Posted by Brigham and Women's Hospital July 15, 2014
Osteoarthritis is the most common form of arthritis in the United States, affecting roughly 12 percent of Americans aged 25 – 74. It’s a chronic joint disease that breaks down cartilage in the neck, lower back, knees, hips, shoulders, and/or fingers. Common symptoms are pain, stiffness, and limited joint movement.
What is the difference between rheumatoid arthritis and osteoarthritis?
Rheumatoid arthritis and osteoarthritis both cause joint pain, stiffness, and limited range of motion, but the two diseases are distinct in their root cause and treatment.
Rheumatoid arthritis is an autoimmune condition where a person’s own immune system attacks their joints, causing inflammation. Rheumatoid arthritis typically affects many joints simultaneously, especially in the hands, wrists, and feet, and is treated with medications to suppress the immune response.
Osteoarthritis is not an autoimmune disease, and although the exact causes are not known, multiple risk factors have been identified. In a healthy joint, cartilage provides cushioning and a smooth joint surface for motion. In an osteoarthritic joint, as cartilage is irreversibly destroyed and bone abnormalities develop, movement becomes painful and more difficult.
What causes osteoarthritis?
Osteoarthritis is classified as either primary or secondary. Primary osteoarthritis is the most common form. Although there is no known cause, numerous risk factors have been identified. Secondary osteoarthritis is caused by another disease that sets off the joint degeneration, such as an infection, severe injury, or a congenital deformity.
The following are some of the most common risk factors for osteoarthritis:
- Age – Osteoarthritis is more common among the elderly, but even young adults can develop osteoarthritis.
- Obesity – Excessive weight can put stress on joints and promote cartilage damage.
- Injury – Significant injury, such as ligament damage, can eventually lead to osteoarthritis.
- Gender – Women are more likely to develop osteoarthritis.
- Heredity – Slight joint defects or increased joint mobility (“double-jointed”) may contribute to the development of osteoarthritis.
- Muscle weakness.
- Scoliosis or other curvatures of the spine.
- Birth defects that affect the hip joint, such as congenital hip dysplasia or congenital dislocation.
How is osteoarthritis diagnosed?
The physician will begin with a complete medical history and a physical examination. During the exam, the doctor will look for an enlarged or bumpy joint, signs of swelling, or decreased range of motion. Your doctor may then order x-rays, which can show a decrease in the cartilage space, new bone formation, or incorrect alignment. In some cases, your doctor may perform an aspiration – the removal of fluid from a swollen joint or bursa – to exclude infection, gout, or rheumatoid arthritis as possible causes of your joint pain.
How is osteoarthritis treated?
There are many treatments for osteoarthritis that are designed to reduce your joint pain, increase mobility, and improve how your joints function.
- Anti-inflammatory and pain medication, such as acetaminophen and non-steroidal anti-inflammatory drugs
- Topical analgesics
- Injections of cortisone to decrease inflammation
- Injection of viscosupplements (gel-like substances that act like natural joint fluids)
- Physical therapy
- Occupational therapy
- Weight loss
- Aerobic and strength training exercises
- Bracing and orthotics
- Self-management strategies
- Nutritional supplements
- Arthroscopy is a minimally-invasive procedure to diagnose and treat conditions affecting joints. The surgeon first examines the internal structure of the joint through a small video camera inserted through the skin. Additional steps to improve joint function then can be taken, such as the removal of loose cartilage or meniscal repair.
- Arthroplasty is a surgical procedure to replace or restore a severely osteoarthritic joint to ease pain and improve mobility, thereby adding to the patient’s quality of life.
- An osteotomy involves the removal of a portion of bone to realign the joint – a temporary treatment for osteoarthritis.
- Cartilage repair and regeneration can replace damaged cartilage and may be useful for patients with certain types of cartilage defects.
What can I do to prevent osteoarthritis?
Maintaining a healthy lifestyle may help prevent osteoarthritis. Eating nutritious foods, maintaining a healthy weight throughout your life, and exercising regularly to strengthen muscles that protect the joints are three very important methods that may reduce your risk of developing osteoarthritis.– Chris P.