Osteoarthritis

Osteoarthritis is the type of arthritis that many people get as they age. It happens when the cartilage that cushions your joints—like your knees and hips—gradually breaks down. Then the bones rub against each other. This causes damage and pain. There are many treatments that can help with the pain and make it easier to move.

Education Topics

Activity

What types of exercises and activity can help osteoarthritis?

Aerobic, strengthening, and range-of-motion exercises can help arthritis. When you combine these types of exercises, they can help protect your joints and keep them flexible. They also make your joints, heart, and lungs stronger.

Strength exercises for osteoarthritis: Getting started

These types of exercises can make muscles around a joint stronger and help protect and reduce stress on your joints. For example, stronger thigh muscles can help reduce stress on your knees and hips.

Before you start to do strength exercises, ask a physical therapist or your doctor which exercises would be best for you. And ask how to do strength exercises safely so you don't get hurt. Exercise books and videotapes can also show you how to do strength exercises the right way.

  • Lift light weights or dumbbells, or use elastic tubing.

    You can use these at your local health club, or you can buy them to use at home.

  • Use an exercise machine at home or weight machines at your local health club.

Aerobic activity for osteoarthritis: Getting started

Talk to your doctor before you start an exercise program or activity. Ask what kind of exercise is best for you and how to exercise if a joint is sore or swollen.

When you start an exercise program or activity, start slowly, and don't push yourself too hard. Pace yourself. For example, do 10 minutes of activity at a time, 1 or 2 times a day. Then work your way up to where you can do it for a longer time. Aim for at least 2½ hours of moderate activity a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. Pacing yourself is especially important if you haven't exercised for a while.

Aerobic exercise makes your heart and lungs stronger and builds your endurance. There are many ways to get aerobic activity.

  • Walk as much as you can.

    You can walk outdoors through your neighborhood or on city paths. Or walk indoors on a treadmill or at the mall.

  • Work out in a pool.

    The water helps take the weight off painful joints, and it provides some resistance.

    • Try walking in water that is up to your waist or your chest.
    • Swim at your local health club, YMCA, or neighborhood pool. Many locations offer classes designed for people with arthritis.
  • Bike outdoors or use an indoor bike.
  • Be more active in your daily routine.

    Doing vacuuming, housework, gardening, or yard work can all be aerobic.

Exercising safely with osteoarthritis

Talk to your physical therapist or doctor before you start an exercise program or activity. Ask what kind of exercise is best for you and how to exercise if a joint is sore or swollen. Also ask if you should take nonsteroidal anti-inflammatory drugs (NSAIDs) to make it easier for you to exercise and if you should use ice or heat after you're done exercising.

Exercise and activity can help arthritis. But a common symptom of arthritis is pain after activity, which may make you not want to exercise. Here are some tips to help you manage the pain and be sure that you don't hurt your joints when you exercise.

  • Start slowly, and don't push yourself too hard.

    Pace yourself. For example, do 10 minutes of activity at a time, 1 or 2 times a day. Then work your way up to where you can do it for a longer time or do the exercise with more effort. Aim for at least 2½ hours of moderate activity a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. Pacing yourself is especially important if you haven't exercised for a while.

    Ask which strength exercises would be best for you and how to do them safely so you don't get hurt. Exercise books and videotapes can also show you how to do strength exercises the right way.

  • Manage your pain.
    • You may want to take an over-the-counter pain medicine before you exercise. These medicines include acetaminophen (for example, Tylenol) or an NSAID such as ibuprofen (for example, Advil or Motrin) or naproxen (for example, Aleve).
    • If your joint pain gets worse after exercise, try using ice or heat on the joints that hurt. But don't use heat if the joint is swollen or hot.
    • Use assistive devices that can help you do your daily activities with less stress on your joints.
    • Sharp or unusual pain may be a sign of injury. Talk to your doctor or physical therapist if you have new pain or if your pain is a lot worse.
  • If an activity makes you feel sore, try something else. Or change how you do the activity.

