It is also called degenerative joint disease or “wear and tear” arthritis because it most often develops slowly over time as people age. (1,2) Other common symptoms of osteoarthritis include:
Swelling around the jointClicking or cracking sound when the joint bendsReduced range of motion, which may go away with movementMuscle weakness around the joint (1,2,3)
Osteoarthritis can occur in any joint, but it most commonly affects the joints of the hands, hips, and knees, as well as the lower back and neck. (3,4) Learn More About the Signs and Symptoms of Osteoarthritis Cartilage serves as a shock absorber that also allows bones to glide over each other when a joint bends or straightens. Thanks to its water content, cartilage can change shape to absorb impacts when it is compressed. In people with osteoarthritis, the cartilage loses a lot of its water content (often through normal wear and tear) and deteriorates, reducing its ability to absorb shocks. Without this cartilage, the bones underneath can rub together, causing pain and inflammation at the joint. Cartilage can undergo some repair when damaged — slowly, since it contains no blood vessels — but the body does not produce new cartilage after injury. (2) Cartilage breaks down in both types of osteoarthritis; the difference between the two types lies in the underlying cause of this breakdown. Primary osteoarthritis, which is more common, is the “wear and tear” type of osteoarthritis that develops over time without a specific cause. It affects women more often than men, especially after menopausal age. Most often, primary osteoarthritis affects the fingers, spine, hips, knees, and big toes. (2,5,6) Secondary osteoarthritis, on the other hand, has a specific cause other than normal wear and tear. For example, young people can get secondary osteoarthritis if they’re athletes who use their joints a lot or if they have jobs that require the same bodily movements over and over. Causes of secondary osteoarthritis include:
Injury — sports-related injuries in particularObesity, which adds extra weight onto joints, causing them to wear fasterPhysical inactivityCongenital (present from birth) joint disorders, such as congenital hip dysplasiaScoliosisHemophilia and other disorders that cause bleeding in the jointsDisorders that block the blood supply near a joint, such as avascular necrosisOther types of inflammatory arthritis, such as rheumatoid arthritis and goutBeing “double-jointed” or having another condition associated with increased joint laxityAbnormal growths of bone and cartilagePaget’s disease, a chronic disease marked by deterioration of bone tissue (2,3,5,7,8,9)
Older age and being female are high risk factors for primary osteoarthritis. Primary osteoarthritis occurs in equal frequency for men and women younger than age 55 but is more common in women among adults older than age 55. (8) Having a close relative with osteoarthritis or a family history of the disease is also a risk factor for primary osteoarthritis. In fact, most people with primary osteoarthritis have family members with the condition, according to the Cleveland Clinic. (2) Risk factors for secondary osteoarthritis include:
Being overweight or obese, which particularly affects and puts more wear and tear on the joints of the hips, knees, ankles, and feetPrevious joint injuryFractures and injuries to the cartilage and ligaments in the jointsAn occupation that requires repetitive use of certain joints, such as a lot of kneeling, lifting, or walking up flights of stairsPlaying sports, especially those that involve direct impact on joints or involve joint twisting or throwing motionsLack of physical activityType 2 diabetes and elevated glucose levels (2,10)
In reviewing your medical history and giving you a physical examination, your doctor will look for signs that indicate osteoarthritis, including:
Pain that worsens with activity and gets better with restAge over 45 yearsMorning stiffness that lasts less than 30 minutesEnlargement of the bony jointsReduced range of motion (11,12)
The physical exam may also reveal various other signs of osteoarthritis, including joint tenderness, joint swelling, crepitation (joint crackling during movement), altered gait, and instability of the joint. (8) Your healthcare provider may conduct various other tests if he suspects you might have osteoarthritis. Blood tests and other laboratory tests will not help diagnose osteoarthritis but may help rule out other potential causes of your symptoms, such as inflammatory arthritis. Imaging tests, including X-rays, magnetic resonance imaging (MRI) scans, and ultrasounds, are usually not necessary. But they can help rule out other causes of symptoms and show the extent of damage to your cartilage, bones, and ligaments. (8,11,12)
Prognosis of Osteoarthritis
Pain from osteoarthritis can make it difficult to enjoy — or even execute — everyday activities, such as running errands, cleaning house, exercising, or getting good rest. Some research suggests that osteoarthritis symptoms and restlessness from a lack of activity can interfere with sleep. In fact, about 70 percent of people with osteoarthritis have sleep issues. (8,13) The course of osteoarthritis varies between people and depends on the joints affected. Pain and disability due to hip osteoarthritis usually worsens over time, while osteoarthritis affecting the fingers initially causes intermittent pain and stiffness but fewer symptoms later on. (12) The disease may rapidly progress if you have:
ObesityAdvanced ageOsteoarthritis affecting multiple jointsBowlegs (varus deformity) (11)
