Osteoarthritis—also known as degenerative joint disease—is the gradual age-related deterioration of cartilage within the joints, causing pain and sometimes deformity. (Joint inflammation is uncommon.) It is the most common form of arthritis: nearly all people have developed some degree of osteoarthritis in one or more joints by the age of 60. Osteoarthritis can occur in any joint, but most commonly it affects the fingers, neck, spine, hips, knees, and feet.

As the elastic cartilage that serves as a cushion between bones breaks down, bone ends may rub together, causing them to develop uneven outgrowths called osteophytes, or bone spurs, that may grind against each other as the joint moves. Damage usually develops gradually over a period of years.

In some people, symptoms of osteoarthritis remain mild or even fade; in others, symptoms grow progressively worse until they are severely disabling. Joints affected by osteoarthritis may begin to lose their shape and alignment. Weakness and wasting of the muscles surrounding the joints may occur if pain and stiffness prevent normal motion.

Osteoarthritis has no impact on longevity (unlike some other forms of arthritis), but it can diminish overall quality of life. There is no cure for osteoarthritis, but a number of treatments can ease pain and minimize disability.

Symptoms of Osteoarthritis

• Joint pain that is aggravated by movement and relieved by rest.

• Stiffness, especially in the morning or after exercise; loss of flexibility in the affected joints.

• Knobby overgrowths on the joints closest to the fingertips (Heberden’s nodes) or on the fingers’ middle joints (Bouchard’s nodes).

• Audible crackling noises upon movement of the joints.

• Changes in gait.

• Rarely, redness, warmth, and swelling of a joint.

What Causes Osteoarthritis?

• Osteoarthritis occurs as a part of aging, owing to years of cumulative wear and tear on the joints. Obesity increases the risk of developing osteoarthritis in weight-bearing joints, such as the hips, knees, and those of the back.

• Trauma or overuse of a joint can hasten the development of osteoarthritis. This is common among athletes and those whose occupations require constant repetitive motions, such as pianists, typists, machinists, and dancers.

Prevention of Osteoarthritis

• Maintain a healthy weight.

Diagnosis of Osteoarthritis

• Patient history and physical examination are needed.

• X-rays may be taken.

• In rare cases when diagnosis is in question, fluid may be drawn from the affected joint through a needle for laboratory analysis.

How To Treat Osteoarthritis

• Cold packs, warm compresses, heat lamps, and warm baths or showers may bring relief of pain from osteoarthritis.

• Splints, braces, neck collars, crutches, or canes may provide support and limit stress on the affected joint.

• A regular exercise program under the guidance of a doctor or physical therapist is recommended. The right program can help to maintain flexibility, strengthen muscles (and thus lessen stress on joints), and improve overall fitness. Therapists can also evaluate the performance of daily activities (such as dressing, brushing teeth, preparing a meal) that may be affected by osteoarthritis and recommend ways to improve function.

• The primary indication for drug treatment is pain relief. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen, and salsalate) may be very helpful.

• Another type of treatment for knee osteoarthritis, called viscosupplementation, is designed to reduce joint pain by supplementing or enhancing the natural lubricating and shock absorbing properties of synovial (joint) fluid. Two drugs derived from hyaluronan (a substance found naturally in joint fluid) have been approved by the FDA. These drugs (Hyalgen and Synvisc) are recommended for the treatment of knee osteoarthritis after traditional therapies have failed.

• A variety of surgical procedures, including arthroplasty (total joint replacement), may be warranted in severe cases of osteoarthritis. Most joint replacements are of the hip or knee. Discussion of the activities the patient would like to continue after the replacement aids the surgeon in selecting the appropriate type of prosthesis and makes the patient more aware of the risks and limitations of surgery.

• Researchers are studying new agents that may halt or repair the damage done by osteoarthritis. Glucosamine and chondroitin sulfate have received much media attention. These naturally occurring substances play important roles in forming and maintaining joint cartilage and may initiate repair. Although these agents seem to cause few or minimal side effects, studies are needed to determine their long-term benefits and safety.

• Occasional use of corticosteroid injections into the joint space may be advised for relief of severe pain from osteoarthritis, particularly if only one or a few joints are involved. One injection can provide pain relief lasting from a few weeks to several months.

When To Call A Doctor

• If the symptoms of osteoarthritis begin to interfere with the enjoyment of normal activities, make an appointment with a doctor.

For more information on osteoarthritis and related conditions click on this link -- Johns Hopkins Health Alerts: Arthritis

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