Osteoarthritis, the most common form of arthritis, affects more than 30 million adults in the US. It is sometimes referred to as degenerative joint disease, and it occurs when soft tissue at the end of the bone wear away. Osteoarthritis tends to affect weight-bearing joints like the knees, hip and spine, but the condition can also affect fingers, thumbs and other joints. Symptoms include:
- Pain concentrated around the affected joint
Risk Factors for Osteoarthritis
Risk factors that can increase the likelihood for developing osteoarthritis include:
- Joint injury or overuse. Activities like knee bending or putting repetitive stress on a joint can cause an overuse injury.
- Age. Risk of osteoarthritis increases with age.
- Obesity. Extra weight places strain places strain on the joints – especially the hips and knees.
- Sex. Females are more likely than males to develop osteoarthritis – particularly after the age of 50.
- Family history. Genetics play a role in a person’s likelihood to develop osteoarthritis.
- Race. Certain Asian populations have a lower risk for osteoarthritis when compared with other races.
To diagnosis OA, the doctor will first perform a physical exam to get a closer look at the affected joint – checking for swelling, redness, tenderness and any range of motion issues. Based on those findings, the doctor may also recommend lab and imaging tests.
The pictures of affected joints obtained through imaging tests can provide further insight into the progression of OA. The types of tests used include:
X-rays. X-ray images can help to determine whether or not there’s narrowing space between your joints, which would indicate loss of cartilage. X-rays can also reveal whether there are bone spurs around a joint, which could indicate osteoarthritis.
Magnetic resonance imaging (MRI). An MRI can produce detailed images of bone, cartilage and other soft tissues by using radio waves and a strong magnetic field. This testing is normally reserved for complex osteoarthritis cases.
Lab Testing. Your doctor will likely recommend testing your blood or joint fluid in order to help confirm the diagnosis:
Blood testing. Blood tests do not definitively confirm osteoarthritis, but certain tests can help to rule out other conditions that can cause joint pain, such as rheumatoid arthritis.
Joint fluid testing. Joint fluid testing for osteoarthritis involves using a needle to draw fluid out of the affected joint. From this fluid the doctor is able to determine if there’s inflammation and whether or not your joint pain can be attributed to an infection or gout instead of osteoarthritis.
Treatment Options for Osteoarthritis
If your joint pain is definitively caused by osteoarthritis, there are a few treatment options that can help to alleviate the discomfort. The process underlying the progression of osteoarthritis cannot be reversed, but exercising and maintaining a healthy weight are typically the most effective ways of treating osteoarthritis. Your doctor may also recommend:
Acetaminophen. Acetaminophen can help alleviate mild to moderate pain in people with osteoarthritis.
Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as products with ibuprofen and naproxen sodium, can help to alleviate pain associated with osteoarthritis. Topical NSAIDs can also be effective. In more extreme cases, the doctor may prescribe prescription-grade NSAIDs to help reduce the inflammation.
Duloxetine. Duloxetine (Cymbalta) is typically prescribed to treat depression, but it is also indicated to treat chronic pain, which includes osteoarthritis pain.
Physical therapy. Physical therapists can help create an exercise and stretching plan tailored to your individual needs. These exercises are geared toward strengthening the muscles around the affected joint to increase range of motion and lower pain levels. Exercises appropriate for osteoarthritis care include walking and swimming.
Occupational therapy. Occupational therapists can assist you in learning how to do the everyday tasks you need to do without exacerbating the osteoarthritis. For example, if you suffer from osteoarthritis in your finger, an occupational therapist may recommended a toothbrush with a larger grip to make brushing easier.
Calming movement therapies. Movement therapies like tai chi and yoga can help reduce the stress in your life while stretching and breathing deeply. These therapies can also help to loosen you up a bit help reduce the pain associated with osteoarthritis.
Surgery and other procedures
When traditional therapies fail to bring the relief you need, your doctor may recommend other procedures, including:
Bone realignment. If the osteoarthritis has damaged one side of a joint more than another, the doctor would recommend an osteotomy.
Cortisone injections. Cortisone injections in the joint can help to alleviate the pain. To do this, the doctor numbs the area around the affected joint before injecting the medication directly into the joint. You can usually only get three or four of these injections per year. A surgeon will cut into the joint and add a wedge of bone or remove a piece to restore balance.
Joint replacement. In the most extreme cases, a joint replacement (arthroscopy), can be performed to remove the damaged joint surfaces. The doctor can then place them with plastic or metal parts.