What You Need To Know About Osteoarthritis

Osteoarthritis is the most common type of arthritis diagnosed in the US, with over 32 million adults¹ affected.

Anybody can develop OA, but it's more common in older people. Overall, women have a higher risk of developing OA² than men. 62% of people who have OA³ are women, but in OA patients younger than 45, the condition is more common in men.

Younger people can have osteoarthritis too. Some people develop OA because of deformities, while others develop it because they regularly participate in high-impact sports, which can injure the joint. Being overweight is thought to hasten the development of OA.

The joint that OA most commonly affects is the knee. Estimates show that osteoarthritis of the knee affects at least 19% of over 45-year-olds in the US⁴.

People with osteoarthritis are more likely to develop depression⁵, which can be caused by increased tiredness and disability linked to pain.

In the early stages of osteoarthritis, you may not experience any symptoms, or you may have symptoms that occur in one or several joints. These symptoms often appear gradually.

Here are the symptoms you may develop:

• Swelling and pain during activity

• Joint stiffness in the mornings or after rest

• Tenderness in your joints

• Trouble moving the affected joint

• A crackling or grating sound in your joint (crepitus)

• Muscle bulk loss

When OA progresses, you might develop bony growths around your joints, damaged cartilage or cartilage loss, and mild inflammation of your joint tissues.

With osteoarthritis, the symptoms and pain usually get worse at certain times. You may feel great one day, then experience a flare-up the next. To help ease your discomfort during a flare-up, speak to your doctor about pain relief medicine.

What are the complications of osteoarthritis?

Osteoarthritis is a chronic degenerative disease. Cartilage doesn’t tend to grow back once it breaks down.

Over time, you may develop complications from living with osteoarthritis, such as:

Stiffness and pain

Joint stiffness and pain that gets worse over time is the primary complication of osteoarthritis. It tends to be most painful in the morning when you wake up. You may have problems moving your joints as well as you did in the past. You may also experience some "crunching" or "scraping" when you move your joints.

Mobility and physical challenges

OA can make your joints painful, stiff, and weak over time, which might mean you become less active in your day-to-day life. OA might reduce your quality of life when it makes it more challenging to carry out everyday tasks. For example, you might find it harder to:

• Bend over

• Hold on to household objects

• Move up and down stairs

Your osteoarthritis might increase your risk of falling and hurting yourself, which can be pretty frightening. A healthcare professional can work with you to create a strategy that lowers your risk of falling and eases your symptoms.

Can osteoarthritis lead to other conditions?

Osteoarthritis can lead to other conditions, such as:

Cardiovascular disease

While joint pain, swelling, and damage are the main characteristics of OA, other parts of your body can be affected.

Studies show that people with degenerative joint conditions are also at risk of heart problems. Osteoarthritis patients are nearly three times more likely¹ to develop heart failure or cardiovascular disease than people without OA. This is particularly true in people whose OA affects specific joints, such as the hip or knee joints.

Anxiety and depression

The pain you might experience from OA can negatively affect your mental health. Studies researching the link between OA and depression and anxiety² found these two mental health conditions are common in OA patients.

Difficulty sleeping

Around 70% of individuals with osteoarthritis³ have some type of sleep problem. Issues include waking up earlier than you want and trouble falling or staying asleep at night.

One reason for OA keeping you awake at night is pain. Pain can either prevent you from getting comfortable when trying to fall asleep or wake you up. It is also thought that a lack of high-quality sleep actually makes your OA pain worse.

Falls

Research⁴ shows that people with osteoarthritis have more falls and a higher risk of fracture. When you have OA, it can:

• Weaken your muscles

• Decrease function

• Make falls more likely

• Affect your overall balance

You may be more affected if you have OA in your hips or knees. Falls can also happen as a result of OA medication side effects like dizziness.

There are several potential causes of OA and risk factors that could increase your chance of developing the condition.

What causes osteoarthritis?

Doctors don't know the exact cause of osteoarthritis, but it appears to develop when your body can no longer repair joint tissue in the way it used to. It can affect people of any age but is more common in older adults and people with specific risk factors.

Risk factors for developing osteoarthritis

Certain risk factors¹ can cause OA, including:

• Joint injury — a ligament tear, a cartilage tear, or a bone fracture can cause osteoarthritis (OA can develop faster in these cases than in cases where there's no obvious injury)

• Age — your risk of OA increases as you age, and symptoms tend to appear in individuals over the age of 50

• Obesity — being overweight increases the pressure placed on your joints, causing damage over time, and excess fat cells can also lead to more inflammation.

• Overuse — when you use the same joints over and over (perhaps due to a sport or your job), it can lead to OA.

• Weak muscles — when your muscles don't effectively support your joint, it can cause misalignment (and, in turn, OA)

• Musculoskeletal abnormalities — misaligned joint or bone structures can speed up the development of OA.