    Here are some things you can try:

    • Rest between each exercise or activity.
    • Decrease your speed.
    • If you like to walk or swim, go a shorter distance. You might take two or three short walks in a day rather than one long walk.
    • Do a shorter workout, then rest and do a little more later.
    • Lift less weight.
  • Rest your joints when you need to.

    Balance your exercise with rest and joint care. If your joints hurt or you have redness or swelling, rest your joints until your pain gets back to the level that is normal for you. Then exercise for less time or with less effort, or try another exercise that doesn't cause pain. For example, if your knees are swollen, don't use the stairs for a few days. Walk a shorter distance, and switch to swimming or riding an indoor bike.

    Be sure you know when you have sore muscles, and not joint pain. If your muscles are sore, you can safely exercise through the soreness. (You could exercise through joint pain too, but it's not safe to do so.)

How do exercise and activity help osteoarthritis?

Exercise and activity can help you feel better and make it easier to do daily tasks. They can reduce joint pain and stiffness, protect your joints, and help prevent arthritis from getting worse.

Complementary and Alternative Treatments

What are the types of complementary medicine for osteoarthritis?

A lot of people use some form of complementary medicine to treat osteoarthritis. These treatments are often used along with standard care to help relieve their arthritis symptoms.

Some of these treatments may help you move more easily and deal with the stress and pain of arthritis. But in some cases, not much is known about how safe they are or how well they may work.

Be sure to tell your doctor about any complementary treatments you use or want to use. He or she can tell you about the possible benefits and side effects of these treatments and whether these treatments may interfere with your standard care. For example, some diet supplements and herbal medicines may cause problems if you take them with another medicine.

Dietary supplements

SAM-e.

SAM-e is short for S-adenosylmethionine. It's a substance that occurs naturally in the body. The body makes less of it with age, so some people think that this supplement may be helpful for certain diseases.

Vitamin B3.

Taking a type of vitamin B3 called niacinamide seems to improve joint flexibility in some people who have arthritis. It also helps pain and swelling. Some people are able to cut down on their pain medicines by taking vitamin B3. It is often included in combination pills that contain several B vitamins.

Vitamins C and E.

These vitamins may help to reduce pain and stiffness.

Avocado-soybean extract.

Avocado-soy extract is a soft gel pill made with avocado oil and soybean oil. It's also called ASU. Taking this supplement every day may help arthritis pain.

Glucosamine and chondroitin.

These supplements are available in tablet, capsule, powder, or liquid form. Some people believe they help arthritis symptoms. But there isn't much evidence that they help.

Fish oil.

Fish oil can be found in fish. But you can also get it in pills or liquid form. It may help arthritis symptoms.

Other treatments

Acupunctureand massage.

Some people find treatments like acupuncture and massage helpful for their knee arthritis. But they may not help any more than a placebo (fake treatment) does.

Capsaicin cream.

Capsaicin is found in different types of hot peppers. When a capsaicin cream or ointment is used on the skin, it helps relieve pain. Capsaicin works by first stimulating and then decreasing the intensity of pain signals in the body. Capsaicin may cause a burning feeling at first. But it usually decreases after the first use.

Mind-body practices.

Mind-body practices, such as yoga, tai chi, and qi gong, can help reduce stress and relax your mind and muscles. Stress can make pain worse. So learning to control stress and relax may help with pain.

Taping of the knee.

Taping uses tape that sticks to the knee to help keep the kneecap in place and relieve pain. You can do taping at home. But first have your doctor or physical therapist show you the right way to put it on.

Braces for the knee.

Braces can help shift weight off the part of your knee that hurts. It's not clear how well these work, but there isn't a lot of risk in trying them.

Pulsed electromagnetic field therapy.

This kind of therapy uses magnets to produce an electrical pulse that may help cartilage grow.

Transcutaneous electrical nerve stimulation (TENS).

TENS uses a mild electrical current to reduce pain.

Course

What happens when you have osteoarthritis?

It's hard to know if and how fast arthritis will get worse. Symptoms may come and go, stay the same, or get worse over time.

