Search Encyclopedia:    
List of Topics Print This Page
 

Osteoarthritis


Definition:

Osteoarthritis (OA) is the most common joint disorder. It is due to aging and wear and tear on a joint.

Alternative Names:

Hypertrophic osteoarthritis; Osteoarthrosis; Degenerative joint disease; DJD; OA; Arthritis - osteoarthritis

Exams and Tests:

A physical exam can show:

  • Joint movement that causes a crackling (grating) sound, called crepitation
  • Joint swelling (bones around the joints may feel larger than normal)
  • Limited range of motion
  • Tenderness when the joint is pressed
  • Normal movement is often painful

Blood tests are not helpful in diagnosing OA.

An x-ray will likely show:

  • Loss of the joint space
  • Wearing down of the ends of the bone
  • Bone spurs
Treatment:

OA cannot be cured. It will most likely get worse over time. However, your OA symptoms can be controlled.

You can have surgery, but other treatments can improve your pain and make your life much better. Although these treatments cannot make the arthritis go away, they can often delay surgery.

MEDICINES

Over-the-counter (OTC) pain relievers can help with OA symptoms. You can buy these medicines without a prescription.

Most doctors recommend acetaminophen (Tylenol) first. DO NOT take more then 3 grams (3,000mg) a day. If you have liver disease, talk with your doctor before taking acetaminophen.

If your pain continues, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs). Types of NSAIDs include aspirin, ibuprofen, and naproxen.

Supplements that you may use include:

  • Pills, such as glucosamine and chondroitin sulfate
  • Capsaicin skin cream to relieve pain

LIFESTYLE CHANGES

Staying active and getting exercise can maintain joint and overall movement. Ask your health care provider to recommend an exercise routine. Water exercises, such as swimming, are helpful.

Other lifestyle tips include:

  • Applying heat and cold to the joint
  • Eating healthy foods
  • Getting enough rest
  • Losing weight if you are overweight
  • Protecting your joints from injury

If the pain from OA gets worse, keeping up with activities may become more difficult or painful. Making changes around the home can help take stress off your joints to relieve some of the pain. If your work is causing stress in certain joints, you may need to adjust your work area or change work tasks.

PHYSICAL THERAPY

Physical therapy can help improve muscle strength and the motion of stiff joints as well as your balance. If therapy does not make you feel better after 6 to 8 weeks, then it likely will not work at all.

Massage therapy may provide short-term pain relief. Make sure you work with a licensed massage therapist who is experienced in working on sensitive joints.

BRACES

Splints and braces may help support weakened joints. Some types prevent the joint from moving. Others allow some movement. Use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.

ALTERNATIVE TREATMENTS

Acupuncture is a traditional Chinese treatment. It is thought that when acupuncture needles stimulate certain points on the body, chemicals that block pain are released. Acupuncture may provide short-term pain relief for OA.

S-adenosylmethionine (SAMe, pronounced "Sammy") is a manmade form of a natural chemical in the body. It may help reduce joint inflammation and pain.

SURGERY

Severe cases of OA might need surgery to replace or repair damaged joints. Options include:

Which of these medicines can help relieve osteoarthritis (OA) pain?The correct answer is all of the above. Your doctor may recommend acetaminophen first, because it has fewer long-term side effects than the others.  If your pain continues, your doctor may recommend other pain relievers. Always ask your doctor which medicine is safest for you and how much to take.Exercise is one of the best treatments for arthritis pain.The correct answer is true. Staying active not only helps reduce pain, but also relieves stiffness, boosts your energy, and improves bone and muscle strength. But some sports or exercises may make your pain worse. Work with your doctor or physical therapist to develop an exercise routine for you.You can help treat OA at home by doing the following:The correct answer is all of the above. Losing extra pounds can take pressure off joints in the legs and feet. Getting enough sleep helps you recover more quickly after a flare-up. And eating a balanced diet helps keep your whole body healthy.Physical therapy can benefit many people with OA.The correct answer is true. Physical therapy can help improve muscle strength and the motion of stiff joints, as well as your sense of balance. Therapists have many techniques for treating OA. If you don't get relief, ask your doctor about other treatment options.Over-the-counter remedies that can help relieve OA symptoms include:The correct answer is all of the above. Glucosamine, chondroitin sulfate, and capsaicin cream have all been shown to help relieve OA pain in some people. Talk to your doctor about which over-the-counter remedies may work best for you.Which of the following treatments is better for OA pain?The correct answer is both heat and cold. Hot packs, warm towels, or taking a warm bath can help increase blood flow and make your joints more flexible. Cold packs can help numb the painful area and reduce joint pain. Work with your doctor to see what works best for you.You should only use a brace if your doctor recommends it.The correct answer is true. Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. You should use a brace only when your doctor or therapist recommends one and ask how to use it. Using a brace the wrong way can cause joint damage, stiffness, and pain.How often can you receive corticosteroid injections to treat pain?The correct answer is two to four times a year. Corticosteroids are hormones that help reduce swelling in the joint. They are effective as a short-term treatment to relieve joint pain. However, experts recommend that you have no more than four injections a year.If you have OA, you’ll need to have surgery sooner or later.The correct answer is false. Although you may need to have surgery if your symptoms are severe, many people can treat their symptoms without ever having surgery. Talk to your doctor about what treatments may help relieve your OA pain.The only type of surgery for OA involves replacing the joint.The correct answer is false. Although joint replacement surgery is common, other surgeries can repair a damaged joint. If you are thinking about surgery, talk with your doctor about all of your options.
Support Groups:

Organizations that specialize in arthritis are good resources for more information on OA.

Outlook (Prognosis):

Your movement may become limited over time. Doing everyday activities, such as personal hygiene, household chores, or cooking may become a challenge. Treatment usually improves function.

When to Contact a Medical Professional:

Call your health care provider if you have symptoms of OA that get worse.

Prevention:

Try not to overuse a painful joint at work or during activities. Maintain a normal body weight. Keep the muscles around your joints strong, especially the weight-bearing joints (knee, hip, or ankle).

References:

Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377:2115-2126. PMID 21684382 www.ncbi.nlm.nih.gov/pubmed/21684382.

Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2012;4:465-474. PMID 22563589 www.ncbi.nlm.nih.gov/pubmed/22563589.

Lozada CG. Treatment of osteoarthritis. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelly's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 100.

Nelson AE, Jordan JM. Clinical features of osteoarthritis. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelly's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 99.


Review Date: 2/8/2015
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

   View History
  Osteoarthritis

   
   

 

About UPHS   Contact Us   Site Map   Privacy Statement   Legal Disclaimer   Terms of Use

The University of Pennsylvania Health System, Philadelphia, PA 1-800-789-PENN © 2015, The Trustees of the University of Pennsylvania