Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 22, 2016

More than 21 million people in the United Stated have osteoarthritis. This chronic degenerative disease can occur at any age but usually starts around the age of 40. If left untreated, it causes progressive loss of the joint's cartilage and underlying bone. Even though there is no cure for osteoarthritis, its symptoms can be controlled through diet, exercise, and medication.


Definition & Facts

Osteoarthritis is a degenerative joint disease that affects the cartilage. It's the most common form of arthritis and the leading cause of chronic disability in people over 70. This disorder causes the breakdown of articular cartilage in the synovial joints.

Healthy cartilage helps reduce the shock of movement and allows bones to glide over each other. Osteoarthritis causes the bones to rub together under the cartilage, leading to reduced motion and debilitating pain. This disease can affect any joint, including the hands, knees, hips, and spine.

Symptoms & Complaints

The most symptoms of osteoarthritis are joint pain and joint swelling. Patients may also experience numbness of the arms and legs, decreased range of motion, hard knobs at the middle finger joints, stiffness during rest, and crepitus. Pain is usually worse toward the end of the day or after physical activity.

Depending on the joints affected, this disorder can also cause valgus deformity, varus deformity, lateral instability, popliteal cysts, joint effusion, pain in buttocks, and sensory loss in the lower extremities. A patient may have severe pain in one knee, with almost normal function of the opposite leg.

Osteoarthritis causes structural, metabolic, and biochemical changes in cartilage. Without adequate treatment, bits of bone can break off and the joints can become permanently damaged. This disease makes it hard to lift objects, climb the stairs, walk, and do everyday tasks, such as holding a pencil or opening a box of food.


Several factors can lead to the development of osteoarthritis. These include certain metabolic disorders, joint injuries, abnormal limb development, and being overweight. Individuals with a family history of osteoarthritis are more likely to develop this condition. Physical trauma and certain occupations may increase the risk of developing this disorder too.

Research indicates that osteoarthritis is typically caused by mechanical stress on the joints. For example, jobs that require prolonged standing, heavy lifting or repetitive bending may lead to joint overuse and inflammation. Over time, the cartilage wears down completely.

The risk also increases with age. Women are more likely to develop this condition than men. Excess body weight can speed up the progression of osteoarthritis. Every extra pound increases the stress on the knee joints up to five times. Underweight individuals can develop this condition too.

Weak thigh, hip, and calf muscles may lead to injury to the meniscus and other joints that could bring on osteoarthritis symptoms. Inflammatory diseases seem to have a key role in cartilage breakdown. Other risk factors include rheumatoid arthritis, gout, impairment of peripheral nerves, joint infection, and diabetes.

Diagnosis & Tests

Doctors can usually diagnose osteoarthritis based on the patient's medical history and physical examination. X-rays may be needed to confirm the diagnosis. The goal of testing is to identify the severity and location of the disease, distinguish it from other forms of arthritis, and track the results of various treatments.

The most widely used tests include radiography, erythrocyte sedimentation rate test, synovial fluid analysis, cyclic citrullinated peptide (CPP) antibody test, rheumatoid factor (RF) test, and arthroscopy. The physician will also perform a careful analysis of the affected area, symptoms, and pain duration.

The presence of Bouchard's nodes, Heberden's nodes, and bony enlargement of the joints are typical signs of osteoarthritis. Laboratory tests are usually not required to make the diagnosis. If gout is suspected, a uric acid level may be required. MRIs can be also used to examine the affected joints.

Treatment & Therapy

There is no permanent treatment for osteoarthritis. However, this disease can be successfully managed. Painkillers are often recommended by doctors to relieve pain and stiffness. Depending on the severity of symptoms, patients may need steroid injections into the joint, non-steroidal anti-inflammatory drugs, or combined painkillers. The role of medicines is to slow down or reverse joint damage.

Regular exercise can help reduce pain and increase joint flexibility. Stretching and aerobic exercise have been shown to improve muscle strength, boost range of motion, and restore normal joint movement. Exercise also aids in weight loss, which helps reduce pressure on the knees and joints. Many hospitals are now offering special programs for osteoarthritis patients, including water aerobics, tai chi, pilates, and spinning.

People suffering from this condition can also try alternative treatments, such as glucosamine and chondroitin supplements, fish oil, krill oil, capsaicin cream, balneotherapy, and acupuncture. Dietary supplements containing omega fatty acids, omega-3 and omega-6 help decrease inflammation. Heat therapy and cold therapy, massage, physiotherapy, and yoga have been proven effective too. Rest and joint care are essential to successful recovery.

Surgery is only required in severe cases where symptoms have not responded to other treatments. The most common type of surgery for osteoarthritis is total joint replacement. Artificial joints can last up to 20 years before wearing off.

Prevention & Prophylaxis

Simple lifestyle changes, such as losing weight and exercising daily, can lower the risk of osteoarthritis. Health-conscious individuals should strive to maintain a healthy weight and make exercise a habit. It is recommended to avoid repetitive stress on the joints, lift weights with proper form, and use ergonomic furnishings. Maintaining good posture is critical for joint health. Older adults can use a walking stick and other assistive devices to reduce the stress on a painful knee or hip.

Currently, there are numerous programs that teach people about osteoarthritis and self-care. Members can learn how to prevent and control this disease, how to reduce pain while staying active, and how to live an independent life. Patient education plays an important role in preventing this condition. Many people are not aware that obesity, smoking, and lack of exercise increase osteoarthritis risk. While some factors can not be controlled, there are small steps anyone can take to improve joint function and prevent osteoarthritis.