• Gender — women are at more risk of developing OA than men

• Genetics — when a family member has osteoarthritis, you have a higher risk of developing the condition yourself

How is osteoarthritis diagnosed?

To diagnose osteoarthritis, your doctor will start by looking at your personal and family history and performing a physical examination.

You might need to undergo some tests to help diagnose your symptoms and rule out other causes. Initial tests could include:

• X-rays — to show narrowing within a joint or bone spurs around a joint that suggest cartilage has broken down

• MRI — if an X-ray is inconclusive, your doctor may ask you to undergo an MRI scan

• Blood tests — may help your doctor to rule out other conditions that could be causing your symptoms, such as rheumatoid arthritis.

Joint fluid analysis

Your doctor may perform a procedure in their office called arthrocentesis. During this procedure, the doctor uses a sterile needle to draw out joint fluid, which they'll analyze. Analyzing joint fluid helps the doctor exclude things like infection, gout, and other causes of inflammatory arthritis.

The doctor may also inject your joints with corticosteroids during arthrocentesis to help ease swelling, pain, and inflammation.

Arthroscopy

Arthroscopy is a form of keyhole surgery where a viewing tube is placed into the space inside your joint. Through this procedure, a medical professional can detect cartilage damage, abnormalities, and bony spurs, which might indicate osteoarthritis. They may also carry out repairs using the arthroscope.

You can undergo arthroscopy with a local anesthetic, or in some cases, general anesthetic. Patients often recover from successful arthroscopic surgery faster than open joint surgery.

There are several different treatments for osteoarthritis, and your doctor can work with you to create a treatment plan that’s suited to you, and they may refer you to specialists. They may also recommend lifestyle changes to help manage your OA symptoms.

How is osteoarthritis treated?

No proven treatment exists to reverse osteoarthritis joint damage. The goal of treatment is to improve joint function and decrease pain, and this is often possible with a combination of medication, physical therapy, and in some cases, surgery.

Types of osteoarthritis treatment include:

Physical therapy

• Thermotherapy — heat and cold can help decrease joint stiffness and pain (try wrapping an ice pack or hot water bottle in a towel and place it on your affected joint)

• Transcutaneous electrical nerve stimulation (TENS) — a therapist attaches a TENS unit to the skin with electrodes to transfer electrical currents that reduce the transmission of pain signals.

• Manual therapy — a physical therapist can help keep your joints supple and flexible, and they may also give you some exercises to help strengthen your joints at home.

Assistive devices

• A cane or stick — use a cane or walking stick on the opposite side of your body to your affected joint to help keep weight off your joint and decrease your risk of a fall.

• Special insoles or footwear — if you have OA in your hips, knees, or feet, these can help to evenly distribute weight across your body (you can also get shock-absorbing insoles designed to decrease pressure on your joints)

• Leg braces, splints, and supportive dressings — help rest and support a painful joint

Surgery

• Joint replacement (commonly replaced joints are knees and hips)

• Joint fusion

• Osteotomy (removing or adding bone around your joint)

Surgery for treating osteoarthritis is usually considered a last resort, recommended for people whose OA has not improved with medication or lifestyle changes.

Which types of medication are generally prescribed?

Anti-inflammatory and pain medications for osteoarthritis can be used in the form of pills, creams, patches, syrups, injectables, and gels.

Medications for OA include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs help relieve pain and inflammation and are the most common OA medication for this purpose. They include ibuprofen, celecoxib, aspirin, and naproxen. Your doctor may prescribe you NSAIDs, or you can pick them up over the counter.

Analgesics

These include opioids and acetaminophen, which are pain relievers. Your doctor can prescribe opioids, and you can get acetaminophen over the counter.

Corticosteroids

Corticosteroids are prescribed anti-inflammatory medications, and they work similarly to the hormone cortisol. You either take them orally, or they're injected into your joint by your doctor.

Counterirritants

Counterirritants are over-the-counter medications that contain ingredients like menthol, capsaicin, and lidocaine that aggravate your nerve endings to make painful areas feel warm, cold, or itchy. This helps to take your focus off the pain.

Platelet-rich plasma (PRP) injections

Injected by your doctor, PRPs may ease inflammation and pain. The process involves taking plasma from your own blood and injecting it into your affected joint. A 2019 review¹ of studies concluded that the efficacy of PRP injections is still “open for debate,” and they are not yet FDA-approved² for treating OA patients. However, you may be able to get the treatment “off label.”

Other medications

Both pregabalin (Lyrica), an anti-seizure drug, and duloxetine (Cymbalta), an antidepressant, are oral medications that are approved by the FDA to treat osteoarthritis pain.

Can lifestyle changes help to manage osteoarthritis?

Some lifestyle changes help to relieve OA symptoms. These include:

Managing your weight

Being overweight places extra strain on your joints, causing pain and damage. When you take steps to reduce your body weight and maintain a healthy weight, it can help ease this pressure. Ultimately, this could decrease your pain and slow the progression of the disease.

