What is osteoarthritis?

There are many different types of arthritis and osteoarthritis is the most common. It results when the cartilage which cushions the bones in your joints gets worn out. Then, the surfaces of the bones get roughened; in fact, the bones may try to compensate for the worn cartilage by “thickening”. This results in formation of “spurs”, or little sharp points along the surface of the bone. When these form, motion of the joint often becomes painful. Although there is no known cure for osteoarthritis, many of the secondary effects of the disease are treatable.

What are the secondary effects of osteoarthritis?

Because motion often becomes painful, there is a subconscious for conscious tendency to move less and, therefore, muscle and/or joint stiffness develops. In addition, the muscles surrounding affected joints become weakened through relative disuse. Also, depending upon which joints are affected, the bone spurs can compress other structures. For example, oseoarthritis of the wrist may lead to carpal tunnel syndrome, a compression of the median nerve, with consequent numbness, weakness, and pain. Osteoarthritis of the spine can sometimes cause lumbar stenosis, or compression of nerves within the spinal canal. Heel spurs can cause pain with ambulation. Sometimes a “trigger finger” can develop in the hand as the result of a spur rubbing against a tendon sheath. In all of these cases, although the osteoarthritis itself is not curable, the secondary condition can often be treated.

What are the symptoms of osteoarthritis?

Most often, the symptoms develop over a long period of time. The patient notices gradual stiffness or achiness in one or more joints, usually worse in the morning or after being sedentary. Usually after a hot shower or some activity, the joints “loosen up” and the pain subsides to some extent. Most people find that the pain worsens once again as the day wears on. In addition, the affected joints often “crackle” with motion—this is called crepitus. Although crepitus is often heard in normal people, it is believed to be more frequent in osteoarthritic joints. Overuse of affected joints results in increased pain and occasional swelling of the joint.

Osteoarthrititis generally occurs in weight bearing joints, such as the knees, hips, and spine. It also occurs fairly often in the neck, the hands, and fingers. In the fingers, the appearance often becomes “knobby” as spurs develop, especially in the joint near the nail (these are called Heberden’s nodes). Although actual joint swelling can occur, this is much less common with osteoarthritis than it is with rheumatoid arthritis or other “inflammatory” conditions.

Who gets osteoarthritis?

Approximately 40 million Americans have symptoms of osteoarthritis. It is more common in people over age 60, but certainly not uncommon in people in their thirties and forties. Although x-rays taken in people from 40 and up will commonly show evidence of osteoarthritis, the percent of patients who actually have symptoms is much less. Other than age, other predisposing factors include a family history of osteoarthritis and obesity. Being overweight makes osteoarthritis in the hips and knees more likely. In addition, although physical activity itself does not seem to be a predisposing factor for the eventual development of osteoarthritis, a past history of injuries is. For example, if a person has had a prior fracture or multiple ankle sprains, that person is more likely to develop osteoarthritis in the joint.