Treatments aim to reduce pain and other symptoms, improve joint function, slow the progression of the disease, and maintain quality of life. (1) Common treatments for osteoarthritis include:
Injections of thick liquids (hyaluronic acid “gel”) into the joints to mimic the functionality of normal joint fluidSupportive or assistive devices, such as crutches, shoe inserts, splints, and bracesPhysical activity, including aerobics and strength training exercisesPhysical therapy and occupational therapyHot and cold therapiesWeight loss (if necessary)Self-management strategiesSurgery (2,4,9,11,14)
The American College of Rheumatology and Arthritis Foundation produces guidelines and recommendations for the treatment of hip, knee, and hand osteoarthritis. In their latest guidelines, published in the journal Arthritis Care & Research in February 2020, the experts strongly recommended the following treatments:
ExerciseWeight loss (for knee and hip osteoarthritis in people who are overweight)Self-sufficiency and self-management programsTai chiCertain supportive or assistive devices, such as canes and knee bracesOral nonsteroidal anti-inflammatory drugs (NSAIDs)Topical NSAIDs and intra-articular glucocorticoid injections for knee osteoarthritis (15)
Medications for Osteoarthritis
Various medications may play a role in osteoarthritis treatment, including:
NSAIDsAnalgesics (pain relievers), including acetaminophen (Tylenol) and opioidsCorticosteroidsThe antidepressant duloxetine (Cymbalta) and the antiseizure drug pregabalin (Lyrica), which are FDA-approved to treat osteoarthritis painLidocaine, capsaicin cream, and other topical counter-irritantsTramadol (1,15)
Recent research suggests various other medications may soon be available to treat osteoarthritis. These include:
An anti-inflammatory antibody called canakinumab (16)Injections of adenosine triphosphate to help regrow lost cartilage (17)Injections of a novel molecule blocker to halt cartilage destruction (18)Growth factors delivered via nanoparticles to regenerate cartilage (19)
AcupunctureGlucosamine and chondroitin sulfateTai chiNutritional supplements, including fish oil and curcumin (active ingredient in turmeric)Transcutaneous electrical nerve stimulation (TENS)Platelet-rich plasma injectionsMassage therapyAdenosyl-L-methionine (SAMe) (2,20,21)
Speak with your doctor before trying any alternative and complementary treatments for osteoarthritis, as many of them lack clear evidence of benefit and may carry risks. For example, the American College of Rheumatology and the Arthritis Foundation do not recommend TENS, glucosamine, or chondroitin, but conditionally recommend (on a case-by-case basis) yoga. (15) RELATED: Natural Remedies for Osteoarthritis Pain Learn More About Treatments for Osteoarthritis
Prevention of Osteoarthritis
Since most cases of osteoarthritis are caused by normal wear and tear on the joints, it’s not possible to prevent it. But you may be able to reduce your risk of getting osteoarthritis with these measures:
Maintain an active lifestyle, nutritious diet, and healthy weightExercise regularly to strengthen muscles that protect joints, especially weight-bearing joints (knee, hip, or ankle)Avoid using a painful jointPractice good postureAvoid injury to joints (8,9,22)
Complications of osteoarthritis can vary depending on the severity of the condition and the joint involved. Potential complications and related disabilities include:
Long-term (chronic) painDifficulty moving and performing daily tasksInability to workBone deathBleeding in the jointInfection in the jointStress fracturesPinched nerve (in spinal osteoarthritis)Joint deformities — hard or bony nodules that form where two bones come together, often giving the joint a knobby or knotted appearanceMisaligned jointsDecreased joint motionNerve root damageImpaired balance and increased risk of falling (4,11,23,24)
In the United States, nearly 27 million adults have clinical osteoarthritis, according to a study published in the journal Arthritis Rheumatology. (25) A more recent study, published in August 2015 in the journal Arthritis Care & Research, found that an estimated 30.8 million U.S. adults (13.4 percent of the adult population) had osteoarthritis between 2008 and 2011. (26) Estimates from the CDC place the prevalence of osteoarthritis at more than 32.5 million adults. (4) Worldwide, it affects an estimated 302 million people and is a leading cause of disability among older adults. (15)
Knee Osteoarthritis, or KOA, Is Not Rare
The knee is the joint most commonly affected by osteoarthritis. Approximately 14 million people have symptomatic knee osteoarthritis, according to a study published in March 2016 in the journal Arthritis Care & Research. More than half these people are younger than 65. (27) Research suggests that people who are overweight or obese are 2.5 or 4.6 times, respectively, more likely to have knee osteoarthritis than those who are “normal” weight. (28) Other studies have shown that knee osteoarthritis has doubled in prevalence since the mid-20th century, but this increase cannot be explained by increased longevity and body mass index alone. (29) RELATED: Osteoarthritis Knee Pain Hand osteoarthritis is also fairly common. While the lifetime risk of developing symptomatic knee osteoarthritis is 45 percent, one study found that the lifetime risk of systematic hand osteoarthritis is about 40 percent. Nearly 1 in 2 women and 1 in 4 men have an estimated lifetime risk of developing hand osteoarthritis by age 85. Comparatively, the lifetime risk of developing hip osteoarthritis is 25 percent. (30)
Osteoarthritis vs. Rheumatoid Arthritis: What Is the Difference?
