Overview and Frequently Asked Questions
Osteoarthritis is a mechanical wear and tear disease of the joints, where the normal cartilage of the joint breaks down and no longer provides a cushion between the bones of the joint. It most affects middle aged to older individuals. While some people do not even know they have osteoarthritis, in others it leads leads to functional disability and pain.
Commonly involved joints include the back, hips, knees and fingers.
We do not have medications which can reverse the osteoarthritis process. Symptom control remains the key objective.
Exercise, muscle strengthening, diet and weight control are all important to control osteoarthritis. Braces for the knee or hand, and walking aids can also be useful. In some instances, these simple steps is all that is required to reduce pain and maintain joint function.
Acetaminophen (Tylenol) is the first choice for pain relief. When used properly, it is an effective and safe option for most patients with osteoarthritis. Follow the directions provided closely and discuss its optimum use with your doctor.
Anti-inflammatories, or NSAIDs, can also be used for pain relief and can be safely used with acetaminophen. However, NSAIDs are not a good option for patients with heartburn, a stomach ulcer, a heart condition or kidney problems.
Glucosamine is a natural product which has been studied to relieve pain and slow the progression in osteoarthritis. While its effects remain unclear when studied, some patients find it effective. It can take 2-3 months to work.
Joint injections, either with corticosteroids or hyaluronic acid, are also effective and safe options.
If none of these options are effective, often in combination, and you have uncontrolled pain or you are unable to go about your day to day activities as you would like, you may need to discuss further pain control options, or joint replacement surgery, with your doctor.
What is Osteoarthritis?
Osteoarthritis, or OA, is a degenerative disease of the joints. It usually occurs because of excessive loads across otherwise normal joints. Genetics can also play a role, particularly with osteoarthritis of the hand.
What other names are there for OA?
OA has also been referred to as Degenerative Joint Disease. In the spine, it is sometimes referred to as Degenerative Disc Disease.
How common is osteoarthritis?
OA is the most common joint disorder. It increases with age; In patients over the age of 65, 10% have knee OA and 5% hip OA which causes them difficulties.
OA is more common in women than men.
Are there any other risks for developing OA?
Obesity, joint damage from old injuries and smoking are some of the more common risk factors associated with OA.
What are the typical symptoms of OA?
Patients with OA describe pain in the involved joints. It is better with rest and worse with activity, but remains painful at rest in some patients. There is sometimes a cracking or grinding sound heard when moving the joint. You may notice bony enlargement of the joints with decreased range of motion. This is often seen as nodes on the finger joints. Some patients feel stiff in the affected joints in the morning, but usually for less than one hour.
Which joints are affected by OA?
Typical joints include the hips, knees, the distal joints in the fingers, and the base of the thumbs and toes.
Is Osteoarthritis the same thing as Rheumatoid Arthritis?
No, while both cause joint problems, they are actually very different diseases. The cause, pattern of joint involvement and joint pain require different treatment approaches. Please go to the page on rheumatoid arthritis for more information.
How is Osteoarthritis diagnosed?
OA is a clinical diagnosis made by your physician based on your medical history and an appropriate physical examination.
Isn’t there a blood test or x-ray to confirm the diagnosis?
Blood tests do not help in the diagnosis of osteoarthritis. While an x-ray can be helpful, not everyone who has the symptoms of OA has typical changes on their x-rays. Conversely, there are many people who have x-rays changes which are consistent with OA but do not have any symptoms.
Is there a cure for OA?
Unfortunately, we do not have a cure to reverse the degenerative effects of osteoarthritis. Treatment is based on alleviating the symptoms of OA. For best results, patients can combine different treatment modalities to work together.
I don’t like taking medications. Is there anything I can do to help my OA?
There are many non-pharmacologic to help in the management of OA. Please discuss these options with your physician for further information. They include:
Walking aids e.g. cane, walker
Exercise to maintain strong muscle around affected joints
Heat or cold therapy
Water therapy and exercise including swimming & aquasize
Are there any medications recommended for OA pain?
There a number of different options available, usually starting with over-the-counter acetaminophen. Others include anti-inflammatories such as ibuprofen (Motrin or Advil), and naprosyn (Naproxen or Aleve), as well as stronger prescription pain medications. You should all discuss these options with your physician to ensure their safe and appropriate use for you.
What about joint injections?
A joint injection is a good option for some patients with OA, particular when only one or two joints are affected, such as the knees. A joint injection, either with cortisone or viscosupplementation, can be done a few times a year, and if effective, may decrease your need for regular pain medication.
What is the long term prognosis for osteoarthritis?
While OA never goes away, it is difficult to predict if it will continue to get worse and if so, how quickly. Reducing risk factors. regular exercise, maintaining a healthy weight, and smoking cessation may all be helpful. If pain ever becomes so poorly controlled that medications are not effective, or OA is limiting your activity too much, it may be time to consider joint replacement therapy.