At first, you may have pain only when you are active. Over time, you may also have pain when you are resting. Joints can become stiff, and you may lose the full range of motion you used to have. Joints can become misshapen over time, especially the small joints of the hands and feet.

If you have arthritis in your fingers, the joints at the tip or middle part of your fingers may get bigger and form bumps. These are known as Heberden's and Bouchard's nodes.

Arthritis of the spine can also narrow the openings that make space for the spinal cord and for the nerves that branch off the spinal cord (spinal nerves). This narrowing is called spinal stenosis. It can lead to pressure on the spinal cord or spinal nerves. This pressure can cause pain, weakness, or numbness.

Even though there is no cure for arthritis, most people can manage their symptoms with medicine and lifestyle changes. But in a few people, arthritis may get painful enough that they decide to have surgery.

Definition

Osteoarthritis

Osteoarthritis is the type of arthritis that many people get as they age. It happens when the cartilage that cushions your joints—like your knees and hips—gradually breaks down. Then the bones rub against each other. This causes damage and pain. There are many treatments that can help with the pain and make it easier to move.

Diagnostics

How is osteoarthritis diagnosed?

Your doctor can often diagnose arthritis by asking you questions about your joint pain and other symptoms and examining you. You may also have X-rays and blood tests. Blood tests can help make sure another disease isn't causing your symptoms.

Living With

Finding ways to cope with osteoarthritis

Living with osteoarthritis can be stressful. But there are some simple things you can do to feel better and keep the joy in your life and relationships.

  • Ask your family and friends for help.

    Don't be afraid to let people help you with some of your tasks, especially on days when you have a lot of pain.

  • Balance your activity with rest.

    If you get tired when you do a task, break the task down into smaller tasks, and rest between them.

  • Learn ways to reduce stress.

    Stress can make your pain feel worse. You might try deep breathing and relaxation exercises or meditation to help reduce stress and relax your mind and muscles.

  • Meet with friends.

    At times, you may not want to go out because you're too tired or don't want to be seen using a cane or wheelchair. But being social can help you feel better. If you isolate yourself, you may get depressed.

  • See a counselor.

    Cognitive-behavioral therapy teaches you how to express your fears and concerns. And it helps you learn new ways of coping with arthritis.

  • Be creative.

    Find ways to still do the things that you enjoy, but do them in a different way that doesn't cause pain. For example, plant flowers in a raised garden bed instead of planting them directly into the ground. Then you won't have to kneel.

  • Join a support group.

    This is a great place to share your concerns and hear how other people cope with the challenges of arthritis. Online forums and chat groups are also good places to find support.

  • Keep a pain diary.

    Write down how your moods, thoughts, sleep patterns, activities, and medicine affect your pain. Having a record of your pain can help you and your doctor find the best ways to treat your pain.

  • Educate yourself.

    The more you know about arthritis, the more you'll be able to cope with any lifestyle changes that you may need to make as your symptoms get worse. Encourage your family and friends to learn about arthritis too. Then they can know what you're dealing with and learn ways they can help you.

  • Stay positive.

    Adopting a "good-health attitude" and healthy habits, such as eating a balanced diet, staying at a healthy weight, and getting enough sleep, will make you feel better and help you stay active. When you think in a positive way, you may be more able to:

    • Care for yourself and handle the challenges of arthritis.
    • Avoid or cope with stress, anxiety, and depression.
  • Talk to your boss.

    If your arthritis makes it hard for you to do your job, talk to your boss. Discuss the changes you can make to your schedule and the things you can do to modify your work area. You might ask if:

    • You can have a later start time.
    • You can work part-time or work from home.
    • You can switch to a light-duty position, if your job involves a lot of lifting, bending, or standing.

If a family member or friend is helping to care for you, be sure to let that person know how grateful you are for the help. Keep in mind that your caregiver's life may be changing along with yours. And he or she may be dealing with some of the same emotions as you. Talking is a great way for each of you to share your concerns and support for each other.

Coping with osteoarthritis

Living with arthritis can be stressful. The good news is that you can do some simple things to feel better and keep the joy in your life and relationships.

  • Ask your family and friends for help.

