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Osteoarthritis is a painful problem with the joints. Healthy joints help your body move, bend, and twist. Knees glide up and down stairs without creaking or crunching. Hips move you along on a walk without a complaint. But when you have arthritis, such simple, everyday movements can hurt. Using the stairs can be painful. Walking a few steps, opening a door, and even combing your hair can be hard.
Arthritis is mainly a disease of the spine, hip, hand, knee, and foot. But it can happen in other joints too. A joint is where two bones connect. And you have them all over your body.
Arthritis is most common in older people. Even though you can't cure arthritis, there are many treatments that can help with your pain and make it easier for you to move. And you can do things to keep the damage from getting worse.
The simplest way to describe arthritis is that it's wear and tear on the cartilage of your joints. This cushioning tissue is firm, thick, and slippery. It covers and protects the ends of bones where they meet to form a joint.
With arthritis, there are changes in the cartilage that cause it to break down. When it breaks down, the bones rub together and cause damage and pain. Experts don't know why this breakdown in cartilage happens. But aging, joint injury, being overweight, and genetics may be a part of the reason.
Your doctor will check that your pain is not caused by another problem. He or she will ask questions about your symptoms, such as:
If your joints are tender and swollen and the muscles are weak, this will also help your doctor confirm whether you have arthritis. You may also have X-rays to check your joints for damage. Your doctor may want to do blood tests or other tests to see if there are other causes for your pain.
There are many treatments for arthritis, but what works for someone else may not help you. Work with your doctor to find what is best for you. Often a mix of things helps the most.
Your treatment may include:
There are also some things you can do at home to help relieve your symptoms. For example, there are devices and tools that can take the stress and weight off of your joints and make it easier for you to hold objects, open and close things, and walk. Doorknob covers, tape, braces, splints, and canes may help.
You might also try changing activities or the way you do things to reduce the stress on the joint that hurts and allow you to move better. For example, walk instead of jog. Or use a sewing machine to make a quilt instead of making it by hand.
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Osteoarthritis occurs when changes in cartilage cause it to break down and wear away. When cartilage breaks down, the bones rub together and cause damage and pain. Experts don't know why this happens. But things like aging, joint injury, being overweight, and genetics may increase your risk.
In some cases, arthritis is caused by other conditions that damage cartilage.
Symptoms of osteoarthritis can range from mild to severe.
They may include:
Arthritis of the spine can also narrow the openings that make space for the spinal cord and for the nerves that branch off the spinal cord (spinal nerves). This is called spinal stenosis. It can lead to pressure on the spinal cord or spinal nerves. This pressure can cause pain, weakness, or numbness.
Some medical conditions can cause symptoms similar to osteoarthritis, such as joint injuries and other forms of arthritis.
One Man's Story:
"I thought the stiffness and pain in my hip was just from the stress I was putting on my muscles. But when I changed my exercise routine or stopped working out, the pain was still there ... The pain would come and go. It wasn't a sharp pain, but a kind of ache that would keep me awake a lot. I could never stay in one position for very long."— Steve
Read more about Steve and how he learned to cope with arthritis.
Osteoarthritis occurs when the cartilage that cushions your joints breaks down and wears away. When this happens, the bones rub together and cause damage and pain. In most cases, it takes years for cartilage to break down.
It's hard to know how fast arthritis may progress. You may not have any symptoms for years, until the bones and tissues become damaged. Or symptoms may come and go, stay the same, or get worse over time.
Arthritis can cause problems in any joint in the body. But in most cases, you'll have symptoms in only one or two joints or groups of joints. Arthritis may cause problems in your hands, hips, knees, or feet, and sometimes in your spine. At first, you may only feel pain when you're active. As the disease gets worse, you may also feel pain when you're at rest.
If you have arthritis in your fingers, the joints at the tip or middle part of your fingers may get bigger and form bumps. These are known as Heberden's and Bouchard's nodes.
Even though there is no cure for arthritis, most people can manage their symptoms with medicine and lifestyle changes. But in a few people, arthritis or complications of arthritis may get so bad that they decide to have surgery to replace the worn joint or to fuse the bones together so that the joint won't bend.
Things that can increase your risk for osteoarthritis are called risk factors. Some risk factors, such as your age or family history, can't be changed or prevented.
