What is Osteoarthritis?

Osteoarthritis (OA), also known as degenerative joint disease, is the most common form of arthritis. OA consists of loss of the protective cartilage that covers the ends of the bones. The cartilage wears down over time, narrowing the space between the bones of the joint and leading to pain, swelling and problems moving the affected joint. OA most commonly affects the hand joints, spine, hips, and knees. It’s a top cause of disability in middle-aged to older adults.

Baptist Health is known for advanced, superior care for patients with orthopedic conditions and the diagnosis, treatment and management of OA. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Osteoarthritis Signs and Symptoms

Symptoms of OA can include:

• Bone spurs – extra pieces of bone that may form in deteriorating joints damaged by arthritis.

• Grating, clicking or cracking sensations or sound in the joint.

• Loss of flexibility and normal range of motion.

• Mild swelling around the joint.

• Pain, during or after movement.

• Stiffness, especially after a period of inactivity or upon waking.

• Tenderness with pressure.

Diagnosis

If OA is suspected, a physical examination that includes specific questions about symptoms will be performed. Advanced diagnostic procedures and technology may be used to diagnose, determine treatment and monitor the condition. Common diagnostic procedures can include:

Blood tests: Blood tests check the levels of certain substances to rule out other conditions, like rheumatoid arthritis (RA).

X-rays: A common imaging test of bones or joints. Cartilage doesn't show up on X-rays, but cartilage loss is revealed by a narrowing of the space between the bones in the joint.

Joint aspiration and analysis: During this test, fluid is removed from a joint and analyzed for substances that can indicate infection, inflammation, RA, gout, or pseudogout.

Magnetic Resonance Imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of bone and soft tissues, including cartilage.

Stages

There are four stages of osteoarthritis. Each stage is different and gets progressively worse.

The four stages of osteoarthritis:

• Stage 1—In this stage, you may feel a little stiffness or occasional pain in your fingers, knees, ankles, and joints.
• Stage 2—In stage two, you may have slightly more stiffness or pain. You may also notice that you are starting to feel a little stiff as you walk or climb stairs. Your doctor will see bone spurs on X-rays.
• Stage 3—In the third stage, you will feel stiffness or pain for extended periods of time. Your doctor will likely see multiple bone spurns during X-rays.
• Stage 4—In this stage, you may experience a lot of stiffness or pain all the time. Your doctor will likely see a significant amount of bone spurs or large bone spurs during X-rays.

What Causes Osteoarthritis?

Primary OA occurs over time as a noninfectious progressive joint degeneration that is of unknown cause and can be seen at any age, but is most common in the elderly. Secondary OA is caused by an injury or disease that damages the joint. Contributing factors to OA can include:

• Obesity
• Lack of exercise
• Stress on Joints as in certain occupations

Risk Factors

Risk factors that can contribute to osteoarthritis include:

Age: The risk of developing osteoarthritis increases with age. OA begins as early as the second or third generation, but symptoms may not be noted until after age 50 because the disease progresses slowly. 

Bone or joint deformities: Malformed joints or defective cartilage, present at birth, can increase the risk of OA.

Gender: Women are more likely to develop this condition.

Genetics: Heredity plays a role in OA. Individuals born with other diseases are more likely to develop OA. Examples include conditions associated with increased joint laxity such as being "double-jointed,” some dysplasias (abnormal growths of bone and cartilage), and Paget's disease (a type of inflammation in bone that occurs in older people).

Occupational stress: Repetitive motion or activities can put stress on joints, leading to OA.

Prevention

Many cases of OA can’t be prevented, but there are things you can do to reduce and manage symptoms, including:

Take care of your joints: Avoid repetitive stress activities and get plenty of rest after activity.

Manage weight: Lose weight and maintain a healthy weight through diet and exercise.

Prognosis

The prognosis for people with OA depends upon how far the condition has advanced prior to treatment. In advanced OA, everyday activities may become challenging.

Osteoarthritis Treatment and Recovery

OA treatment depends on symptoms and the condition’s progression. The main treatments for OA are:

Gentle Exercise

Regular, low-impact exercise like swimming, walking, yoga and tai chi can help stretch and strengthen the muscles around an affected joint and maintain flexibility.

Injections

Injections of corticosteroid medications relieve joint pain for some people. These treatments are limited because too much of these medications can worsen joint damage over time. Lubricating injections of hyaluronic acid may relieve knee pain for certain patients.

Medications

Drugs to reduce pain and swelling of the joints may include over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs), COX II inhibitors (Celebrex), Tylenol (acetaminophen) and certain antidepressants.

Surgery

• Bone Realignment Surgery: If OA has damaged one side of the knee more than the other, a surgeon may perform a knee osteotomy, cutting across the bone above or below the knee and removing or adding a wedge of bone. This procedure shifts body weight away from the damaged area.

• Full or Partial Joint Replacement: In this procedure, also known as arthroplasty, a surgeon removes damaged joint surfaces and replaces them with plastic and metal parts. Although technology has greatly improved the longevity of these artificial joints, they still may need replacement over time.

Therapies

Physical therapy can help strengthen muscles around the joint, increase flexibility and reduce pain. Occupational therapy can help people with OA do everyday tasks with less pain and less stress on an affected joint.

Alternative Medicine

Acupuncture, supplements – like glucosamine and chondroitin – and certain anti-inflammatory creams or ointments have helped some people with OA.

Complications

Complications of OA may include:

Inability to perform daily tasks: Everyday tasks and activities like climbing stairs, opening doors, getting dressed and caring for loved ones or pets may become difficult and painful.

Inability to work: If OA is severe, it may impede a person’s ability to perform in the workplace, leading to loss of employment.