Osteoarthritis Treatment at Penn Medicine
Osteoarthritis (OA) is the most common joint disorder. It is caused by "wear and tear" on a joint.
Cartilage, the firm, rubbery tissue that cushions the joints and allows bones to glide over one another, can break down and wear away over time. As a result, the bones rub together, causing pain, swelling and stiffness.
Bony spurs or extra bone may form around the joint, allowing the ligaments and muscles around the joint to become weaker and stiffer.
The exact cause of osteoarthritis is often unknown, but it is mainly related to aging. The first symptoms of osteoarthritis usually appear in middle age and, by age 70, most everyone has some symptoms. Before age 55, osteoarthritis occurs equally in men and women. After age 55, it is more common in women.
Other factors that lead to osteoarthritis:
- Osteoarthritis tends to run in families.
- Being overweight increases the risk of osteoarthritis in the hip, knee, ankle and foot joints.
- Fractures or other joint injuries can lead to osteoarthritis later in life.
- Long-term overuse at work or in sports can lead to osteoarthritis.
Medical conditions that can lead to osteoarthritis include:
- Bleeding disorders that cause bleeding in the joint, such as hemophilia.
- Disorders that block the blood supply near a joint can lead to avascular necrosis.
- Other types of arthritis, such as chronic gout, pseudogout, or rheumatoid arthritis.
Pain and stiffness in the joints are the most common symptoms of osteoarthritis. The pain is often worse after exercise and when placing weight or pressure on the joint.
Over time, the joints become stiff and harder to move, and patients may notice a rubbing, grating or crackling sound when moving the joint.
The phrase "morning stiffness" refers to the pain and stiffness people feel when they first wake up in the morning. The stiffness usually can last up to 30 minutes or less and is improved by mild activity that "warms up" the joint.
During the day, the pain may get worse with activity and feel better when resting. Eventually, the pain may be present when resting and may even wake people up at night.
Other people might have no symptoms even though X-rays show the changes of osteoarthritis.
A physical exam can show:
- Joint movement causes a cracking (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
X-rays of the affected joints show a loss of the joint space. In advanced cases, a wearing down of the ends of the bone and bone spurs can be seen.
Blood tests are not used in diagnosing osteoarthritis.
OA cannot be cured and it will most likely become worse over time. However, osteoarthritis symptoms can be controlled with therapy, over-the-counter pain relievers, steroid injections, and lifestyle changes.
Although these treatments cannot make the arthritis go away, they can often delay or postpone surgery. Severe cases of osteoarthritis may require surgery to replace or repair the damaged joints.