    Don't be afraid to let people help you with some of your tasks, especially on days when you have a lot of pain.

  • Balance activity with rest.

    If you get tired when you do a task, break the task down into smaller tasks, and rest between them.

  • Learn ways to reduce stress.

    Stress can make your pain feel worse. You might try deep breathing and relaxation exercises or meditation to help reduce stress and relax your mind and muscles.

  • Meet with friends.

    At times, you may not want to go out because you're too tired or don't want to be seen using a cane or wheelchair. But being social can help you feel better. If you isolate yourself, you may get depressed.

  • See a counselor.

    Cognitive-behavioral therapy allows you to express your fears and concerns and learn new ways of coping with arthritis.

  • Find ways to still do the things that you enjoy.

    You may need to do things in a different way that doesn't cause pain. For example, plant flowers in a raised garden bed instead of planting them directly into the ground. Then you won't have to kneel.

  • Join a support group.

    This is a great place to share your concerns and hear how other people cope with the challenges of arthritis. Online forums and chat groups are also good places to find support.

  • Keep a pain diary.

    Write down how your moods, thoughts, sleep patterns, activities, and medicine affect your pain. Having a record of your pain can help you and your doctor find the best ways to treat your pain.

  • Learn more about arthritis.

    The more you know about arthritis, the more you'll be able to cope with any lifestyle changes that you may need to make as your symptoms get worse. Encourage your family and friends to learn about arthritis too. Then they can know what you're dealing with and learn ways they can help you.

  • Talk to your boss if arthritis makes it hard to do your job.

    Ask what changes you can make to your schedule and things you can do to modify your work area.

    You might ask if:

    • You can have a later start time.
    • You can work part-time or work from home.
    • You can switch to a light-duty position, if your job involves a lot of lifting, bending, or standing.
  • Try to stay positive.

    Adopting a "good-health attitude" and healthy habits, such as eating a balanced diet, staying at a healthy weight, and getting enough sleep, will make you feel better and help you stay active.

    When you think in a positive way, you may be more able to:

    • Care for yourself and handle the challenges of arthritis.
    • Avoid or cope with stress, anxiety, and depression.
  • Support your caregiver.

    If a family member or friend is helping to care for you, be sure to let that person know how grateful you are for the help.

    Keep in mind that your caregiver's life may be changing along with yours. And he or she may be dealing with some of the same emotions as you are. Talking is a great way for each of you to share your concerns and support for each other.

  • Tell your doctor if you feel depressed.

    Some people with arthritis feel down or depressed. They may describe this as feeling "depressed," "unhappy," "short-tempered," "blue," or "down in the dumps." Treating these symptoms may help you feel better and make it easier for you to do your daily tasks.

How can you cope with osteoarthritis?

Living with osteoarthritis can be stressful. But there are some simple things you can do to feel better and keep the joy in your life and relationships. For example, ask for help when you need it, balance activity with rest, or join a support group.

Making changes to your daily activities when you have osteoarthritis

If your joints hurt when you do an activity, you can do a number of things to help yourself.

  • Use the largest joints or strongest muscles to do things.
    • When you lift a heavy object off the floor, use your hip and knee muscles, not your back.
    • When you carry a bag of groceries, use the palm of your hand or your forearm instead of grasping it with your fingers.
    • Push doors open with your hip or shoulder instead of your hand or arm.
  • Break bigger tasks into several smaller tasks.

    Rest between tasks.

  • Use electric tools.

    Electric tools such as can openers, blenders, power tools, and sewing machines can make it easier to open cans, mix things, do home repairs, or sew.

  • Try not to stand for a long period of time.

    And try not to kneel or squat.

    Sit or take regular breaks when doing tasks that take a long time.

  • Use higher chairs or seat cushions.

    Avoid sitting in chairs that are very low.

  • Go a shorter distance when you walk, jog, swim, or do another activity.
  • Break up an exercise or activity.

    For example, you might take two or three short walks in a day rather than one long walk. Or do a shorter workout, then rest and do a little more later.

  • Make an activity less intense.

