Osteoarthritis, also known as degenerative arthritis, affects over 15 million Americans. Osteoarthritis occurs more frequently in men before the age of 45, and after the age of 55 in women. There are actually over 100 different types of arthritis, but osteoarthritis is the most common form.

What is Osteoarthritis?

Osteoarthritis is a breakdown of the cartilage in a joint, eventually leading to abnormal bone changes. The role of joints is to provide flexibility, stability, support and protection. Cartilage assists in these functions by coating the ends of the bones. When cartilage starts to breakdown in a joint, osteoarthritis develops. In the early stages of osteoarthritis, the surface of the cartilage becomes swollen, forming tiny crevasses. Inflammation may also occur in the synovium, a fluid-filled sac that surrounds the joint and provides nutrients and oxygen. As the cartilage loses elasticity, it becomes vulnerable to further damage from repetitive use. This can cause a great deal of joint pain and swelling. In advanced cases, there is a complete loss of cartilage cushion between the joint and bone, which causes pain and limited joint mobility. The joints most commonly affected are the knees, hips, spine, hands and toes.

Osteoarthritis is not a systemic condition - in other words, it does not spread throughout the body, but instead affects only the joint or joints where the deterioration has occurred.

What are the symptoms of osteoarthritis?

Symptoms can vary among individuals, some being completely debilitated, while others may experience few symptoms despite the severity of their condition. Symptoms may also be intermittent, and some may have long lengths of time between each interval of symptoms.

In osteoarthritis of the spine, pain can occur in the neck or lower back. If bony spurs develop, this can irritate the nerves in the spine, causing numbness, tingling and severe pain. Osteoarthritis in the fingers can cause a formation of hard bony enlargements, and bunions can form at the base of the big toe if this area is affected.

The most common symptom is pain in the affected joint(s) after repetitive use. Joint pain is usually worse later in the day. People often experience swelling, pain and stiffness, particularly after long periods of inactivity. In advanced cases when there is total loss of cartilage, the pain can be ongoing, even at rest.

What is the cause of Osteoarthritis?

Most cases of osteoarthritis are "primary osteoarthritis", where the cause is unknown. When the cause is known, it is referred to as "secondary osteoarthritis". Primary osteoarthritis occurs from aging, as the water content in the cartilage increases and the protein portion degenerates.

Secondary osteoarthritis is usually due to another disease or condition, such as obesity, repeated trauma or surgery on a joint, or gout. Obesity can cause osteoarthritis due to the excess weight and stress on the cartilage, particularly on the joints in the knees and hips. However, metabolic disturbances associated with excess body fat may also promote osteoarthritis.

What are the risk factors?

• Genetics - there may be a heredity factor involved in the cause of osteoarthritis.
• Age - risk increases with age
• Obesity - excess weight puts a great deal of mechanical stress on the cartilage, causing degeneration.
• Repetitive trauma or surgery to a particular joint
• Gout - uric acid crystals from gout can cause osteoarthritis.

How is osteoarthritis diagnosed?

•  X-rays can reveal loss of joint cartilage, narrowing of the joint space between adjacent bones, and bone spur development.
• Joint fluid analysis by arthrocentesis (fluid is removed from the joint for analysis) can help rule out other possible conditions, such as gout or an infection.
• Arthroscopic surgery can allow the physician to view the damaged cartilage through a viewing tube inserted into the joint, and possibly repair it. Visual analysis by the physician can help diagnose osteoarthritis by observing for the appearance of bony enlargements or bone spurs.

What can I do to help alleviate my arthritis pain?

• Lose weight (if you are overweight), to help alleviate excess mechanical stress on the affected joint(s).
• Avoid activities that aggravate the joint cartilage, or decrease the intensity and/or frequency to help alleviate pain and reduce swelling.
• Exercising can actually be beneficial as long as it is performed at a level that does not stress the affected joint(s). It is important to strengthen the muscles that surround the joint. In addition, physical activity helps improve and maintain joint mobility. It is also beneficial for weight reduction. Some types of activities that may be helpful are swimming, stationary cycling and light weight training - all which put little stress on the joints.