Osteoarthritis 101: Symptoms, Causes, Stages, Diagnosis & Treatment

What is Osteoarthritis?

Osteoarthritis (OA) is the most common type of arthritis and long-term joint concern. This condition is related to the wear-and-tear of joints, which happens primarily due to aging. For this reason, some people also refer to OA as degenerative joint disease (DJD) or “wear-and-tear arthritis”.

People who have osteoarthritis experience pain and stiffness in their bones – typically in the joints of their hips, knees, and hands. This happens because the connective tissues protecting the joints (cartilage) start to break down, causing the two joints to rub together.

The changes involved in OA don’t happen overnight. In fact, they usually develop slowly and then get more severe over time.

Osteoarthritis Symptoms

The symptoms of osteoarthritis generally include:

Pain and Stiffness

Just like other types of arthritis, the most common symptoms of OA are pain and stiffness in the affected joints. However, the time at which you observe pain and stiffness varies. Generally, they are more notable:

• When you wake up – People with osteoarthritis often experience “morning stiffness” where they feel pain and stiffness in the affected joint after waking up. Usually, it lasts for about 30 minutes, but may extend especially when there’s inflammation. Morning stiffness improves upon activity, when the joints have “warmed up”.
• After considerable inactivity – For instance, people who sat for hours may find it hard to stand up.
• When you use your joint – During the day, it’s also common for OA to “attack” after you use your joint, such as when you exercise or put weight or pressure on it. In these instances, resting often relieves pain and stiffness.

Tenderness and Swelling

Another common OA symptom is tenderness. Your joints are tender if you feel some pain or discomfort when you press or apply pressure on or around it. In some cases, there may also be swelling on or around the joint.

Limited Range of Motion

People with osteoarthritis often experience loss of flexibility in the affected area. What it means is that their joint won’t move to its full range of motion. For example, they cannot completely bend their knees or raise their arms. 

Cracking or Popping Sound

Joints normally work smoothly, that is, you won’t feel that they are rubbing together. However, if you have osteoarthritis, you may feel some grating sensation in the affected joint. If it’s not a grating sensation, you may hear some popping or cracking sound.

A Note on Osteoarthritis Symptoms

While we have outlined the most common signs and symptoms of OA above, remember that they still vary from person to person.  

Some people experience the symptoms intermittently, which means that their OA symptoms flare up for a while and then disappear. Others have more severe and continuous symptoms that can make it hard for them to perform activities of daily living (ADLs).

Furthermore, please remember that OA can affect almost any joint in the body. But, most people experience knee osteoarthritis or hip osteoarthritis.

Osteoarthritis Causes

OA occurs due to the deterioration of the cartilage surrounding the joint.

Cartilage is a connective tissue between two bones. You can think of them as a cushion or protective covering that prevents friction between the two bones. In osteoarthritis, the cartilage breaks down or deteriorates, which eventually results in the joints rubbing together. Over time, the bones underneath will change and the joint lining becomes inflamed.

While the exact cause of the cartilage breakdown is still unclear at the moment, there are several notable risk factors that contribute to the development of OA.

Osteoarthritis Risk Factors

• Age – The risk of having OA increases with age. According to reports, most people would have experienced some symptoms of osteoarthritis by the age of 70. This also explains the wear and tear theory: the older you are, the more you’ve already used and damaged your cartilage and joints, and hence are more likely to have OA.
• Gender – The exact reason is unknown, but before the age of 55, the risk of OA is the same between men and women; but after 55, women are more likely to get OA.
• Weight – People who are overweight or have obesity are at a higher risk of experiencing osteoarthritis. For one, excess weight stresses the joints more, especially in the knees, hips, foot, and ankles. Additionally, fat tissues produce proteins that inflame the joints and the tissues surrounding it.
• Injuries – Joints that have been fractured or injured before, such as those from sports and vehicular accidents, are more vulnerable to osteoarthritis, even after they have healed.
• Overworked Joints – If your job involves squatting or kneeling for more than an hour a day, you may be more at risk of osteoarthritis. The same goes for people whose job includes walking, climbing stairs, or lifting.
• Family History – OA tends to run in the family, but experts still cannot pinpoint a particular gene responsible for it. If one of your relatives has OA, your risk might be higher.
• Certain Medical Conditions – Some medical conditions also lead to osteoarthritis or similar symptoms. Examples include bleeding disorder in the joints (such as hemophilia), blocked blood supply in the bones that lead to tissue death, and other types of arthritis like gout and rheumatoid arthritis. 

Types of Osteoarthritis

Before we enumerate and explain the different types of OA, let’s first highlight how it is different from rheumatoid arthritis.

