Osteoarthritis

Causes

There are more than 200 bones and more than 100 joints in our bodies. The joints are covered with cartilage. This tough elastic material protects the ends of bones like a shock absorber allowing us to move our arms legs and fingers smoothly. Over time cartilage begins to break down. Bits of cartilage may break off and cause pain and swelling in the joint between bones. Eventually the cartilage may wear away entirely causing the bones to rub together. This form of arthritis can affect any joint but usually involves the hips knees hands and spine.

Researchers haven't been able to identify any one specific cause for osteoarthritis. It may very well be a combination of factors including heredity; excess weight; injury; or joint damage from another type of arthritis.

Symptoms

Usually osteoarthritis develops slowly. At first you may notice aches and pains in the joints at the end of a day of hard work or after you've exercised. Over time other symptoms will develop depending on which joints are affected.

Fingers

  • Pain and swelling of the finger joints
  • Bony growth spurs or nodes at the joint at the end of the finger or at the middle joint
  • Redness tenderness and swelling in the affected joints especially early on when the nodes are forming
  • Enlarged joints
  • Difficulty with pinching movements such as picking an item up from a table or grasping a pencil or pen.

Spine

  • A breakdown of the spinal discs resulting in bony overgrowth
  • Stiffness and pain in the neck and lower back
  • Pressure on the nerves in the spinal cord (pinched nerves)
  • Pain in the neck shoulder arm lower back and legs
  • Weakness or numbness in arms and legs due to pinched nerves

Knees

  • Pain when moving the knee
  • Grating or catching when moving the knee
  • Pain when walking up and down stairs or getting up from a chair
  • Pain that prevents you from exercising your leg
  • Weakened large thigh muscles

Hips

  • Pain in groin inner thigh and buttock
  • Referred pain in knee and side of thigh
  • Limping when walking

Feet

  • Pain and tenderness in the large joint at the base of the big toe
  • Pain when wearing tight shoes or high heels

Treatment

No single test can diagnose osteoarthritis but it is usually not difficult to tell if a person has it. X-ray testing can be helpful but many people have some findings of osteoarthritis on their joint x-ray but are completely asymptomatic. Usually the diagnosis is straightforward but your caregiver may want to do some extra testing to rule out other conditions.

Osteoarthritis treatment plans include ways to manage pain and make movement easier. This can involve exercise rest and joint care pain relief weight control medicines and surgery.

Exercise

Research shows that exercise is one of the best treatments for osteoarthritis:

  • It helps reduce pain and prevents further joint damage.
  • It can help you maintain a healthy weight which puts less strain on your joints.
  • It keeps muscles around a joint strong which helps reduce pain.

The Arthritis Society of Canada recommends three types of exercise:

  • Range of motion exercises reduce stiffness and help keep your joints moving. A range of motion exercise for your shoulder would be to move your arm in a large circle.
  • Strengthening exercises maintain or increase muscle strength
  • Endurance exercises strengthen your heart give you energy and control your weight. These exercises include walking swimming and cycling.

Remember to check with your doctor before starting an exercise program.

Medicine

Acetaminophen is often the first medication chosen to treat osteoarthritis. It can relieve pain but does not reduce inflammation. Always be careful not to exceed daily limits as a serious overdose of acetaminophen can cause liver damage.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aspirin and Advil helps reduce the pain and swelling of the joints and decrease stiffness. However this drug will not prevent further joint damage.

Cortisone may be injected into the joint to relieve severe inflammation. Cortisone is a steroid that reduces inflammation and swelling.

Ask your doctor about other medicines that may help you. And remember that many medicines even over-the-counter drugs that are used to treat osteoarthritis have side effects. Ask your doctor or pharmacist to explain these to you.

Heat/Cold

  • Applying heat helps relax aching muscles and reduces joint pain and soreness.
  • Applying cold helps to lessen the pain and swelling in a joint.

Relaxation

Relaxing the muscles around an inflamed joint reduces pain. Developing good relaxation and coping skills can give you a greater feeling of control over your arthritis and a more positive outlook.

Surgery

If one of your joints becomes badly damaged or if the pain is too strong your doctor may recommend surgery. With some surgery bits of cartilage are removed from the joint. Other kinds of surgery repair or rebuild parts of the bone or replace a joint with an artificial or a man-made joint.

Prevention

The Arthritis Society of Canada offers these additional tips to protect your joints from every day stress:

  • Be kind to your body. After doing heavy work or doing the same task over and over stop. Slow down by doing an easy task or by taking a rest.
  • Use your back arms and legs in safe ways to avoid putting stress on joints. For example carry a heavy load close to your body.
  • Use helpful devices such as a cart to carry your grocery bags or an enlarged handle that fits over a knife handle so you can hold it easily. A cart will help you to walk more safely. A grab bar which attaches to a shower will help you to get in and out of the tub more easily.
  • Maintain a healthy weight to avoid putting extra stress on your joints.

Additional Reading

Popular arthroscopic knee surgery may not provide relief from arthritis

Additional Resources

The Arthritis Self-Management Program (ASMP) is a unique self-help program offered by The Arthritis Society to help you better control and manage your arthritis.