Joint pain that
is aggravated by movement and relieved by rest.
especially in the morning or after exercise; loss of flexibility
overgrowths on the joints closest to the fingertips (Heberden's
or on the fingers' middle joints (Bouchard's nodes).
crackling noises upon movement of the joints.
redness, warmth, and swelling of a joint.
When To Call Your Doctor
the symptoms of osteoarthritis begin to interfere with the enjoyment
of normal activities, make an appointment with a doctor.
What Is It?
Osteoarthritisalso known as degenerative
joint diseaseis 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?
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,
activities that may lead to joint overuse as much as possible.
history and physical examination are needed.
may be taken.
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
packs, warm compresses, heat lamps, and warm baths or showers
may bring relief.
braces, neck collars, crutches, or canes may provide support
and limit stress on the affected joint.
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.
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
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.
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.
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.
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.
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