Knees.
• Hips.
• Neck (cervical spine).
• Lower back (lumbar spine).

Types of osteoarthritis

A healthcare provider might classify osteoarthritis as one of two types:

• Primary osteoarthritis is the most common form of osteoarthritis that develops in your joints over time. Experts think it’s usually caused by normal wear and tear of using your joints throughout your life.
• Secondary osteoarthritis happens when something directly damages one of your joints enough to cause osteoarthritis. Injuries and traumas are common causes of secondary osteoarthritis. Other types of arthritis can damage the cartilage in your joints enough to cause osteoarthritis, too.

How common is osteoarthritis?

Osteoarthritis is very common. Experts estimate that more than 80% of adults older than 55 have osteoarthritis, even if some of them never experience symptoms.

Around 60% of people with osteoarthritis have symptoms they can notice or feel.

What are osteoarthritis symptoms?

The most common symptoms of osteoarthritis include:

• Pain in a joint (especially when you’re moving it).
• Stiffness.
• Swelling near a joint.
• A decreased range of motion (how far you can move a joint).
• Feeling like a joint isn’t as strong or stable as it usually is.
• A joint looking noticeably different than it used to (joint deformity).

What causes osteoarthritis?

Experts aren’t sure what causes osteoarthritis. Primary osteoarthritis usually develops slowly as you age. As you get older, normal wear and tear on your joints might contribute to their cartilage breaking down.

Anything that directly damages your joints can also cause osteoarthritis, including:

• Sports injuries.
• Falls.
• Car accidents.
• Health conditions that affect your joints, like Ehlers-Danlos syndrome or joint hypermobility syndrome.

Other forms of arthritis (specifically inflammatory arthritis) can cause osteoarthritis, including:

• Rheumatoid arthritis.
• Gout.
• Psoriatic arthritis

Osteoarthritis risk factors

Anyone can develop osteoarthritis. Adults older than 55 and people who are in postmenopause are more likely to develop osteoarthritis.

People with certain health conditions are more likely to experience osteoarthritis, including:

• Obesity (having a body mass index, or BMI, greater than 30) or overweight (having a BMI over 25).
• Diabetes.
• High cholesterol (hyperlipidemia).
• Some autoimmune diseases that affect your joints.

How is osteoarthritis diagnosed?

A healthcare provider will diagnose osteoarthritis with a physical exam and imaging tests. They’ll look at your joints and ask you when you first noticed any symptoms. Tell them if any activities make your symptoms worse, or if they come and go.

What tests are done to diagnose osteoarthritis?

Your healthcare provider might use X-rays to take pictures of your joints. They might also use an MRI (magnetic resonance imaging) or CT (computed tomography) scan.

You might need blood tests to rule out other conditions or issues that cause similar symptoms.

How is osteoarthritis treated?

Your healthcare provider will help you find treatments that relieve your osteoarthritis symptoms. There’s no cure for arthritis, and you can’t regrow the cartilage in your affected joints. Your provider will help you find ways to manage your symptoms when you’re experiencing them.

The most common treatments for osteoarthritis include:

• Medication: Over-the-counter (OTC) pain relievers can help reduce pain and inflammation. You might need medication you take by mouth or topical pain relievers (creams, ointments or patches you put on your skin near your affected joints).
• Exercise: Moving your joints can relieve stiffness and strengthen the muscles around them. Low-impact activities like swimming, water aerobics and weight training can all help. Your provider might recommend that you work with a physical therapist.
• Supportive devices: Wearing shoe inserts or a brace can support and stabilize your joints. Using a cane or walker can take pressure off your affected joints and help you move safely.
• Heat and cold therapies: Applying heat or cold to your affected joints might help relieve pain and stiffness. Your provider will tell you how often (and for how long) you should apply a heating pad, ice packs or a cool compress.
• Complementary therapy: Complementary therapies may work alongside other treatment options. Examples of complementary medicine include acupuncture, massage, meditation, tai chi and dietary supplements. Talk to your provider before you start taking any herbal or dietary supplements.
• Surgery: Most people don’t need surgery to treat osteoarthritis. Your provider might recommend surgery if you’re experiencing severe symptoms and other treatments haven’t worked. You might need a joint replacement (arthroplasty). Your provider or surgeon will tell you what to expect.

How can I prevent osteoarthritis?

The best way to prevent osteoarthritis is to maintain good overall health, including:

• Avoiding tobacco products.
• Doing low-impact exercise.
• Following a diet plan that’s healthy for you.
• Always wearing your seatbelt.
• Wearing proper protective equipment for any activity, sport or work you’re doing.
• Visiting a healthcare provider for regular checkups and as soon as you notice any changes in your joints.

What can I expect if I have osteoarthritis?

Most people with osteoarthritis need to manage their symptoms for the rest of their lives. Your healthcare provider will help you find the right combination of treatments to reduce your symptoms.

If you have osteoarthritis, it’s important to stay as active as possible. If joint pain and other symptoms make it too hard for you to move, you may face a greater risk for other serious health conditions like heart disease, diabetes and some types of cancer.

Talk to your healthcare provider if osteoarthritis makes it hard (or impossible) to stay active. They’ll help you find new treatments to manage your symptoms.

What can I do to make living with osteoarthritis easier?

You might need to tweak your routine to make living with osteoarthritis easier. Depending on when you’re experiencing symptoms (and how severe they are), you may need to avoid or modify your activities while you’re managing symptoms. You might work with an occupational therapist if you need help performing your daily tasks. Occupational therapists are healthcare providers who can help you manage physical challenges like arthritis. They may recommend:

• Adaptive equipment, such as grips for opening jars.
• Techniques for doing hobbies, sports or other activities safely.
• Tips for reducing joint pain during arthritic flare-ups.

When should I see my healthcare provider?

Visit a healthcare provider as soon as you notice any symptoms of osteoarthritis. Even minor joint pain can be a sign that you need treatment — especially if it doesn’t get better in a few days.

You can’t repair any cartilage degeneration (breakdown) that’s already happened, but starting osteoarthritis treatment can slow down further damage inside your joints.

Talk to your provider if it feels like your symptoms are coming back more often or are more severe than they used to be. Ask your provider about other treatment options or changes you can make to your existing treatments if you feel like they’re not working as well as they usually do.

What questions should I ask my doctor?

• Do I have osteoarthritis or another type of arthritis?
• Which of my joints are affected?
• Which treatments will I need?
• Will I need surgery?
• Would working with a physical therapist or occupational therapist help me?

At what age does osteoarthritis usually start?

Osteoarthritis usually affects people older than 55. However, there’s no set timeline or age restriction on when you might experience it. It also doesn’t start the way some health conditions do — there’s not usually an exact starting point your healthcare provider can precisely identify.

It can take a long time for the cartilage in your affected joints to wear down enough to cause pain and stiffness. So, even if you first notice symptoms around age 55, that doesn’t mean osteoarthritis started exactly at that time.

Where can I learn more about osteoarthritis?

• American College of Rheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver
• The Arthritis Foundation. https://www.arthritis.org/