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One of the major subtypes of arthritis, a disease characterized by inflammation of joints, is degenerative arthritis (osteoarthritis). This article outlines the cause, symptoms, diagnosis and treatment of degenerative arthritis.

Arthritis, a disease characterized by inflammation of joints, is a painful and disabling condition that causes joint stiffness and pain.

More than a 100 different kinds of arthritis exist, and the major types include degenerative arthritis (osteoarthritis), inflammatory arthritis, infectious arthritis and metabolic arthritis.

Osteoarthritis is the most common chronic condition of the joints, and affects approximately 27 million people in the United States. Osteoarthritis most often found in the knees, hips, lower back and neck, small joints of the fingers, and the bases of the thumb and big toe. It can, however, occur in other locations as well.

Causes of osteoarthritis

While it has long been thought the osteoarthritis develops due to regular “wear and tear” of the joints over time, studies have pointed to several other factors that could play a role in the development of this disease:

  • Genetics: some people are more likely to develop osteoarthritis due to various genetic traits that they inherit from their parents. For example, researchers have found that a gene called FAAH is expressed at higher levels in patients with knee osteoarthritis compared to healthy patients.
  • Being overweight: having extra weight on the body adds pressure on the knees and hips. Therefore, studies have shown that being overweight is linked to a higher risk of developing osteoarthritis.
  • Injury: injuries to joints, such as during sports, can lead to osteoarthritis.
  • Repetitive movements: constant, repetitive movements that are conducted every day can lead to osteoarthritis.
  • The presence of other diseases including bone and joint disorders, metabolic disorders and acromegaly (a disease that causes the body to make too much growth hormone) have been associated with the development of osteoarthritis.

Osteoarthritis: Diagnosis

Osteoarthritis is diagnosed after a physician has collected clinical information for your personal and family medical history, as well as conducting a physical examination and performing other diagnostic tests.

For the personal medical history, the doctor will ask you to describe your symptoms, provide details regarding when the pain or symptoms began, whether you have any other medical issues, where the pain is emanating from, to what extent do your symptoms affect your everyday activities and the list of medications you are currently taking.

During the physical examination, the physician will evaluate your joints, test how well each joint moves, and whether those areas are painful or swollen. There are no blood tests that can be used to diagnose osteoarthritis. However, several tests can be done including joint aspiration (which involves withdrawing fluid around the joint to rule out other forms of arthritis), x-rays (which can show damage related to osteoarthritis) and an MRI scan (which can be used to look at cartilage and any associated abnormalities).

Symptoms of osteoarthritis

By far the most common symptom associated with all types of arthritis, and specifically osteoarthritis, is pain and stiffness. This is particularly noticeable in the morning after a period of rest. Furthermore, the joints that are affected might get swollen, especially after a long period of activity. The symptoms associated with osteoarthritis build up over time rather suddenly appearing.

Symptoms of osteoarthritis may differ from one person to the next, as well as depending on the affected joints. If the joints of the hip are affected then pain will be in the groin, buttocks, or inside of the knee or thigh. If knee joint is affected, a patient may feel a grating sensation when moving their knee. If the joint of the finger is affected, then the patient may develop bony growths at the edge of joints. This can cause fingers to become swollen, tender, red and painful. Finally, if toe joint is affected, then the patient will feel pain, tenderness and swelling in the large joint at the base of the big toe.

Here are some other general symptoms of osteoarthritis:

  • Reduced movement of the joint
  • Stiffness of the joint
  • Cracking sound after bending a joint
  • Swelling of a joint
  • Pain worsens after an extended period of activity
  • Simple activities such as walking, climbing stairs and lifting objects become difficult
  • Delicate tasks, such as needlework, are really difficult to perform

Treatment: What can be done to manage osteoarthritis?

Unfortunately, there is no cure for osteoarthritis. However, there are treatments to help manage symptoms including:

  • Medications: Drugs can help manage pain and reduce swelling and inflammation. These include analgesics (pain relievers such as acetaminophen and opioids), nonsteroidal anti-inflammatory drugs (drugs that reduce inflammation such as aspirin, ibuprofen, naproxen and celecoxib), corticosteroids (anti-inflammatory drugs), and hyaluronic acid (injections that help lubricate joints).
  • Physical activity: Moving and conducting physical activity is an important part of treatment. Physical activity has several benefits when it comes to managing osteoarthritis. Strengthening exercises can build muscle tissue around affected joints, which helps lower pain, range-of-motion exercises help improve joint flexibility, and aerobic exercise helps to improve endurance and energy levels.
  • Weight loss: As extra weight adds stress to joints, losing weight can help patients with osteoarthritis reduce pain and stop further joint damage.
  • Physical and occupational therapy: Conducting this type of therapy can help teach how to properly use damaged joints, how to use heat and cold therapy, and exercises that can help increase flexibility.
  • Assistive devices: Your doctor may suggest devices like custom knee braces and shoe wedge to increase your functioning and mobility.
  • Surgery: In some cases, surgery can help repair or replace severely damaged joints, particularly the hips or the knee. Types of surgeries include arthroscopic debridement (removal of excess bone), arthrodesis (helps alleviate pain), osteotomy (realigns bones), and arthroplasty (replacing a joint with an artificial one).
  • Alternative therapies: Patients can use alternative therapies, such as supplements, acupuncture, massage, relaxation techniques, medication and others to improve overall well-being.

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  • Clinical Orthopaedics and Related Research (1976-2007) 427 (2004): S6-S15.
  • Felson, David T., et al. "Osteoarthritis: new insights. Part 1: the disease and its risk factors."
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  • Buckwalter, Joseph A., Henry J. Mankin, and Alan J. Grodzinsky. "Articular cartilage and osteoarthritis."
  • Instructional Course Lectures-American Academy of Orthopaedic Surgeons 54 (2005): 465.
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