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What Is Osteoarthritis?

According to the Arthritis Foundation, more than 20 million people in the United States have osteoarthritis. The condition is characterized by changes in the cartilage and bone of joints. In healthy individuals, cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the joints. In osteoarthritis, the cartilage breaks down, causing pain, swelling and problems using a joint or joints. The condition typically affects individuals over age 40 and develops slowly over many years.

Although osteoarthritis can affect any joint, it occurs most often in the

Knees
Hips
Lower back and neck
Fingers
Base of the thumb and big toe

Am I at Risk for Osteoarthritis?

The exact cause of osteoarthritis is unknown. However, certain individuals may be at greater risk of developing the disease. Factors that can increase your risk include

Heredity
Obesity
Joint injury
Repeated overuse of certain joints
Muscle weakness
Nerve injury
Aging

Diagnosing and Treating Osteoarthritis at Lahey

Your Lahey health care provider will take a detailed medical history and perform a comprehensive exam to determine whether or not you have osteoarthritis. Additional procedures such as X-rays may be recommended to rule out other causes of your joint pain and to determine the extent of joint damage. Joint aspiration (draining and examining fluid from the affected joints) may also be necessary.

The main goals in treating osteoarthritis are to decrease joint pain and stiffness, improve joint movement and increase your ability to perform everyday activities. Our multidisciplinary approach to treatment means that you have direct access to the health care providers you need, including physical and occupational therapists, pain management professionals, and orthopaedic and hand surgeons.

At Lahey, we personalize our treatment programs to suit the needs of each patient and the severity of the condition. Your recommended treatment program may include

Physical and occupational therapy to help improve joint range of motion and muscle strength
Aerobic exercise and stretching activities such as yoga and tai chi
Weight control
Patient education
Psychological counseling

Although most people experience improvement in osteoarthritis symptoms with exercise, physical therapy and other techniques, medications are sometimes prescribed to relieve pain and reduce swelling. What your physician prescribes will vary depending on your medical history and the severity of your pain and stiffness. The most commonly prescribed medications for osteoarthritis are

Non-narcotic analgesics, such as acetaminophen (Tylenol)
Narcotic analgesics such as codeine, oxycodone, propoxyphene (Darvon) and tramadol (Ultram)
NSAIDs, or nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin
Glucocorticoids, medications that are related to cortisone (a natural body hormone), injected into the joint to relieve pain and swelling
Hyaluronan, a substance found naturally in joint fluid that helps to lubricate and cushion, injected into the knee joint
Topical analgesics including pain-relieving creams, gels, patches, rubs or sprays
Nutritional supplements such as glucosamine and chondroitin sulfate, natural substances normally found within cartilage that some research studies indicate slow the progression of osteoarthritis. More research is currently being done on these supplements.

Osteoarthritis and Surgery

Surgery for osteoarthritis, although infrequent, can be beneficial when there is major joint damage, chronic joint pain and disability brought about due to limitations in joint movement. The various types of surgeries for osteoarthritis are outlined below:

Osteotomy corrects limb malalignment by cutting a bone and then resetting it in a better position.
Total joint arthroplasty involves replacing the joint surfaces destroyed by arthritis with artificial joints made of plastic, metal or ceramic.
Arthroscopy allows the inside of a joint to be examined to determine the extent of damage. This procedure is also used to remove loose pieces of damaged cartilage, as well as to repair damage to ligaments and other structures.
Cartilage transplant is an option for people with a very localized cartilage defect, typically due to injury.

To learn more about osteoarthritis and related treatment options, please speak with your Lahey health care provider or visit our Health Encyclopedia.