    Decrease your speed when you jog, walk, run, or swim. If you lift weights, don't lift as much weight.

Medication Therapy

Which nonprescription medicines are used for osteoarthritis?

You can buy some medicines for arthritis without having a prescription. They can help the pain of mild or moderate arthritis. These medicines include:

Acetaminophen (such as Tylenol).

Regular use of acetaminophen can relieve pain caused by osteoarthritis. Your doctor may have you try this medicine first, because it has fewer side effects than any other pain medicine used for arthritis.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen.

NSAIDS can help reduce pain, swelling, and fever. They are also good pain relievers, especially if you don't have stomach problems. They come in pill and topical (such as cream) forms.

Most studies suggest that NSAIDs work better than acetaminophen for arthritis. But for some people, acetaminophen may work as well as NSAIDs for mild to moderate joint pain. And studies show that acetaminophen is better than no treatment.

Capsaicin (Zostrix).

Capsaicin is a pain reliever that comes in a cream and is applied directly to the skin. It has been found to relieve joint pain from osteoarthritis in some people when it's rubbed into the skin over the affected joints.

How are medicines used to treat osteoarthritis?

Medicine can help reduce your symptoms of arthritis and allow you to do your daily activities. But medicine doesn't cure arthritis or slow the time it takes for cartilage to break down.

Medicines that work for some people don't work for others. Be sure to let your doctor know if the medicine you're taking doesn't help. You may need to try several kinds of medicines to find one that works for you.

The goal of medicine is to:

  • Get rid of pain and have few side effects.
  • Keep your joints working and moving well. If pain keeps you from moving your joints, it can cause the ligaments, tendons, and muscles that move your joints to shorten and become tight and weak.

The type of medicine depends on how bad your pain is. For example:

  • For mild to moderate pain, you can try over-the-counter pain medicine, such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.
  • For moderate to severe pain, you may need stronger pain medicine, such as opioids.

Medicine choices

Medicines used to treat arthritis include:

  • NSAIDs to reduce pain and swelling.
  • Acetaminophen to help relieve pain.
  • Tramadol to help relieve pain.
  • Steroid shots in the joint to reduce swelling.
  • Some antidepressants, such as duloxetine, to help relieve pain.
  • Opioids to relieve moderate to severe pain.

Medicine that you put on your skin (topical) may relieve pain for a short time. These include topical NSAIDs, capsaicin, and pain-relieving creams.

Overview

Osteoarthritis: Overview

Arthritis, also called osteoarthritis, is a breakdown of the cartilage that cushions your joints. When the cartilage wears down, your bones rub against each other. This causes pain and stiffness. Many people have some arthritis as they age. Arthritis most often affects the joints of the spine, hands, hips, knees, or feet.

Arthritis never goes away completely. But medicine and home treatment can help reduce pain and help you stay active.

Physical Therapy and Rehab Treatment

How can physical therapy help osteoarthritis?

Physical therapy (PT) can help make daily tasks and activities easier. A physical therapist can help you with walking, grabbing and holding objects, or going up stairs. In PT, you also learn which types of exercises are best for you.

Prevention

How can you prevent osteoarthritis?

You can take steps to help prevent osteoarthritis. If you already have arthritis, these same steps may keep it from getting worse.

Stay at a healthy weight or lose weight if you need to.

Extra weight puts a lot of stress on the large, weight-bearing joints such as the knees, the hips, and the balls of the feet. Experts estimate that every 1 lb (0.5 kg) of body weight adds about 4 lb (1.8 kg) of stress to the knee. This means that if you lost just 5 lb (2.3 kg) , you could take 20 lb (9.1 kg) of stress off of your knees.

Be active.
A lack of exercise can cause your muscles and joints to become weak. But light to moderate exercise can help keep your muscles strong and reduce joint pain and stiffness. For example, if your quadriceps (the muscles in the front of your thigh) are weak, you may be more likely to get arthritis of the knee.
Protect your joints.
A single major injury to a joint or several minor injuries can damage cartilage over time. Try not to do tasks that cause pain or swelling in joints. And try to use the largest joints or strongest muscles to do things.

