What do you need to know

A lifetime of walking, exercise and movement can damage your cartilage – the smooth, shiny, white connective tissue that covers the ends of bones.

Degeneration of this cartilage can lead to arthritis and result in chronic inflammation of the joints.

Osteoarthritis (OA) is the most common form of arthritis. OA is also commonly referred to as degenerative joint disease.

According to the Centers for Disease Control and Prevention (CDC), more than 32.5 million adults in the United States have OA, making it a leading cause of disability in adults.

Cartilage protects the ends of the bones and allows them to move smoothly and easily against each other.

A membrane called synovium surrounds your joints and produces a thick fluid that helps keep cartilage healthy.

Your synovium can become inflamed and thickened as cartilage wears out. This can cause inflammation and accumulation of extra fluid in the joints, resulting in swelling.

The joints most commonly affected by OA are:

As the cartilage deteriorates further, the underlying bones may not have sufficient cushioning in your cartilage.

Once the bone surfaces come in direct contact with each other, there is usually additional pain and inflammation that occurs in the joints and surrounding tissues.

As their bones continue to grind and rub against each other, they begin to develop osteophytes, or bone spurs, one of the most common findings in OA joints.

The older you get, the more common it is to experience mild pain or soreness when you:

  • stand
  • Walk up the stairs
  • exercise

Naturally, your body does not recover as quickly as before.

In addition, cartilage deteriorates naturally with age, and stiffness, especially after sitting or lying down for a long time, is one of the most common symptoms in people living with OA.

As your body’s natural buffers wear out, your joints are less able to absorb the demands that our lives impose on them.

Muscle tone and bone strength also decrease with age, making physically demanding tasks more difficult and stressful for the body.

A common risk factor for the development of OA is age. According to the CDC, in 2040 it is estimated that 26 percent of the United States population aged 18 or over will have a form of arthritis diagnosed by a doctor.

However, almost 50% of people over 65 reported hearing from a doctor who has arthritis.

Other factors that increase a person’s chances of developing the disease include:

Weight

Being overweight can put additional stress on:

This stress can especially affect your knees and hips, and it means that you are less likely to be physically active. Regular physical activity, such as a daily walk, can greatly reduce the likelihood of developing OA.

Family history

Genetics can make a person more likely to develop OA. If you have family members living with the disease, you are at an increased risk of developing OA.

Sex

According to the CDC, most types of arthritis are more common in women, including osteoarthritis.

Occupation

Certain occupations increase the risk of developing OA, such as:

  • construction
  • agriculture
  • cleaning
  • retail

People in these occupations use their bodies more vigorously as part of their jobs, resulting in more wear and tear on their joints.

Younger, more active people can also develop OA. However, it is usually the result of trauma, such as a sports injury or accident. A history of injury or accident can increase the chance of developing OA later.

OA has no cure. Instead, the goal of treatment is to control pain and reduce any contributing factors that may worsen OA symptoms.

The first step in treating OA is to decrease the pain. This is usually done with a combination of:

  • medicines
  • exercise
  • physiotherapy

Treatment for OA is usually adapted to the person’s lifestyle and the triggers that cause pain and discomfort. A range of treatment options is available. These include:

Medication

Over-the-counter (OTC) medications may be what some people living with OA need to treat pain.

Examples include acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin).

Injections

Steroid injections can help to reduce pain in the affected joints. However, they should not be used repeatedly because they can cause additional damage to the joints over time.

Glucocorticoid injections

For people living with knee or hip OA, the American College of Rheumatology (ACR) and the Arthritis Foundation (AF) strongly recommend glucocorticoid injections into your joints. A glucocorticoid is a type of corticosteroid.

Glucocorticoid injections into your joints are only conditionally recommended for people living with hand OA, due to a lack of evidence about their effect on their hands.

FDA-approved glucocorticoids include:

Other types of injections

Studies once praised the benefits of hyaluronic acid (gel) injections in the knee joint and these injections are still routinely used for knee OA. However, a 2019 research review questioned its effectiveness.

Hyaluronic acid injections are approved only by the FDA for use in the knee joint and are not normally used for other arthritic joints.

Receiving hyaluronic acid injections into joints in other places, such as the hand or the hip, would be an example of using off-label drugs.

Off-label medication use

The use of off-label drugs is when a drug approved by the FDA for one purpose is used for a different purpose that has not yet been approved.

However, the doctor can still use the medicine for this purpose. This is because the FDA regulates drug testing and approval, but not how doctors use drugs to treat their patients.

Therefore, your doctor can prescribe a medication in whatever way you think is best for your care.

ACR and AF now conditionally recommend hyaluronic acid injections for people living with knee OA or OA in their first carpometacarpal joint (CMC).

Your first CMC joint is located near your thumb.

The ACR and AF strongly recommend against these injections for people living with hip OA.

Other injections, such as platelet-rich plasma (PRP) and stem cell injections, are being used experimentally.

Surgery

Surgery is usually reserved for people with severe and debilitating OA.

Osteotomy is an operation that realigns a bone, cutting it and repositioning it. This type of operation is sometimes performed around the knee joint to help control OA pain symptoms.

Sometimes, a bone fusion (arthrodesis) is done to treat severely damaged joints. Hip or knee arthrodesis is rarely performed, but a fusion can be made in other joints, such as:

For hip and knee joints with severe arthritis, a total joint replacement (arthroplasty) can provide long-term pain relief and a marked improvement in lifestyle.

Lifestyle and home treatments

To help control pain and reduce symptoms, a few simple lifestyle adjustments can make things easier on your bones and joints. These adjustments can improve function and quality of life.

Options include:

Exercise

Low impact exercises can help strengthen your muscles and keep your bones strong. Exercise also improves joint mobility.

Avoid high impact exercises, such as:

Consider low-impact exercises, such as:

These exercises are easier on the joints.

Also check out these exercises for OA inflammation and pain.

Heat or cold therapy

Apply hot compresses or cold compresses to the joints when they are sore or sore. This can help to relieve pain and reduce inflammation.

Assistive devices

The use of auxiliary devices can help to unload and support arthritic joints. Examples include:

Rest

Giving your sore and aching joints adequate rest can help relieve pain and reduce swelling.

Weight loss

According to Tufts University, losing just 5 pounds can help decrease OA symptoms, especially in large joints like the knees and hips.

It is very common to experience some joint pain and soreness as we age – especially when:

  • standing
  • going up stairs
  • exercise

It is also possible that cartilage degeneration can cause inflammation and OA over time.

However, there are medical treatments and lifestyle changes that you can adopt to help reduce pain and control other symptoms.

If you have OA, it is always a good idea to speak to a doctor to explore your treatment options.

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