Osteoarthritis Treatment

About

Causes

Symptoms

Diagnosis

Treatment

About

Osteoarthritis Treatment

What is osteoarthritis?

Osteoarthritis is the most common type of the more than 100 types of arthritis. It is described as an irreversible “wear and tear” type of arthritis that affects millions of people. Also known as degenerative arthritis, it occurs when the cartilage in bones begins to deteriorate, removing the natural cushion away from joints. This can occur in any joint and causes pain and limitation of motion for people, which may cause limitations in their daily activities and increases one’s chances of developing other chronic diseases like diabetes, high blood pressure and heart disease by 50%.

Who can develop osteoarthritis?

Osteoarthritis affects more than 32 million Americans and is increasing. Women tend to develop the illness more than men, especially after the age of 50. Since osteoarthritis progressively gets worse over time, it is usually initially recognized in middle-aged or older individuals.

Causes

What is the cause of osteoarthritis?

Osteoarthritis is the end result of cartilage wearing away on bones, usually due to cumulative damage to the joint. This leads to increased friction, clicking and locking up of the affected joint. Cartilage is important as it cushions the space between the bones and helps to form the joint. Once the cartilage wears away completely, there is usually bone-on-bone rubbing, which is very painful. Joint inflammation from other types of arthritis like gout, rheumatoid arthritis or lupus, can also be a contributing factor to accelerate cartilage damage. Therefore, if you are young or have more severe osteoarthritis, it’s advised to check with a medical (non-surgical) arthritis specialist, known as a rheumatologist, to see if you could also have inflammatory arthritis, in addition to non-inflammatory osteoarthritis.

What risk factors are there for developing osteoarthritis?

There are a variety of factors that may put someone at greater risk of developing osteoarthritis, such as:

  • Gender - Women appear to develop osteoarthritis more than men, although there is no research on the cause of this.
  • Increase age - As age increases, so does the possibility of developing osteoarthritis.
  • History of previous trauma - Old injuries- even if they healed uneventfully in the past- places someone at increased risk of developing osteoarthritis in the future.
  • Genetics - People with family members who suffer from osteoarthritis may be more susceptible to developing this type of arthritis as well.
  • Overweight - Increased body weight is known to place more stress on joints, increasing one's chances of developing osteoarthritis. Being overweight (BMI > 25) or obese (BMI > 30) was approximately 2.5 and 4.6 times more likely to have knee OA than having normal weight. If you don’t know what your BMI is, go to: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
  • Repeated stress to the joint - Certain jobs or sports may place repeated stress on joints, eventually causing osteoarthritis.
  • Birth defects - Some people may be born with deformed joints and damaged cartilage making them vulnerable to osteoarthritis.
  • Metabolic diseases - Examples of diseases include diabetes, hemochromatosis, etc. which may increase someone’s chances of developing this degenerative arthritis.
  • Race - Some races have been shown to have a lower likelihood of developing osteoarthritis, such as Asian populations.

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Follow Up
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Symptoms

What are the symptoms of osteoarthritis?

There are a variety of different signs and symptoms associated with osteoarthritis that can range from mild to severe. Many times, the onset of the symptoms begins very gradually and progressively gets worse over time. Examples of symptoms include:

  • Pain
  • Stiffness
  • Grinding of bones
  •  Bone protrusion or spurs
  • Swelling
  • Warmth
  • Restriction of joint movement
  • Loose bony fragments within joint space causing clicking or locking up of the joint
  • Redness

Many people report having morning stiffness (usually <30 minutes) or more arthritis symptoms with changes in weather (when it's about to rain). OA symptoms typically improve with rest and can worsen with increased activity. 

Can serious problems arise from osteoarthritis?

Osteoarthritis may progressively get worse over time, causing severe, chronic pain that may negatively impact other aspects of your general health (patients with OA have more chronic diseases), your functional capacity (less able to work or care for yourself) and quality of life. Depression and insomnia have also been linked to people who suffer from long-term, painful osteoarthritis symptoms.

Diagnosis

How is osteoarthritis diagnosed?

