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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board
(Degenerative Joint Disease; Arthritis, Osteo-)

Definition

Osteoarthritis (OA) is the wearing down of cartilage between bones. Cartilage is smooth tissue that cushions bones and helps them move smoothly over each other.

Joints Affected by Osteoarthritis
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Causes

OA is caused by the wearing down of cartilage between bones. The damage worsens over time. For some people, the cartilage may completely wear away.

Risk Factors

OA is more common in older adults. It is also more common in women. Other things that may raise the risk are:

  • Having a joint injury
  • Overusing a joint during work or physical activities
  • Obesity
  • Having other family members with OA

Symptoms

OA is most common in larger joints that support weight, such as the spine, hips, and knees. It is also common in active joints like the hand and feet. Common problems are:

  • Mild to severe pain in a joint, especially after overuse or long periods of rest
  • Stiffness that gets better with activity
  • Creaking or grating sounds in the joint
  • Swelling, stiffness, and problems moving the joint, especially in the morning

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. This is often enough to make the diagnosis.

Images of the joint may be taken. This can be done with:

Treatment

OA cannot be cured. The goal of treatment is to:

  • Ease joint pain and swelling
  • Improve joint function
  • Slow future damage

Treatment may change over time. Options may include:

  • Lifestyle changes, such as losing weight, eating a healthful diet, and exercising regularly
  • Supportive care, such as ice to ease swelling and heat to loosen stiff joints
  • Physical therapy to strengthen muscles and improve range of motion
  • Using supportive devices, such as crutches or canes
  • Over the counter or prescription medicine to ease pain and swelling
  • Medicated creams or lotions to apply over the joints

Some people may need surgery if other methods do not help. Surgery may be done to:

  • Remove loose pieces of bone or cartilage from joints
  • Reposition bones to balance stress on the joint
  • Replace a damaged joint with an artificial one

Prevention

To lower the risk of OA:

  • Maintain a healthy weight.
  • Exercise regularly.
  • Limit repetitive motions.

RESOURCES

American College of Rheumatology  http://www.rheumatology.org 

The Arthritis Foundation  http://www.arthritis.org 

CANADIAN RESOURCES

The Arthritis Society  http://www.arthritis.ca 

Seniors Canada  http://www.seniors.gc.ca 

References

Derry S, Moore RA, et al. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database Syst Rev. 2015;2015(6):CD007402.

Fransen M, McConnell S, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1:CD004376.

Kolasinski SL, Neogi T, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res. 2020;72(2):149-162.

Logan CA, Asnis PD, et al. The Role of Therapeutic Modalities in Surgical and Nonsurgical Management of Orthopaedic Injuries. J Am Acad Orthop Surg. 2017;25(8):556-568.

Osteoarthritis (OA) of the hip. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/osteoarthritis-oa-of-the-hip. Accessed October 8, 2020.

Osteoarthritis (OA) of the knee. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/osteoarthritis-oa-of-the-knee. Accessed October 8, 2020.

Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Disorders website. Available at: http://www.niams.nih.gov/Health%5FInfo/Osteoarthritis/default.asp. Accessed October 8, 2020.

Physical therapy for arthritis. Arthritis Foundation website. Available at: https://www.arthritis.org/health-wellness/treatment/complementary-therapies/physical-therapies/physical-therapy-for-arthritis. Accessed September 6, 2020.

Ren R, Tang G, et al. The Tai Chi training for middle-aged and elderly patients with knee osteoarthritis: a protocol for systematic review and meta-analysis. Medicine. 2020;99(20): p e20242.

Singh JA, Noorbaloochi S, et al. Chondroitin for osteoarthritis. Cochrane Database Syst Rev. 2015;1:CD005614.

Xu Q, Chen B, et al. The Effectiveness of Manual Therapy for Relieving Pain, Stiffness, and Dysfunction in Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Pain Physician. 2017;20(4):229-243.

Revision Information