You may be able to reduce other risk factors by making lifestyle changes or taking medicine.
Call your doctor if you have:
If you have mild joint pain and stiffness, first try home treatment, such as using ice and heat. If you don't feel better in 6 weeks, or if you have other symptoms, call your doctor.
Arthritis can be managed by:
Other health professionals may be part of the treatment team, such as:
In most cases, your doctor can tell you if you have osteoarthritis and recommend treatment based on your symptoms and by doing a physical exam. Your doctor may also do some other tests to be sure that the diagnosis is correct or to rule out other conditions that have similar symptoms.
These tests may include:
Other tests may include a urine test and one or more blood tests, such as:
Even though there is no cure for osteoarthritis, treatment can help reduce your symptoms and make it possible for you to lead a full and active life.
The goals of treatment are to:
Treatment is based on:
In most cases, people who have mild to moderate arthritis can manage their symptoms for many years with a treatment plan that may include:
Some people with arthritis also feel down or depressed. They may describe this as feeling "depressed," "unhappy," "short-tempered," "blue," or "down in the dumps." If you feel like this most of the time, tell your doctor. Treating these symptoms may help you feel better and make it easier for you to do your daily tasks.
If the pain and stiffness from arthritis don't get better or they get worse, your doctor may recommend:
If your pain is very bad, you may decide to have surgery to replace the joint. Or you may decide to have some other kind of surgery that can help keep your joints moving well and prevent your arthritis from getting worse.
Some types of surgery include:
For help deciding whether to have joint replacement surgery, see:
You can take steps to help prevent osteoarthritis. If you already have arthritis, these same steps may keep it from getting worse.
When you have osteoarthritis, you may find it hard to do your daily tasks. Your joints may ache or feel stiff, and they may hurt when you move. You can do some things at home to feel better.
One Woman's Story:
"Gardening books and magazines always have wonderful ideas and innovations that you can use. For instance, I've cut off sections of the rubber insulation that is used to cover water pipes and slipped them over any of the garden tools that I'm going to use, because it gives me a little more cushion and a little extra width for my tools."— Bev
Read more about Bev and how she learned to cope with arthritis.
Living with arthritis can be stressful. At times you may feel overwhelmed, tired, and angry. And you may worry about what your life may be like as your condition gets worse. These feelings are normal. But there are a lot of ways to cope with arthritis. For example, ask for help when you need it, keep a positive attitude, and join a support group.
If you are caring for someone who has arthritis, be sure to take time to care for yourself and find ways to manage stress. Being a caregiver isn't easy. But it can be rewarding, especially when you know that your care makes a positive difference in someone's life.
Medicine can help reduce your symptoms of osteoarthritis and allow you to do your daily activities.
The goal of medicine is to:
The type of medicine depends on how bad your pain is. For instance:
Medicines used to treat arthritis include:
Medicine that you put on your skin (topical) may relieve pain for a short time.footnote 3 These include topical NSAIDs, capsaicin, and pain-relieving creams.
Before you take medicine
Here are a few things to think about:
Effects of medicines
Medicines that work for some people don't work for others. Be sure to let your doctor know if the medicine you're taking doesn't help. You may need to try several kinds of medicines to find one that works for you.
Be safe with medicines. Read and follow all instructions on the label.
In most cases, people can manage their osteoarthritis symptoms with medicine and lifestyle changes. But surgery may be an option if:
"I wasn't sure about having surgery since I was so young. I had heard that an artificial hip could give out in 10 to 20 years ... But when the medicine I was taking stopped working, I figured I had gone as far as I could go with this, and decided to go ahead with the surgery ... It's a strange feeling to be able to walk without a limp and to walk up and down stairs without grabbing on to the railing."— Steve
Types of surgery for arthritis include:
Small joint surgery. Surgery is more common on the larger joints, such as the hip and the knee. But if pain in the small joints of the hands or feet is so bad that the person can't use those joints, surgery may help.
A newer procedure for arthritis of the knee uses a small cup shaped like a "C." It's placed in the joint space of the inner knee and acts as a cushion for the joint. It may help delay surgery to replace the knee.
Before deciding to have surgery
If you're in poor health or have certain health problems, you may not be able to have surgery. Your doctor can help you decide if surgery is right for you.
