The Signs and Symptoms of Osteoarthritis and How to Treat Them

The term arthritis accounts for multiple disease processes affecting the joints of the body. The most common type of arthritis is osteoarthritis, which typically affects the knees, hips, lower back, and knees, as well as the hands. The osteoarthritis disease process involves the breakdown of cartilage, a slippery tissue that usually pads bones to help them move easily in relation to each other. In people with osteoarthritis, this cartilage becomes rough, which causes friction in joints.  

As the disease progresses, the cartilage can wear away completely so that the bones rub together directly. When this happens, bone spurs can form in the joint space. A bone spur is extra growth of bone that can further inhibit the smooth movement of a joint.  

Underlying Issues Contributing to Osteoarthritis 

Researchers have been unable to figure out exactly what causes osteoarthritis. Currently, the hypothesis is that multiple factors involving both the body and the environment drive the development of the disease. For everybody, the likelihood of developing osteoarthritis increases with age, although some people are still more likely than others to develop or acquire this condition.  

Anything that puts additional stress on joints that can increase the wear rate on cartilage. Risk factors include participating in sports that involve repetitive jumping, running, throwing, or twisting. Any trauma that involves a particular joint also put you at risk going forward, including a prior injury or even surgery. For the most part, only adults who are middle-aged and older experience osteoarthritis. However, the condition can occur at any age and trauma is often the driving force behind osteoarthritis in younger adults.  

Another issue that predisposes people to osteoarthritis is having a joint that does not align correctly, as this results in uneven wear. This may happen due to trauma directly to a joint or to surrounding structures. Genetics also plays a role in the pathophysiology of the disease as certain genes are linked to it. 

The Diagnosis of New Onset Osteoarthritis 

Osteoarthritis is a clinical diagnosis, which means there is no definitive test for diagnosing it. Instead, medical professionals make the diagnosis based on the symptoms that a patient is experiencing. While the hallmark symptom of the disease is articular pain, it is important to recognize that not all patients with osteoarthritis experience pain.  

For those who do, it is a pain that typically gets worse with motion and improves with rest. You may experience joint stiffness for the first 30 minutes or so after you stop rest. Alternatively or in addition, you may notice that a particular joint feels loose and unstable, or that it moves less than normal. Another common symptom is swelling in the joint, especially if it gets worse after using the joint repeatedly.  

If you have symptoms like this, usually your physician starts with a full inventory of symptoms and a thorough review of your medical history. They may also order tests and studies. This provides the doctor with information about your risk of developing osteoarthritis and enables them to see how well your symptoms align with the classic presentation.  

Next, the physician will do a physical exam to better assess your joints. Providing photos of swelling and other changes can be very helpful. The physician will also likely order some lab tests to rule out other causes. The first test is typically an x-ray. Remember that there is no test to confirm osteoarthritis, but imaging can further help identify joint changes characteristic of osteoarthritis.  

The Treatment for People with Osteoarthritis 

There is no cure for osteoarthritis. However, with the proper treatment, the progression of the disease can be slowed drastically. Additionally, treatment can reduce the symptoms that you experience. A physical therapist can work with you to improve your strength and flexibility. Osteoarthritis can also affect balance, and physical therapists can help with that as well. Braces or inserts for your shoes may also help. 

Beyond these treatment modalities, topical and oral pain relievers are available. Always let your provider know if you are taking anything over the counter. If the pain is not improving, joint injections of steroids can be used to help reduce discomfort. Acupuncture has also been shown to treat osteoarthritis pain, as can massage. The latter modality increases blood flow and brings warmth to the area to promote healing. Heat and ice also help. In some cases, surgery may be necessary to restore joint functionality.

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