Providers

Who can diagnose and treat osteoarthritis?

Arthritis can be managed by:

  • A family medicine physician.
  • An internist.
  • A nurse practitioner.
  • A physician assistant.
  • A rheumatologist.

Other health professionals may be part of the treatment team, such as:

  • A physiatrist.
  • A pain management specialist.
  • An orthopedic surgeon.
  • A physical therapist.
  • An occupational therapist.
  • A dietitian.
  • A social worker.

Risk Factors

What puts you at risk for osteoarthritis?

You're more likely to have osteoarthritis if you're overweight, you have or had a joint injury, or you have a family history of arthritis.

Self-care Treatment

How can losing weight help osteoarthritis?

Losing weight, if you are overweight, can help your symptoms and let you be more active. Weight loss can be especially important if you have arthritis of the knee or hip. Losing even a few pounds may help.

How do you use ice and heat for osteoarthritis?

For moderate to severe pain from osteoarthritis, try applying heat and cold to the affected joints. Experiment with heat and cold techniques until you find what helps you most. But don't use heat if the joint is swollen or hot.

Self-care Treatment Options

How can you care for yourself when you have osteoarthritis?

You can do a lot to manage the symptoms of arthritis and help prevent the disease from getting worse. Steps you can take include:

Lifestyle changes

Rest.

If your joints hurt a lot or are swollen, take a break. But not for too long—a lack of activity can cause your muscles and joints to become weak.

Get enough sleep.

Good sleep can help your mood and help you cope with pain.

Stay at a healthy weight.

Losing weight can decrease the symptoms of arthritis and allow you to be more active. A healthy weight is very important if you have arthritis in the legs or feet.

Get exercise.

Exercise and activity can help reduce pain and improve balance. Try exercises that don't put a lot of stress on your joints, such as swimming or walking.

Pain relief

Use medicine.

If your pain is mild, over-the-counter pain medicines such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) may help.

Use heat and cold therapy.

For example, you might try hot compresses or cold packs. But don't use heat if the joint is swollen or hot.

Devices

Use assistive devices and orthotics.

They can take the stress and weight off your joints and make it easier for you to hold objects, open and close things, and walk. For example, raised toilet seats, doorknob covers, braces, and canes may help.

Changing how you do things

Protect your joints.

For example, you can use the largest joints or strongest muscles to do things. When you lift a heavy object off the floor, use your hip and knee muscles, not your back.

Change activities.

If your joints hurt when you do an activity, try other ways of doing it that don't cause pain. For example, walk instead of jog. Or use a sewing machine to make a quilt instead of making it by hand.

Modify your home and work area.

For example, use a reacher to pick up things off the floor. Or, instead of standing up at the counter, use a tall stool so you can sit down.

Maintain good posture.

Poor posture puts stress on your back and neck. Having good posture can help reduce pain.

Wear comfortable and supportive shoes.

If you have arthritis in your back, hips, knees, or feet, you may be able to reduce the stress on your joints by wearing the right shoes or by adding insoles to your shoes.

Get support

Living with arthritis can be stressful. But there are a lot of ways to cope with arthritis. For example, you could try asking for help when you need it, keeping a positive attitude, and maybe joining a support group.

How can you care for osteoarthritis?

  • Stay at a healthy weight. Being overweight puts extra strain on your joints.
  • Talk to your doctor or physical therapist about exercises that will help ease joint pain.
    • Stretch. You may enjoy gentle forms of yoga to help keep your joints and muscles flexible.
    • Walk instead of jog. Other types of exercise that are less stressful on the joints include riding a bike, swimming, tai chi, or water exercise.
    • Lift weights. Strong muscles help reduce stress on your joints. Stronger thigh muscles, for example, take some of the stress off of the knees and hips. Learn the right way to lift weights so you don't make joint pain worse.
  • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Use a cane, crutch, walker, or another device if you need help to get around. These can help rest your joints. You also can use other things to make life easier, such as a higher toilet seat and padded handles on kitchen utensils.
  • Do not sit in low chairs. They can make it hard to get up.
  • Put heat or cold on your sore joints as needed. Use whichever helps you most. You can also switch between hot and cold packs.
    • Apply heat 2 or 3 times a day for 20 to 30 minutes—using a heating pad, hot shower, or hot pack—to relieve pain and stiffness. But don't use heat on a swollen joint.
    • Put ice or a cold pack on your sore joint for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.