Getting sufficient sleep

You can lower inflammation and swelling by resting your muscles. Getting enough high-quality sleep during the night can also help ease your pain³.

Exercising

You can strengthen the muscles around your joint and relieve stiffness by keeping active. 150 minutes of moderate activity each week is recommended for adults, and you can reach this goal by exercising several days a week.

Choose low-impact, gentle activities, such as swimming and walking. Yoga and tai chi may also improve the flexibility of your affected joint, making day-to-day life and symptoms easier to manage.

Can osteoarthritis be reversed or cured?

It’s not possible to cure or reverse osteoarthritis⁴. However, treatments can effectively reduce pain and make your life easier. Your doctor can discuss a treatment plan with you that might involve medication or therapy.

Osteoarthritis occurs because of wear and tear on your joints. The older you get, the more worn they become. While you can't prevent osteoarthritis completely, you can take steps to reduce the stress you place on your joints in daily life. This can make developing osteoarthritis less likely, or keep it from getting worse.

How to lower your risk of developing osteoarthritis

By following this guidance, you can help to lower your risk of developing OA.

Maintain a healthy weight

Extra weight increases the stress placed on your joints, particularly your knee and hip joints. Over time, this extra stress will increase your risk of developing osteoarthritis. What’s more, excess fat cells in your body can lead to more inflammation in your joints.

If you are overweight, you should speak to your doctor about potential causes and what you can do going forward to reach a healthy weight.

Keep your blood sugar under control

High blood sugar levels can increase your chances of developing osteoarthritis¹. If you have diabetes, you should regularly check your blood sugar level and follow medical advice to regulate it.

Keep active every day

Being physically active daily can help prevent joint issues and osteoarthritis. Exercise helps to strengthen your muscles and maintain flexibility, and it also helps to prevent obesity, a condition that can cause OA.

Speak to your doctor about safe exercises that will keep your joints healthy. You should aim for a minimum of 30 minutes on most days or 150 minutes per week.

Prevent joint injury

Your risk of developing OA increases when you injure your joints. To lower your chance of injury, start exercising slowly and work your way up to your goal. Allow yourself five to ten minutes of warm-up time before you exercise and include gentle movements and stretches.

Doing the same exercise or activity every day can increase the chance of injuring your joints. Change up your exercise routine each day. By doing so, you'll use different body parts, which will prevent you from placing excess stress on the same joints repeatedly.

Be mindful of your day-to-day activities. Certain activities place extra stress on your joints. For example, instead of holding a heavy bag full of groceries in your hands, hold them in the crook of your arm, close to your body.

Remember to always use protective gear and exercise equipment safely. Follow usage instructions carefully.

Support your body

If you exercise regularly or are an athlete, be sure to take care of your body. Wear athletic shoes and supports that decrease the impact on your knees. Change up the activities you do to work all muscle groups, not the same muscles every time.

Listen to your pain

If you have joint pain that lasts one to two hours after you exercise or perform an activity, you may have overdone it. Use an ice pack to ease your pain and rest your joint. You should speak to your doctor to rule out any problems. Also, consider seeing a physical therapist to be assessed and shown how to protect your joints during activity.

Should people at risk be screened or checked for osteoarthritis regularly?

No specific screening test or blood test can diagnose osteoarthritis. Blood work, if taken, is used to rule out conditions that could cause secondary OA or other types of arthritis that mimic OA.

You’ll see different types of doctors and specialists for the diagnosis and treatment of osteoarthritis. Who you see will depend on factors such as the progression of your OA.

Which types of doctors or healthcare professionals diagnose OA?

In some cases, your primary care doctor will be able to diagnose you with osteoarthritis. However, if your doctor cannot reach a diagnosis and is unsure about your symptoms' underlying cause, they may refer you to a rheumatologist.

Unlike your primary care doctor, a rheumatologist specializes in arthritis, including osteoarthritis and other musculoskeletal conditions. They may use other methods to reach a diagnosis, including different types of imaging and further diagnostic testing such as joint fluid analysis.

Which types of doctors or healthcare professionals treat OA?

As well as diagnosing osteoarthritis, your primary care doctor may be involved with your treatment. For example, they can prescribe medications to help ease your symptoms.

If your pain is persistent and your symptoms do not subside even after treatment, or if you are becoming progressively housebound and unable to handle everyday tasks, your doctor may refer you to a rheumatologist. A rheumatologist may offer different treatments to your primary care doctor.

An orthopedist may also be involved in your OA treatment. They are doctors who treat musculoskeletal injuries and diseases, including osteoarthritis. They can provide treatments such as corticosteroids or hyaluronic acid injections, and they may offer surgical treatment options such as arthroscopy, osteotomy, or joint replacement if needed.

Your doctor might refer you to a physical therapist to help manage your OA symptoms. They can show you specific exercises and movements to improve your strength and flexibility, making everyday life easier.