Now, let’s proceed to the types of osteoarthritis. The two types of OA are classified based on its cause: 

Primary Osteoarthritis

The first type, called primary OA, happens due to age-related wear and tear. This is the more common type of osteoarthritis; in fact, it’s safe to say that primary osteoarthritis is inevitable.

People with primary OA often experience hip osteoarthritis and knee osteoarthritis. It also commonly affects the big toe, thumb, and fingers.

Secondary Osteoarthritis

Secondary OA does not occur due to aging, but rather, due to changes taking place in the cartilage surrounding the joints. These changes can happen due to the risk factors we mentioned earlier:

• Injuries
• Overweight and obesity
• Family history
• Overworked joints
• Other medical conditions

This also means that people can develop secondary osteoarthritis at a younger age.

Osteoarthritis Diagnosis

In order to diagnose osteoarthritis, the doctor will start with a health interview to better understand your symptoms. During the interview, they will also look at your joints for signs of stiffness, pain, and swelling.

The doctor may suspect OA if:

• You are 45 or older
• The pain gets worse the more you use your joints
• The morning stiffness you experience lasts for 30 minutes or less

During the interview, don’t hesitate to give detailed descriptions of your symptoms as this will help in arriving at the correct diagnosis. For instance, if you inform your doctor that the morning stiffness lasts for more than 30 minutes, they may suspect that you have rheumatoid arthritis instead.

If you have the symptoms we discussed in the earlier section or suspect osteoarthritis in your loved ones, the best thing to do is consult a doctor. However, if physically going to the clinic or hospital is not an option for you right now, you can also talk to doctors online, or have one of a physician visit you at your residence.

Besides the health interview, the doctor may also order imaging and laboratory tests for you.

Imaging Tests

To have a more detailed examination of your joints, the doctor may advise you to undergo the following imaging tests:

• X-ray – X-ray is the most common diagnostic test for OA. When the doctor orders for an x-ray, he or she is going to look for cartilage loss. When there is cartilage loss, the space between two joints will look narrowed. The cartilage itself, however, will not show up on an x-ray.
• MRI – MRI or magnetic resonance imaging is not a common diagnostic tool for OA, but can give the doctor more information about your joints’ condition, especially since MRI produces detailed images of your bones and the surrounding tissues, including the cartilage.

Laboratory Tests

• Blood Test – There is no blood test for OA, but by looking at certain antibodies in the blood, the doctor can rule out other conditions such as rheumatoid arthritis.
• Joint Fluid Analysis – In some instances, the doctor may draw fluids from your joints to check for signs of inflammation. Again, this is so that they can rule out other conditions such as an infection.

Osteoarthritis Complications

In general, OA does not result in other illnesses. However, it’s important to note that it is a degenerative disease. This means that the symptoms, particularly pain, stiffness, and swelling, may get worse over time. Increased symptom severity may lead to sleep disturbance or depression, due to the inability to do previously-enjoyed activities.

Osteoarthritis Treatment

At this point, you must be wondering: Is there a cure for osteoarthritis?

As of now, there is still no cure for this degenerative joint disorder. But, your doctor can create a treatment plan to control the symptoms and prevent them from worsening.

Following the physician’s orders is crucial in managing osteoarthritis. Remember that OA tends to get worse over time, but how fast the disease progresses partly depends on how well you’re treating your symptoms.

Generally, there are three ways to treat OA: medications, therapy, and surgery.

Medications

Oral Pain Relievers

People with osteoarthritis will most certainly receive medications for pain. The most common examples of pain relievers used for OA are over-the-counter acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs).

While you can get most of these pain-relievers without a prescription, you should still talk to your doctor about whether they are suitable for you as acetaminophen and NSAIDs have certain restrictions. 

For instance, it’s not recommended to take more than 3,000 mg of acetaminophen daily. If you have a liver condition, the doctor will likely reduce that limit further. As for NSAIDs like naproxen, ibuprofen, and aspirin, there may be some interactions with other drugs. Case in point, individuals with bleeding disorders or are already taking blood-thinning drugs are not suited to take aspirin as it increases the risk of bleeding.

Hence, it is of utmost importance to get your doctor’s approval first before taking OTC pain-relievers regularly. 

Duloxetine

Duloxetine is a medication commonly used to treat depression; however, it’s also an approved drug for osteoarthritis-related chronic pain.

Injections

In some instances, the doctor may give you steroid injections to reduce pain, but most steroid injections only provide short-to-medium term relief from OA.

Rehabilitation Therapy

Your doctor might also recommend physical or occupational therapy to help you manage your osteoarthritis.

Physiotherapy

During physiotherapy sessions, the therapist can teach you exercises that might help to reduce or eliminate your arthritis pain. Additionally, the exercises will also strengthen your muscles and improve flexibility.

