Warning Signs of Osteoarthritis
- Pain and stiffness in a joint after getting out of bed or sitting for long.
- Swelling in one or more joints, especially those at the ends of the fingers (closest to the nail), thumbs, neck, lower back, knees, and hips.
- Crunching feeling or the sound of bone rubbing on bone
- Osteoarthritis may progress quickly, but in most people it develops gradually. It is relatively mild and interferes little with daily life in some people. Others have significant pain and disability.
- If you feel hot or your skin turns red, or if your joint pain is accompanied by a rash, fevers, or other symptoms, you probably do not have osteoarthritis. Check with your health provider about possible other causes, such as rheumatoid arthritis.
A combination of the following methods are used to diagnose osteoarthritis:
Clinical history—You will be asked when the condition started and how your symptoms have changed since. You will also describe any other medical problems you or your family may have, and any medications being taken. This helps your doctor make a diagnosis and understand the disease's impact on you.
Physical examination—Your doctor checks your strength, reflexes, and general health. She or he also examines bothersome joints and observes your ability to walk, bend, and carry out daily activities, such as dressing.
X rays—X-rays will help determine the form of arthritis and how much damage there is, including cartilage loss, bone damage, and bone spurs.
Magnetic resonance imaging —Magnetic resonance imaging (MRI) provides high-resolution computerized images of internal body tissues. It is used if there is pain, X-rays don't show much, or there is damage to other joint tissues.
Other tests—Your doctor may order blood tests to rule out other causes of symptoms. Fluid may also be drawn from the joint for microscopic examination to determine whether the pain is from a bacterial infection or uric acid crystals, indicating gout.
Doctors often combine treatments to fit a patient's needs, lifestyle, and health. Osteoarthritis treatment has four main goals: Improve joint function, keep a healthy body weight, control pain, and achieve a healthy lifestyle. Treatment plans can involve:
Exercise—Research shows that exercise can improve mood and outlook, decrease pain, increase flexibility, strengthen the heart and improve blood flow, maintain weight, and promote general physical fitness. Your doctor and/or physical therapist can recommend the exercises best for you.
Weight control—Weight loss can reduce stress on weight-bearing joints, limit further injury, and increase mobility. A healthy diet and regular exercise help reduce weight. A dietitian can help you develop healthy eating habits.
Rest and relief from stress on joints—Learn to recognize the body's signals, and know when to stop or slow down. Regularly scheduled rest prevents pain from overexertion. Proper sleep is important for managing arthritis pain. If you have trouble sleeping, relaxation techniques, stress reduction, and biofeedback can help.
Nondrug pain relief and alternative therapies—You may find relief from:
- Heat or cold (or a combination of both). Heat—with warm towels, hot packs, or warm bath or shower—can increase blood flow and ease pain and stiffness. Cold packs (bags of ice or frozen vegetables wrapped in a towel) can reduce inflammation, relieving pain or soreness.
- Massage uses light stroking and/or kneading of the muscles to increase blood flow and warm the stressed joint.
- Complementary and alternative therapies—Some people have found relief from such therapies as acupuncture. A large study supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the National Center for Complementary and Alternative Medicine (NCCAM) showed that acupuncture can relieve pain and improve function in knee osteoarthritis.
- Nutritional supplements—such as glucosamine and chondroitin sulfate have been reported to improve osteoarthritis symptoms in some people.
When selecting medicines, your doctor will consider the intensity of pain, potential side effects of the medication, your medical history, and other medications you are taking. By working together, you and she or he can find the medication that best relieves your pain with the least risk of side effects.
The following medicines are commonly used to treat osteoarthritis:
Acetaminophen—A common over-the-counter pain reliever. It is often the first choice for osteoarthritis patients because of its safety and effectiveness compared to some other drugs.
NSAIDs (non-steroidal anti-inflammatory drugs)—A large class of medications for both pain and inflammation. It includes aspirin, ibuprofen, naproxen, and others. Some NSAIDs are available over the counter, while more than a dozen others are available only with a prescription. NSAIDs can have significant side effects. Anyone taking NSAIDs regularly should be monitored by a doctor.
Narcotic or central acting agents—Mild narcotic painkillers containing codeine or hydrocodone are often effective against osteoarthritis pain. But because of their potential for physical and psychological dependence, they are generally for short-term use.
Corticosteroids—Powerful anti-inflammatory hormones that may be injected into the affected joints for temporary relief. No more than four treatments per year are recommended.
Hyaluronic acid substitutes—These medications are injected to help lubricate and nourish joints. They are approved only for osteoarthritis of the knee.
Other medications—Doctors also may prescribe topical pain-relieving creams, rubs, and sprays, which are applied directly to the skin over painful joints. Because most medicines used to treat osteoarthritis have side effects, it is important to learn as much as possible about the medications you take, even the ones available without a prescription.
For many people, surgery helps relieve the pain and disability of osteoarthritis. You may have surgery to:
- remove loose pieces of bone and cartilage (arthroscopy)
- reposition bones (osteotomy)
- resurface bones (joint resurfacing).
Surgeons also may replace affected joints with artificial ones called prostheses. These can last up to 15 years or longer. The surgeon chooses the prosthesis according to the patient's weight, sex, age, activity level, and other medical conditions.
After surgery and rehabilitation, the patient typically feels less pain and moves more easily.