Several different types of arthritis exist. Aside from osteoarthritis, other common types include rheumatoid arthritis (RA), gout, and lupus. (11) Osteoarthritis and RA affect the body differently. In osteoarthritis, which is most often a mechanical (wear and tear) disease, the cartilage that covers the ends of the bones in a joint is damaged by multiple different causes. But in RA, the joint lining becomes inflamed and eventually erodes the joint. This disease is considered an autoimmune condition because the immune system mistakes joint linings for foreign objects and attacks them, resulting in inflammation. Additionally, unlike osteoarthritis, RA develops because of a combination of genetic and environmental factors, such as viruses, bacteria, and severely stressful events. (11,31) Learn More About Rheumatoid Arthritis vs. Osteoarthritis Joint Pain Some Asian populations have a lower risk of osteoarthritis, according to the Centers for Disease Control and Prevention. And while some studies suggest that Black American women are more likely to develop knee osteoarthritis than Black men and white people generally, other studies have found no such connection. (4,10) Cartilage breaks down in both types; the difference between primary and secondary lies in the underlying cause. Primary osteoarthritis is the wear and tear that develops over time, without one specific cause. It is more common, and it affects women more often than men, especially after menopause. (2,6,11) Secondary osteoarthritis has a specific cause other than normal wear and tear. For example, young people can get secondary osteoarthritis if they’re athletes who use their joints a lot or if they have jobs that require the same bodily movements over and over. Specific causes of secondary osteoarthritis, which are listed in the Primary versus Secondary Osteoarthritis section, include obesity, injury, and having other types of arthritis. (2,3,7,8,9,11) The Arthritis Foundation is a nonprofit organization dedicated to helping people with arthritis live their best lives through science, advocacy, and community connections. It also publishes the magazine Arthritis Today. Its website has numerous guides and articles for osteoarthritis and other types of arthritis, including about how to reduce your risk of falls and medical treatments for osteoarthritis. American College of Rheumatology While the American College of Rheumatology’s mission is to help rheumatologists succeed (it even publishes the journals Arthritis & Rheumatology and Arthritis Care & Research), the organization has a web portal dedicated to patients and their caregivers. There you will find guides about disorders of the joints, muscles, and ligaments, including osteoarthritis, to teach you about the symptoms, diagnosis, and treatment of the disorders, among other things. It also contains patient education videos on topics such as when you should see a rheumatologist. CreakyJoints A support, education, advocacy, and research organization for people living with rheumatic disorders, CreakyJoints is dedicated to raising awareness of all forms of arthritis, including osteoarthritis. Their activities include educating people about treatment and management strategies for these disorders. The National Institute of Arthritis and Musculoskeletal and Skin Diseases NIAMSD is the United States’ premier institute for research support, scientific training, and dissemination of information about arthritis, including osteoarthritis. It includes both basic and in-depth guides on osteoarthritis and various other arthritis, musculoskeletal, and skin diseases. This includes information on who treats the diseases and the progress of research on them. Mayo Clinic The Mayo Clinic website is a great initial resource when you’re first diagnosed with osteoarthritis and want to help your loved ones understand what you’re going through. The site offers basic information about osteoarthritis that can help you get a handle on the disorder’s symptoms, diagnosis, and treatment. U.S. Centers for Disease Control and Prevention The CDC strives to protect the American public from public health, safety, and security threats through the control and prevention of diseases. Its guide on osteoarthritis includes basic information on its symptoms, risk factors, and treatment, as well as steps you and your loved ones can take to manage your osteoarthritis.
Favorite Annual Meetings
American College of Rheumatology Annual Meeting This annual meeting hosts 16,000 rheumatologists, rheumatology health professionals, fellows in training, patient advocates, and exhibitors from more than 100 countries. The convention includes more than 450 sessions that provide opportunities for attendees to improve their professional development, network, and access the latest rheumatology research and clinical applications.
Favorite Online Support Network for RA
Live Yes! Arthritis Network This network, hosted by the Arthritis Foundation, provides various lines of support to help people with arthritis live life to the fullest. This includes online forums and a virtual connection group to empower people with arthritis to gain confidence in dealing with their disease proactively.