Occupational Therapy

The occupational therapist will teach you new ways to do simple chores so that you can avoid arthritis pain and discomfort.

For instance, if you have hand osteoarthritis, the therapist might teach you how to use a wide-handled toothbrush. Likewise, if you have knee pain, they may advise you to have a bench inside the shower, so you don’t have to bear too much weight on your joints while showering.

Additionally, there are a number of assistive devices like braces, canes, and splints that can reduce the pressure on affected joints. However, avoid using them without the instruction of an expert such as a therapist as misuse may worsen your symptoms instead.

Do you want to attend a physical or occupational therapy session for your osteoarthritis? Here at Homage, we have certified and dedicated occupational and physiotherapists who can attend to you in the comfort of your home.

Surgery

While surgery is part of the osteoarthritis treatment strategies, it is often the last resort. Depending on your condition, the doctor may recommend a procedure that will either realign your joints or replace damaged bones.

Realigning your joints is often suggested when one side of the knee is more affected than the other. The doctor will cut across the area above or below the knee, and then insert or remove a wedge of bone to align the joints.

If your joint is already damaged, the doctor may recommend joint replacement surgery instead. In this procedure, the surgeon removes the damaged portion of the joint and replaces it with plastic or metal parts.

Living with Osteoarthritis

Given that there’s still no cure for OA, dietary and lifestyle changes are your best bet at reducing the severity of your symptoms.

Exercises for Osteoarthritis

Osteoarthritis can make you feel less inclined to exercise, especially if you often experience pain after physical activity. However, exercising is actually essential in improving your osteoarthritis symptoms. 

With regular exercise, you can improve your balance, flexibility, and muscles strength, significantly reducing the risk of injuries. Furthermore, physical activity releases endorphin, a hormone that acts as the body’s natural pain killer.

Choosing the right type of exercise is especially important when you have OA. Generally, the goal is to choose workouts that do not put a strain on your bones. For example, the following exercises are suitable for individuals with knee osteoarthritis:

• Swimming and other water exercises
• Walking
• Bicycling
• Low-impact strength training

Hot and Cold Packs

Another important part of living with osteoarthritis is taking advantage of hot and cold therapy.

Alternatively applying hot and cold compress over the affected area can not only reduce pain, but also swelling if present. To prepare the compress, you can use a water bottle filled with either hot or cold water. Don’t forget to wrap it in cloth before application to protect your skin. There are also convenient hot and cold packs sold in pharmacies. You can prepare them by either placing them in the freezer or heating them in the microwave.

Finally, if you’re not fond of applying a hot compress, warm showers or baths may work too.

Be Mindful of Your Weight

Since excess weight is a known OA risk factor, it’s crucial for people with osteoarthritis to maintain a healthy weight.

You can manage your weight through physical activity and a healthy diet. 

Be sure to eat a variety of foods, especially fruits and vegetables. One report even revealed that some types of OA, such as knee osteoarthritis, respond well to flavonoid-rich foods. The good news is fruits and vegetables are often filled with flavonoids. Focusing on clean, lean meat and healthy oils also helps.

If you are confused on how you can start your weight loss journey, consult a doctor. They will be able to determine your Body Mass Index (BMI) and suggest an achievable weight loss target.

Take Care of Your Emotions

Long-term osteoarthritis may hinder you from doing previously-enjoyed activities. This can lead to low mood or frustration. 

As you manage the physical symptoms of osteoarthritis, make sure to take care of your emotional and mental health too. Take time to do leisure activities you enjoy like reading a book, listening to music, or visiting museums. 

You may find other leisure activities tiring, but that does not mean you have to give them up completely. As long as your joints do not start aching, you are good to go. Also, do not hesitate to go on a trip. A change of scenery often boosts one’s emotional health.

If your symptoms of sadness, anxiety, and frustration are interfering with your daily life, it’s best to consult a doctor so that you can prevent them from progressing into depression.

Build a Support Network

When you are in pain, socialising can feel like a chore. However, isolating yourself will most likely cause more harm than good.

Living with osteoarthritis does not mean that you cannot maintain or build new interpersonal relationships. Continue to spend time with your loved ones and friends, and, if you are up for it, talk to them about what you are going through. If they offer some kind of help, don’t be afraid to accept it.

You may also consider finding a support group for people with osteoarthritis. Joining a support network, even an online one, allows you to meet individuals in similar situations and will help you feel less alone. You may also share and receive practical tips on how you can cope with the condition. Furthermore, seeing people with OA who live their life to the fullest can inspire you to do the same.

If you or your loved one needs care support for osteoarthritis, our team of caregivers, nurses and therapists can help.