OSTEOARTHRITIS

General Information

DEFINITION--Degeneration of cartilage at a joint and growth of bone "spurs" that inflame surrounding tissue.

BODY PARTS INVOLVED--All joints, but most common in fingers, feet, knees, hips and spine.

SEX OR AGE MOST AFFECTED--Adults over 45.

SIGNS & SYMPTOMS

• Joint stiffness and pain, including backache. Weather changes, especially cold, damp weather, may increase aching.
• Limited movement and loss of dexterity in affected joints.
• No redness, heat or fever in joints (usually).
• Swelling of affected joints (sometimes), especially finger joints.
• Cracking or grating sounds with joint movement (sometimes).

CAUSES--Exact cause is unknown. Appears to be a combination or interaction of mechanical, biologic, biochemical, inflammatory and immunologic factors.

RISK INCREASES WITH

• Obesity.
• Persons with occupations that put stress on joints.
• Stress on joints caused by activity and aging. Most people over age 50 have some osteoarthritis.
• Injury to the joint lining.

HOW TO PREVENT

• Maintain a normal weight for your height and body structure.
• Be physically active, but avoid activities that lead to joint injury, especially after age 40. Try regular stretching or yoga exercises.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood studies to rule out inflammatory forms of arthritis.
• X-rays of painful joints.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• An overall treatment plan will involve understanding the disorder, rehabilitation, activities of daily living and medications.
• Acupuncture (sometimes).
• Surgery for osteoarthritis includes arthroplasty (joint replacement) and arthrodesis (immobilization of a joint).

POSSIBLE COMPLICATIONS

• Crippling (sometimes).
• Muscles around affected joints may become smaller and weaker because of decreased use.
• Tends to be progressive.

PROBABLE OUTCOME--Symptoms can usually be relieved, but joint changes are permanent. Pain may begin as a minor irritant, but it can become severe enough to interfere with daily activities and sleep.

How To Treat

GENERAL MEASURES--

• To relieve pain, apply heat to painful and stiff joints for 20 minutes 2 or 3 times a day. Use hot towels, hot tubs, infrared heat lamps, electric heating pads or deep-heating ointments or lotions. Swim often in a heated pool or spa.
• If osteoarthritis of the neck causes pain in the arms, wear a soft, immobilizing collar (Thomas collar).
• Massage the muscles around painful joints. Massaging the joint itself is not helpful.
• If osteoarthritis affects the spine, sleep on your back on a very firm mattress or place 3/4-inch plywood between your box spring and mattress. Waterbeds help some people.
• Avoid chilling. Wear thermal underwear or avoid outdoor activity in cold weather.
• Keep a positive outlook on life. Remain active to prevent wasting of muscles.

MEDICATION--Your doctor may prescribe:

• Aspirin or other nonsteroidal anti-inflammatory drugs or acetominophen for pain.
• Cortisone injections into painful, stiff joints. These may provide temporary relief.
• Other medications as needed.

ACTIVITY--

• Rest is important only during acute phases when joints are very painful. Resume normal activity as soon as symptoms improve.
• Physical therapy for muscle and joint rehabilitation (severe cases only).
• May need to protect joints from overuse (crutches, cane, walker, elastic knee support).

DIET--If you are overweight, lose weight (see Weight Loss Diet in Appendix).

Call Your Doctor If

• You have joint pain or stiffness.
• New, unexplained symptoms develop.