Take the Pain Out of Arthritis
Arthritis is inflammation of one or more joints where two bones meet.
While there are more than 100 different types of arthritis, osteoarthritis is the most common form and the leading cause of disability in the U.S. Other types of arthritis include rheumatoid arthritis and psoriatic arthritis. About 15% of the U.S. population is affected by osteoarthritis, including half of those over 65 years old.
What is osteoarthritis?
Osteoarthritis (OA) is a chronic breakdown of joint cartilage which causes bones to rub against each other. Cartilage is the "shock-absorber" that cushions the ends of the bones, allowing easy movement of joints. Osteoarthritis most commonly occurs in the weight-bearing joints of the hips, knees, and lower back. It can be diagnosed by your health care provider based on a combination of medical history, physical examination and X-ray. OA causes joint pain and tenderness, loss of range of motion in the joint, stiffness and disability.
What are the risk factors for osteoarthritis?
While many believe OA is a normal result of aging, it's also caused by "wear and tear" on a joint through certain occupations and sports, as well as trauma or injury. Jobs requiring prolonged lifting, kneeling or squatting place people at risk for OA. Sports that involve a direct impact on the joint, twisting and throwing also increase the risk. Genetics play a role in increasing the risk of OA as well.
Can osteoarthritis be prevented?
Obesity is the most important preventable risk factor for osteoarthritis of the knee, hip and hand. For every 10 pounds of weight gain, there is a 36% increase in risk for developing OA. A 10-pound reduction in weight has been shown to decrease the risk of knee osteoarthritis by half in those who are obese.
How is osteoarthritis treated?
Lifestyle interventions for mild osteoarthritis include exercise and, if applicable, weight loss. Regular exercise helps with pain relief and joint protection by increasing overall movement. Your health care provider may refer you to a physical therapist to receive an exercise program based on your mobility, impairment and preferences. Water exercises, such as swimming, are especially helpful. Applying heat and cold to affected areas may also be beneficial.
Assistive devices can help you open jars, reach for items, sit down and get up from a chair or toilet seat. Your health care provider may also recommend using canes, walkers and/or braces.
What medications are used to treat osteoarthritis?
Over-the-counter (OTC) pain relievers can help symptoms of osteoarthritis. The American College of Rheumatology recommends acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. Your health care provider may also recommend prescription NSAIDs. Ask your doctor or pharmacist how to take NSAIDs safely. There's some evidence supporting the use of the dietary supplements glucosamine and chondroitin sulfate for OA.
Applying topical skin creams containing capsaicin (Zostrix) or NSAIDs to affected joints can help with pain relief. These topical products appear to be a better option for people with gastrointestinal sensitivities.
Your doctor may inject corticosteroids into the joint. Artificial joint fluid injections may be beneficial for the treatment of knee osteoarthritis. However, when symptoms are severe or there's a significant loss of function, your provider may recommend joint replacement surgery or other types of surgery to repair damaged joints.
Updated on August 9, 2019
References:
Arthritis Foundation. 2018. Arthritis by the numbers. Book of Trusted Facts & Figures. Arthritis Foundation.
Deveza, LA, and K Bennell. 2019. Management of knee osteoarthritis. 01 26. Accessed 07 10, 2019. https://www.uptodate.com/contents/management-of-knee osteoarthritis?search=osteoarthritis%20treatment%20adult&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2.
Felson, DT, Y Zhang, JM Anthony, A Naimark, and JJ Anderson. 1992. "Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study." Ann Intern Med, 535–539.
Foundation, Arthritis. n.d. Sources of Arthritis Pain. Accessed 2019. https://www.arthritis.org/living-with-arthritis/pain-management/understanding/types-of-pain.php
Hochberg, MC, RD Altman, KT April, M Benkhalti, G Guyatt, J McGowan, T Towheed, V Welch, G Wells, and P Tugwell. 2012. "Am College of Rheumatology 2012: Recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip and knee." Arthritis Care & Research 465–474.
Lementowski, PW, and SB Zelicof. 2008. "Obesity and osteoarthritis." Am J of Orthopedics, 148–151.