Osteoarthritis, sometimes called degenerative joint disease or osteoarthrosis, is the most common form of arthritis. Osteoarthritis occurs when cartilage in your joints wears down over time.

Osteoarthritis can affect any joint in your body, the disorder most commonly affects joints in your:

• Hands
• Hips
• Knees
• Neck
• Lower back

Osteoarthritis gradually worsens with time, and no cure exists. But osteoarthritis treatments can relieve pain and help you remain active. Taking steps to actively manage your osteoarthritis may help you gain control over your symptoms.

Osteoarthritis Symptoms

Osteoarthritis symptoms often develop slowly and worsen over time.

Signs and symptoms of osteoarthritis include:

• Pain: Your joint may hurt during or after movement.
• Tenderness: Your joint may feel tender when you apply light pressure to it.
• Stiffness: Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity.
• Loss of flexibility: You may not be able to move your joint through its full range of motion.
• Grating sensation: You may hear or feel a grating sensation when you use the joint.
• Bone spurs: These extra bits of bone, which feel like hard lumps, may form around the affected joint.

When to see a doctor

If you have swelling or stiffness in your joints that lasts for more than two weeks, make an appointment with your doctor. If you're already taking medication for osteoarthritis, contact your doctor if you experience side effects such as:

• Nausea
• Abdominal discomfort
• Black or tarry stools
• Constipation
• Drowsiness

Causes of Osteoarthritis

Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints deteriorates over time. The smooth surface of the cartilage becomes rough, causing irritation. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone — causing the ends of your bones to become damaged and your joints to become painful.

It isn't clear what causes osteoarthritis in most cases. Researchers suspect that it's a combination of factors, including:

• The aging process
• Joint injury or stress
• Heredity
• Muscle weakness
• Obesity

Risk Factors of Osteoarthritis

Factors that increase your risk of osteoarthritis include:

• Older age. Osteoarthritis typically occurs in older adults. People under 40 rarely experience osteoarthritis.
• Sex. Women are more likely to develop osteoarthritis, though it isn't clear why.
• Bone deformities. Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.
• Joint injuries. Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis.
• Obesity. Carrying more body weight places more stress on your weight-bearing joints, such as your knees.
• Certain occupations. If your job includes tasks that place repetitive stress on a particular joint, that may predispose that joint toward eventually developing osteoarthritis.
• Other diseases. Having gout, rheumatoid arthritis, Paget's disease of bone or septic arthritis can increase your risk of developing osteoarthritis.

Preparing for Osteoarthritis Appointment

While you may initially bring your concerns to your family physician, he or she may refer you to a rheumatologist, a doctor who specializes in joint disorders.

You may want to write a list that includes:

• Detailed descriptions of your symptoms
• Information about medical problems you've had
• Information about the medical problems of your parents or siblings
• All the medications and dietary supplements you take
• Questions you want to ask the doctor

What to expect from your doctor

During the physical exam, your doctor will closely examine your affected joint, checking for tenderness, swelling or redness. He or she will also check the joint's range of motion.

Osteoarthritis Tests and Diagnosis

In addition to the physical exam, your doctor may also recommend the following tests.

Imaging tests

• X-rays. X-ray images of your affected joint may reveal a narrowing space within a joint, which indicates that the cartilage is breaking down. An X-ray may also show bone spurs around a joint. However, many people have X-ray evidence of osteoarthritis before they experience any symptoms.
• Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce detailed images of bone and soft tissues, including bone cartilage. This can be helpful in determining what exactly is causing your pain

Lab tests

• Blood tests. Blood tests may help rule out other causes of joint pain, such as rheumatoid arthritis.
• Joint fluid analysis. Your doctor may use a needle to draw fluid out of the affected joint. Examining and testing the fluid from your joint can determine if there's inflammation and if your pain is caused by gout or an infection.

Osteoarthritis Treatment

There's no known cure for osteoarthritis, but treatments can help to reduce pain and maintain joint movement so that you can go about your daily tasks.

Medications

Acetaminophen

Acetaminophen (Tylenol, others) can relieve pain, but doesn't reduce inflammation. It has been shown to be effective for people with osteoarthritis who have mild to moderate pain. Taking more than the recommended dosage of acetaminophen can cause liver damage, especially if you consume three or more alcoholic drinks a day. Ask your doctor for guidance on limiting or abstaining from alcohol if you take acetaminophen regularly. Acetaminophen can also affect other medications you may be taking, so be sure to inform your doctor if you're taking it.