Signs and Symptoms

What are the symptoms of osteoarthritis?

The symptoms of arthritis include pain and stiffness in the joints. Arthritis also makes it harder to bend the joint or get the full range of motion you used to have. The symptoms may be mild to severe.

What are the differences between rheumatoid arthritis (RA) and osteoarthritis?

Rheumatoid arthritis and osteoarthritis are different types of arthritis. They share some similar characteristics, but each has different symptoms and requires different treatment. So an accurate diagnosis is important.

Osteoarthritis is the most common form of arthritis. Rheumatoid arthritis affects about one-tenth as many people as osteoarthritis. The main difference between osteoarthritis and rheumatoid arthritis is the cause behind the joint symptoms. Osteoarthritis is caused by mechanical wear and tear on joints. Rheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the body's joints.

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Characteristics of rheumatoid arthritis and osteoarthritis

Characteristic

Rheumatoid arthritis

Osteoarthritis

Age at which the condition starts

It may begin any time in life.

It usually begins later in life.

Speed of onset

Relatively rapid, over weeks to months

Slow, over years

Joint symptoms

Joints are painful, swollen, and stiff.

Joints ache and may be tender but have little or no swelling.

Pattern of joints that are affected

It often affects small and large joints on both sides of the body (symmetrical), such as both hands, both wrists or elbows, or the balls of both feet.

Symptoms often begin on one side of the body and may spread to the other side. Symptoms begin gradually and are often limited to one set of joints, usually the finger joints closest to the fingernails or the thumbs, large weight-bearing joints (hips, knees), or the spine.

Duration of morning stiffness

Morning stiffness usually lasts longer than 1 hour.

Morning stiffness usually lasts less than 1 hour. Stiffness returns at the end of the day or after periods of activity.

Presence of symptoms affecting the whole body (systemic)

Frequent fatigue and a general feeling of being ill are present.

Whole-body symptoms are not present.

Social and Emotional Aspects

How does osteoarthritis affect your social and emotional health?

Living with osteoarthritis can be stressful. You may worry about how it may change your life, work, and relationships.

It's hard to know how fast your arthritis may progress. Your symptoms may come and go, stay the same, or get worse over time. Some days you may feel fine and be able to do the things you need—and want—to do with little pain. Other days the pain may be too much for you to do simple tasks like getting dressed or brushing your teeth.

Some people feel overwhelmed, tired, and angry. They may be afraid that they might become disabled and not be able to care for themselves. They may even wonder if they can keep working. It's okay if you have any of these feelings. Most people who have arthritis feel this way at one time or another.

Some people with arthritis also feel down or depressed. They may describe this as feeling "depressed," "unhappy," "short-tempered," "blue," or "down in the dumps." If you feel like this most of the time, tell your doctor. Treating these symptoms may help you feel better and make it easier for you to do your daily tasks.

Surgical Treatment

What can help you decide about surgery for osteoarthritis?

If you're thinking about surgery, here are some things to consider:

  • After surgery, most people are able to go back to doing their daily tasks and sports with less pain.
  • You will need several months of physical therapy to get the best use of your joint.
  • Replacement joints typically last 10 to 20 years. You may need another surgery if the new joint wears out.
  • In some cases, after surgery you might have a harder time getting back to your normal activities. For example, it may be harder if you have already lost a lot of strength, flexibility, balance, endurance, and ability to be active.

If you're in poor health or have certain health problems, you may not be able to have surgery for arthritis. Your doctor can help you decide if surgery is right for you.

How is surgery used to treat osteoarthritis?

