Osteoarthritis is a disease of the joints. According to the CDC, it is the most common form of arthritis and affects over 20 million Americans. Osteoarthritis is characterized by stiffness, reduced range of motion, and deep pain in the joints that increases with use.
What is Osteoarthritis?
Joints are the connections between bones, and include soft tissues that connect the bones and cushion movement of the joints. Every joint has an articular surface between the bones, and the articular cartilage provides nourishment to the joint. Fluid within the joints, known as synovial fluid, is created by the synovial membrane. With age, all of these structures degenerate. The cartilage may dry out, and pain is experienced when there is no longer an adequate cushion between the bones.
Three Stages of Osteoarthritis:
Osteoarthritis is known to progress in five stages and eventually lead to damage:
- Stage 0 – The joint shows no sign of osteoarthritis and is considered healthy. The patient doesn’t experience any pain or impairment.
- Stage 1 – A minor bone spur growth is present and joint components show slight wear. While OA is present, it is not typical for the patient to experience significant pain or discomfort.
- Stage 2 – The bone spur continues to grow and mild pain begins to emerge. Pain stems from long periods of activity or joint stiffness after resting periods.
- Stage 3 – Frequent moderate pain is experienced. Joint swelling, cartilage damage, and a narrowing of the space between the bones occur. These conditions cause frequent pain while bending, walking, kneeling, or running.
- Stage 4 – The most severe stage of osteoarthritis, the cartilage around the knee has significantly deteriorated. Furthermore, the joint space between bones has dramatically reduced, and synovial fluid has decreased. People with stage four OA report great pain and discomfort from normal activities.
Where does it Target?
Osteoarthritis can affect any joint in the body. Weight bearing joints are typically affected, including the joints of the hips, knees, lumbar spine, and feet. The joints of the hand may also be involved.
Since it is a degenerative disease, the goals of treatment are relief of pain and discomfort, and strengthening of muscles while maintaining range of motion. Although the disease normally is associated with aging, trauma to the cartilage or joint may result in osteoarthritis in younger patients. This is typically called post-traumatic arthritis.
When diagnosing arthritis, a physician will consider the history, which may include a gradual increase in pain, limitation of movement, and stiffness during rest. As the disease begins to develop, rest may relieve the pain, but as it progresses, the joints may become unstable and weight bearing may be shifted inappropriately, causing stress on other joints.
Imaging studies may reveal loss of joint space or other bony deformities, but the diagnosis is typically made by history and examination. Pain is the most significant symptom.
Early in the course of the disease process, pain may be relieved by rest or by medications like acetaminophen or ibuprofen. However, if the pain becomes more severe and persists during rest, other therapy may be necessary.
Treatment of pain is the primary goal of therapy, but therapeutic measures also include limitation of changes in joint function and even improvement of joint range and stability. A combination of treatment modalities may include exercise or physical therapy, weight loss, and analgesics. If arthritis continues to progress and pain is not relieved by medical treatment, patients may be referred for surgical procedures that can include joint replacement.