Usually, osteoarthritis must be diagnosed by a healthcare professional such as our staff at TeleMed2u. A thorough medical history will be taken to determine if there is a prior history of trauma, a family history of the illness, or if there are other medical conditions that can contribute to the development of osteoarthritis. Next, a physical examination will be performed to evaluate for range of motion, or the lack thereof, any swelling or warmth, and pain associated with movement of the symptomatic joint(s). Finally, x-rays may be obtained to determine the severity of joint space narrowing, fluid in the joint, or joint destruction. Laboratory tests such as an erythrocyte sedimentation rate, C-reactive protein, or joint fluid analysis may be obtained to rule out other causes of OA like inflammatory arthritis.

Treatment

What are treatment options for osteoarthritis?

There is no cure for osteoarthritis, and if there is any joint damage, this cannot be reversed; however, there are treatment options available to help manage symptoms and improve your function. Treatments are usually more successful when diagnosis and interventions are initiated early on. TeleMed2U rheumatologists recommend that the treatment of any form of arthritis start with a “S.E.N.S.E.”-ible approach. Here are the different types of treatments available for osteoarthritis: 

  • Stress management -  Managing your stress on a daily basis is very important to control your joint pains. Reducing stress on your joint(s) are also important, by:
    • Modification of activities - restrictions may need to be made about the amount of time or type of activities done while at work or playing certain sports.
    • Physical and/or occupational therapy - known to be beneficial with developing a fitness program to improve flexibility, range of motion, and reduce pain. Therapists can also help with assistive devices and help patients learn to use them effectively. Examples include braces, canes, walkers, crutches, or wheelchairs.
    • Weight loss program - recommendations for weight loss may be explored if weight may be an issue, especially if it affects a weight bearing joint that is arthritic.
  • Exercise - staying active may be recommended by your physician, and suggestions on low-impact exercise may be explored to improve symptoms.
  • Nutrition - Eating less processed, more whole foods (fruits and vegetables) to help with weight loss is important for the management of all chronic diseases.
  • Sleep - Getting (7-9) hours of uninterrupted sleep is very important as it allows your body time to heal itself and you will have energy the next day to stay as active as possible.
  • Engagement - engaging with non-profit organizations like the Arthritis Foundation: https://www.arthritis.org/home?donorsource=thd_google&gclid=cjwkcajw3mshbhb3eiwaxcaeu5luizk5vn0fopzggdcrtbcqasx_614ygvya8pvhkn_qiol9xir3vxockq0qavd_bwe or Creaky Joints: https://creakyjoints.org is a great way to stay informed and supported by individuals also living successfully with arthritis.

To learn how you can customize your own lifestyle management program to lose weight and control your chronic diseases with fewer medications, make an appointment today with our integrative rheumatologist, Dr Barry Shibuya.

  • Medications- sometimes medications such as nonsteroidal anti-inflammatory drugs (NSAIDS) or pain relievers may be prescribed to help you manage your pain. A stronger anti-inflammatory such as corticosteroids (prednisone) may also be used in an injection or oral form for temporary relief of symptoms, especially if you have an inflammatory arthritis.
  • Surgery-  if you have “end stage” OA and have failed conservative/non-surgical options, you may want to consider surgery. An orthopedic surgeon can help you to weigh the risks and potential benefits of several surgical treatment options including: 
    • Arthroscopy
    • Joint fusion
    • Joint replacement
    • Osteotomy

Osteoarthritis is the most common form of arthritis. Although there is no cure for this condition, there are several treatment options that can be explored with our medical providers at TeleMed2U. If you are having trouble deciding what the best treatment options are for you to manage your osteoarthritis, we may be able to help develop a comprehensive treatment plan for you so you can get back to the things you love.

References

American Academy of Orthopedic Surgeons. (2017, August).  Osteoarthritis.  https://orthoinfo.aaos.org/en/diseases--conditions/osteoarthritis/ 
Centers for Disease Control and Prevention. (2020, July). Osteoarthritis. https://www.cdc.gov/arthritis/basics/osteoarthritis.htm 
Mayo Clinic. (2020, February). Osteoarthritis.https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925#:~:text=Osteoarthritis%20is%20the%20most%20common,%2C%20knees%2C%20hips%20and%20spine.

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998.  Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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