In most cases, people can manage their arthritis symptoms with medicine and lifestyle changes. But surgery may be an option if:

  • You have very bad pain.
  • You have lost a lot of cartilage.
  • You have tried medicine and other treatments, but they haven't helped.
  • Your overall health is good.

Surgery choices

Types of surgery for arthritis include:

Arthrodesis.

This joins (fuses) two bones in a damaged joint so that the joint won't bend. Doctors may use it to treat arthritis of the spine, ankles, hands, and feet. In rare cases, it's used to treat the knees and hips.

Arthroscopy.

This may be used to smooth a rough joint surface or remove loose cartilage or bone fragments. In some people it may help relieve pain for a short time and allow the joint to move better.

Hip resurfacing surgery.

This is most often done in younger, more active people who have pain and disability caused by a badly damaged hip.

Joint replacement.

This is done when other treatments haven't worked and damage to the joint can be seen on X-rays. It involves surgery to replace the ends of bones in a damaged joint. The surgery creates new joint surfaces. The joints that are replaced most often are the hip, knee, and shoulder. But other joints such as the elbow and the ankle can also be replaced.

Osteotomy.

This is done to correct certain defects in the hip and knee. In most cases, it's done in active people younger than 60 who want to delay surgery to replace a hip or knee.

Small joint surgery.

Surgery is more common on the larger joints, such as the hip and knee. But if pain in the small joints of the hands or feet is so bad that the person can't use those joints, surgery may help.

Treatment

What are some experimental treatments for osteoarthritis?

Experts are testing new medicines and methods that they hope will one day help prevent, reduce, or repair cartilage damage. Two examples are cartilage transplants and the use of stem cells to grow new cartilage. So far, ways to repair cartilage have only been studied in younger people with small, well-defined holes in their knee cartilage. This isn't a common problem for most older adults who have arthritis of the knee.

Treatment Options

How is osteoarthritis treated?

There is no cure for arthritis. But treatment can help slow or limit the breakdown of cartilage and help you reduce your pain and continue to lead an active life.

The goals of treatment are to:

  • Reduce your pain and stiffness.
  • Keep your joints working and moving well.
  • Keep you from becoming disabled.
  • Prevent more damage to your joints.

There are many treatments for arthritis. You may need to try several different ones to find what works for you.

Treatment for mild to moderate arthritis

In most cases, people who have mild to moderate arthritis can manage their symptoms for many years with treatment. A treatment plan may include:

Pain medicines.

These include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Or you may use a topical medicine such as capsaicin cream on your skin.

Physical therapy or occupational therapy.

Physical therapy can help with pain and how well you get around. Occupational therapy helps you live as independently as possible.

Self-care.

Self-care is also an important part of your treatment. It may include:

  • Getting rest.
  • Being active.
  • Staying at a healthy weight.
  • Putting ice or heat on a sore joint.
  • Using assistive devices such as reachers or a cane.
  • Changing activities or the way you do things.

Treatment if arthritis gets worse

If the pain and stiffness from arthritis don't get better or they get worse, your doctor may recommend:

  • Steroid shots in the joint to reduce swelling.
  • Pain medicine called tramadol.
  • An antidepressant, such as duloxetine, to help relieve pain.
  • Opioid pain medicines.
  • Physical therapy or occupational therapy.

In most cases, people can manage their osteoarthritis symptoms with medicine and lifestyle changes. But surgery may be an option if you have very bad pain, you have lost a lot of cartilage, or you have tried medicine and other treatments but they haven't helped.

Some types of surgery include:

  • Arthrodesis.
  • Arthroscopy.
  • Finger or toe surgery.
  • Joint replacement (hip, knee, or shoulder).
  • Osteotomy (knee or hip).

What Causes It

What causes osteoarthritis?

In osteoarthritis, the cartilage that cushions and protects your joints breaks down and wears away. When it breaks down, the bones rub together and cause damage and pain. Experts don't know why this happens.

What It Is

What is osteoarthritis?

Osteoarthritis is the type of arthritis that many people get as they age. It happens when the cartilage that cushions your joints gradually breaks down and the bones rub against each other. This causes damage and pain. Osteoarthritis is usually called arthritis.

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