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Arthritis

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Osteoarthritis

Symptoms

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.

When To Call Your Doctor

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


What Is It?

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. It can occur in any joint, but most commonly osteoarthritis 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 spurs, that may grind against each other as the joint moves. Damage usually develops gradually over a period of years. In some people, symptoms remain mild or even fade; in others, symptoms grow progressively worse until they are severely disabling. Affected joints 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, but a number of treatments can ease pain and minimize disability.

What Causes It?

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

Maintain a healthy weight.

Avoid repetitive activities that may lead to joint overuse as much as possible.

Diagnosis

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 It

Cold packs, warm compresses, heat lamps, and warm baths or showers may bring relief.

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) and recommend ways to improve function.

Medications can be very effective for relieving pain. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen, aspirin, salsalate, and COX-2 inhibitors) may be helpful.

Viscosupplementation is designed to reduce joint pain by supplementing or enhancing the natural lubricating and shock absorbing properties of synovial (joint) fluid. Three drugs derived from hyaluronan (a substance found naturally in joint fluid) have been approved by the FDA. These drugs (Hyalgan, Supartz, and Synvisc) can be used for the treatment of knee osteoarthritis after traditional therapies have failed, but they provide only temporary relief.

A variety of surgical procedures may be warranted in severe cases, including arthroscopy (insertion into the affected joint of a thin, flexible viewing scope that can be used to smooth or repair cartilage) and arthroplasty (total joint replacement). 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.

Corticosteroid injections into the joint space may be advised for relief of severe pain, particularly if only one or a few joints are involved.


From Johns Hopkins Symptoms and Remedies, the complete home medical reference. You can order this book now on our secure server.

 


 


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2005
WHITE PAPERS

Arthritis

The arthritis White Paper from The Johns Hopkins White Papers series is an annual, in-depth report written by Hopkins physicians.


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Johns Hopkins Symptoms and Remedies
An easy-to-use reference work that can help you pinpoint the cause of hundreds of symptoms, from abdominal pain to skin rash to swollen glands.

 

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