Commonly known as "wear and tear" arthritis, osteoarthritis is a progressive wearing down of the cartilage that acts as cushioning in your joints.
Where two or more bones meet in a joint, the end of each bone is covered with a layer of cartilage, which allows the joint to move freely without friction between the bones. As these layers wear away-whether due to age, obesity, prior injury, or genetic factors-the bones begin to rub against each other, causing severe pain.
Common symptoms of osteoarthritis include pain, inflammation, stiffness, or swelling in the joint. Your first appointment with an orthopedic specialist will probably begin with a series of questions, including:
- Has the joint ever been injured?
- When did the pain begin?
- What does the pain feel like?
- Is it continuous, or does it come and go?
- Do you experience similar pain in any other areas?
- Is the pain worse at night?
- Does the pain occur when you walk or run, or do you feel it while you're at rest?
The doctor will then examine the joint in different positions to check your range of motion and to listen for any clicking or popping noises.
An X-ray will usually show any narrowing of joint space, erosion of bone tissue, fluid excess, bone spurs, or other abnormalities that will allow the physician to diagnose you with osteoarthritis. Some lab tests may also be performed to rule out other diseases.
If osteoarthritis is diagnosed early, nonsurgical treatments can help slow its progression and improve the joint's range of motion. These may include:
- Visco-supplementation injections (such as Orthovisc): Your physician injects a preparation of hyaluronic acid, a naturally occurring substance found in the synovial (joint) fluid.
- Lifestyle modifications: Your physician may recommend that you eliminate or modify certain activities; for example, runners may want to consider switching to swimming or cycling. A weight-loss program may also be recommended, as excess weight can complicate osteoarthritis in weight-bearing joints such as hips and knees.
- Medications: Your doctor may prescribe non-steroidal anti-inflammatory drugs, such as ibuprofen, or corticosteroid injections to temporarily relieve pain and swelling.
- Physical therapy: Working with a physical therapist can help strengthen the muscles around the joint, improve your flexibility, reduce pain, and improve range of motion.
If the above nonsurgical treatments don't provide long-term relief, your physician may recommend one of the following surgeries:
- Arthroscopy: A small, fiber-optic instrument called an arthroscope allows the surgeon to see inside the joint and fix some problems such as bone spurs or loose fragments. Because of the miniature size of the instrument, only a couple of 1/4-inch incisions are needed.
- Osteotomy: The surgeon adds or removes a small wedge of bone to realign the joint so that the weight is shifted to a non-damaged area.
- Joint replacement: The surgeon replaces the damaged joint with an artificial replacement (prosthesis). See Arthritis and Joint Replacement for more information.