Ibuprofen or Naproxen

Over-the-counter drugs such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Mediproxen, others) reduce inflammation and relieve pain. Stronger versions of these drugs are available by prescription. This type of drug can cause stomach upset, particularly when taken by mouth. Other side effects include ringing in your ears, cardiovascular problems, and liver and kidney damage. The risk of major side effects is greatest if you use these drugs at high dosages for long-term treatment.

Tramadol

Tramadol (Ultram) is a centrally acting analgesic that's available by prescription. Tramadol has no anti-inflammatory effect, but can provide effective pain relief. However, tramadol may cause nausea and constipation. It's generally used for short-term treatment of acute flare-ups. Your doctor may recommend using tramadol in combination with acetaminophen to increase pain relief.

Stronger Painkillers

Prescription pain pills, such as codeine, may provide relief from more severe osteoarthritis pain. These stronger medications carry a risk of dependence, though that risk is thought to be small in people who have severe pain. Side effects may include nausea, constipation and sleepiness.

Cortisone Shots

Injections of corticosteroid medications may relieve pain in your joint. During this procedure your doctor numbs the area around your joint and then inserts a needle into the space within your joint and injects medication. It isn't clear how or why corticosteroid injections work in people with osteoarthritis. Your doctor may limit the number of injections you can have each year, since too many corticosteroid injections may cause joint damage.

Therapy

Physical Therapist

Ask your doctor for a referral to a physical therapist. The physical therapist can work with you to create an individualized exercise regimen that will strengthen the muscles around your joint, increase your range of motion in your joint and reduce your pain.

Avoid Stress on Your Joints

Find ways to go about your day without stressing your joints. An occupational therapist can help you discover ways to do everyday tasks or do your job without putting extra stress on your already painful joint. For instance, a toothbrush with a large grip could make brushing your teeth easier if you have finger osteoarthritis. A special seat in your shower could help relieve the pain of standing if you have knee osteoarthritis.

Braces or Shoe Inserts

Consider trying special splints, braces, shoe inserts or other medical devices that can help reduce your pain. These devices can immobilize or support your joint to help you keep pressure off it.

Chronic Pain Management Class

The Arthritis Foundation and some medical centers have classes for people with osteoarthritis or chronic pain. Ask your doctor about classes in your area or check with the Arthritis Foundation. These classes teach skills that help you manage your osteoarthritis pain. And you'll meet other people with osteoarthritis and learn their tips and tricks for reducing and coping with joint pain.

Surgery and Other Procedures

Viscosupplementation

Injections of hyaluronic acid derivatives (Hyalgan, Synvisc) may offer pain relief by providing some cushioning in your knee. These treatments are made of rooster combs and are similar to a component normally found in your joint fluid. Viscosupplementation is only approved for knee osteoarthritis, though researchers are studying its use in other joints.

Joint Replacement

In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surfaces and replaces them with plastic and metal devices called prostheses. The hip and knee joints are the most commonly replaced joints. But today implants can replace your shoulder, elbow, finger or ankle joints. How long your new joint will last depends on how you use it. Some knee and hip joints can last 20 years. Joint replacement surgery can help you resume an active, pain-free lifestyle. In smaller hand joints, it can also improve appearance and comfort and may improve your joint's mobility. Joint replacement surgery carries a small risk of infection and bleeding. Artificial joints can wear or come loose and may need to eventually be replaced.

Realigning Bones

Surgery to realign bones may relieve pain. These types of procedures are typically used when joint replacement surgery isn't an option, such as in younger people with osteoarthritis. During a procedure called an osteotomy, the surgeon cuts across the bone either above or below the knee to realign the leg. Osteotomy can reduce knee pain by transferring the force of the joint away from the worn-out part of the knee.

Fusing Bones

Surgeons can also permanently fuse bones in a joint (arthrodesis) to increase stability and reduce pain. The fused joint, such as an ankle, can then bear weight without pain, but has no flexibility. Arthrodesis may be an option if you experience severe pain in your joint, but can't undergo joint replacement surgery.

Risks and Complications From Osteoarthritis

Osteoarthritis is a degenerative disease that worsens over time. Joint pain and stiffness may become severe enough to make getting through the day difficult, if not impossible. Some people are no longer able to work. When joint pain is this severe, doctors typically suggest joint replacement surgery.