Here are some things to think about if you're thinking about surgery:
If you decide to have surgery
In the days or weeks before your surgery, talk to your doctor about what you need to do to get ready for your return home. For example, you may need to arrange for someone to drive you home and to help you after your surgery. Or you may need to make changes to your home, such as removing small rugs, to help you move around.
Many people use some form of complementary medicine to treat certain health problems, including osteoarthritis. These treatments are often used along with standard care to help relieve their arthritis symptoms.
Some of these treatments may help you move more easily and deal with the stress and pain of arthritis. But in some cases, not much is known about how safe they are or how well they may work.
Be sure to tell your doctor if you're using a complementary therapy or if you're thinking about trying one. He or she can discuss the possible benefits and potential side effects of these treatments and whether any of these treatments may interfere with your standard care. For example, some diet supplements and herbal medicines may cause problems if you take them with another medicine.
"After I have a massage and acupuncture, I feel like a new person. I encourage people to find out what treatments others have tried and what things have worked for them. I'm a believer in other people's ideas. Obviously, what works for one person may not work for another, but unless you try it, you'll never know if it'll help."— Bev
There are many treatments for arthritis, but what works for someone else may not work for you. You may need to try several different treatments to find what works for you.
Experts are testing new medicines and methods that they hope will one day help prevent, reduce, or repair cartilage damage. For example, they're looking at cartilage transplants and the use of stem cells to grow new cartilage. So far, therapies to repair cartilage have only been studied in younger people with small, well-defined holes in their knee cartilage. This isn't a common problem for most older adults who have arthritis of the knee.
Messier SP, et al. (2005). Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis and Rheumatism, 52(7): 2026–2032.
Stitik TP, et al. (2010). Osteoarthritis. In WR Frontera et al., eds., DeLisa's Physical Medicine and Rehabilitation: Principles and Practice, 5th ed., vol. 1, pp. 781–809. Philadelphia: Lippincott Williams and Wilkins.
Lozada CJ (2013). Treatment of osteoarthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology 9th ed., vol. 2, pp. 1646–1659. Philadelphia: Saunders.
Towheed TE, et al. (2006). Acetaminophen for osteoarthritis. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.
Other Works Consulted
American Academy of Orthopaedic Surgeons (2013). Summary of recommendations. Treatment of Osteoarthritis of the Knee, 2nd ed. Available online: http://www.aaos.org/research/guidelines/guidelineoaknee.asp.
Derry S, et al. (2012). Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database of Systematic Reviews (9).
Dunlop DD, et al. (2011). Physical activity levels and functional performance in the Osteoarthritis Initiative. Arthritis and Rheumatism, 63(1): 127–136.
Easley ME, et al. (2011). Results of total ankle arthroplasty. Journal of Bone and Joint Surgery, American Version, 93(15): 1455–1468.
Hinman RS, et al. (2014). Acupuncture for chronic knee pain: A randomized clinical trial. JAMA, 312(13): 1313–13222. DOI: 10.1001/jama.2014.12660. Accessed July 23, 2015.
Hochberg MC, et al. (2012). American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care & Research, 64(4): 465–474.
Li S, Micheletti R (2011). Role of diet in rheumatic disease. Rheumatic Disease Clinics of North America, 37(1): 119–133.
Lin EHB, et al. (2003). Effect of improving depression care on pain and functional outcomes among older adults with arthritis: A randomized controlled trial. JAMA, 290(18): 2428–2434.
Louie GH, et al. (2011). Sleep disturbances in adults with arthritis: Prevalence, mediators, and subgroups at greatest risk. Data from the 2007 national health interview survey. Arthritis Care and Research, 63(2): 247–260.
Peak EL, et al. (2005). The role of patient restrictions in reducing the prevalence of early dislocation following total hip arthroplasty. Journal of Bone and Joint Surgery, 87-A(2): 847–853.
Current as ofJune 10, 2018
Author: Healthwise StaffMedical Review: Anne C. Poinier, MD - Internal MedicineAdam Husney, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineMartin J. Gabica, MD - Family MedicineKathleen Romito, MD - Family MedicineStanford M. Shoor, MD - Rheumatology
Current as of:
June 10, 2018
Medical Review:Anne C. Poinier, MD - Internal Medicine & Adam Husney, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Martin J. Gabica, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Stanford M. Shoor, MD - Rheumatology
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