What You Need to Know: Osteoarthritis

Arthritis affects our joints. A joint is where the ends of two or more bones meet. A healthy joint glides easily without pain because a smooth, elastic tissue called articular cartilage covers the ends of the bones that make up the joint.

What Is Osteoarthritis?

Osteoarthritis, also known as "wear and tear" arthritis, is a progressive disease of the joints. It is the most common type of arthritis and mostly affects the cartilage of the joints that provide us “cushioning”.

What Causes Osteoarthritis?

Articular cartilage covers the ends of our bones in our joints. Osteoarthritis is caused when this cartilage gradually wears away. Where there was once smooth articular cartilage that made the bones move easily against each other, there is now a frayed, rough surface. Joint motion along this exposed surface is painful.  

Who Gets It?

Osteoarthritis usually develops after many years of use. It typically affects people who are middle-aged or older. Other risk factors for osteoarthritis include obesity, previous injury to the affected joint, and a family history of osteoarthritis.

Symptoms Of Osteoarthritis

Osteoarthritis can affect any joint in the body, with symptoms ranging from mild to disabling. A joint affected by osteoarthritis may be painful and inflamed. Without cartilage, bones rub directly against each other when the joint moves. This is what causes the pain and inflammation. Pain or a dull ache usually develops gradually over time. Pain may be worse in the morning and feel better with activity. Vigorous activity may cause pain to flare up.

Diagnosis of Osteoarthritis

A complete medical history, physical examination, X-rays, and possibly laboratory tests will be completed. The doctor will want to know if the joint has ever been injured. He or she will want to know when the joint pain began and what the pain feels like: Is the pain continuous, or does it come and go? Does it occur in other parts of the body? It is important to know when the pain occurs: Is it worse at night? Does it occur with walking, running or at rest? The doctor will examine the affected joint in various positions to see if there is pain or restricted motion. He or she will look for creaking or grinding noises (crepitus) that indicate bone-on-bone friction, muscle loss (atrophy), and signs that other joints are involved. The doctor will look for signs of injury to muscles, tendons, and ligaments.

An x-ray can show the extent of joint deterioration, including narrowing of joint space, thinning or erosion of bone, excess fluid in the joint, and bone spurs or other abnormalities. They can help the doctor distinguish various forms of arthritis.

Treatment:

Many patients believe surgery is a first option, but rather, there are many ways to treat osteoarthritis varying on the diagnosis, with surgery usually being a last resort based on pain and condition of the joint.

• Nonsurgical Treatment: Early, nonsurgical treatment can slow progression of osteoarthritis, increase motion, and improve strength. Most treatment programs combine lifestyle modifications, weight management, medication, and physical therapy/activity.
• Medications: Non-steroidal anti-inflammatory drugs can help reduce inflammation. Sometimes, the doctor may recommend strong anti-inflammatory agents called corticosteroids, which are injected directly into the joint. Corticosteroids provide temporary relief of pain and swelling. Hyaluronic injections are also a good option for patients with mild to moderate osteoarthritis. Hyaluronic acid is similar to a substance that occurs naturally in the joints. It works by acting like a lubricant and shock absorber in the joints and helps the joints to work properly.
• Physical Therapy: A balanced fitness program, physical therapy, and/or occupational therapy may improve joint flexibility, increase range of motion, reduce pain, and strengthen muscle, bone, and cartilage tissues. Supportive or assistive devices (such as a brace, splint, elastic bandage, cane, crutches, or walker) may be needed. Ice or heat may need to be applied to the affected joint for short periods, several times a day.
• Surgical Treatment: If early treatments do not stop the pain or if they lose their effectiveness, surgery may be considered. The decision to treat surgically depends upon the age and activity level of the patient, the condition of the affected joint, and the extent to which osteoarthritis has progressed.

If you are having pain or swelling in the joints and find it difficult to participate in your everyday activities, schedule a consultation today at our partner provider Orthopedic Specialists by calling 515-955-6767 or schedule an appointment with your primary physician.