Osteoarthritis, a degenerative joint disease, is the most common type of arthritis. Nearly 14 percent of U.S. adults have osteoarthritis, according to the Centers for Disease Control and Prevention (CDC). It affects women more than men and is a leading cause of disability. The classic signs of osteoarthritis are pain — particularly with activity — as well as swelling and stiffness in the joints.
If you suspect you have osteoarthritis, these 10 questions for your doctor may be helpful:
1. What causes osteoarthritis?
Many factors contribute to osteoarthritis, including joint overuse, repetitive trauma, and injury, such as an anterior cruciate ligament (ACL) tear in the knee. Osteoarthritis runs in families, so there’s also a genetic component. And obesity is another risk factor due to excess weight on the joints.
“There is no one trigger or common cause,” says Jonathan Samuels, MD, associate professor of medicine in the division of rheumatology at NYU Langone Medical Center in New York City. “[Whatever the cause], you end up having the same end damage to joints.”
2. How does osteoarthritis affect my joints?
Osteoarthritis occurs when you lose connective tissue (cartilage) in one or more joints — usually in the knees, hips, or hands. In fact, knee osteoarthritis is one of the five leading causes of disability among non-hospitalized adults. Pain or swelling in the joints may make it difficult to move the joint, disrupting your daily activities.
3. What’s the difference between osteoarthritis and rheumatoid arthritis?
Osteoarthritis is a chronic condition of the joints, says Dr. Samuels. “Rheumatoid arthritis is an autoimmune disease that most often affects the joints, but can affect other organ systems as well."
Age is one of the biggest risk factors for osteoarthritis: About one-third of people with osteoarthritis are over 55, says Samuels. Rheumatoid arthritis, on the other hand, primarily affects women of childbearing age.
Another difference between the two is that they usually affect joints in the hands. Osteoarthritis commonly occurs in the joints near the fingernails and at the base of the thumb, while rheumatoid arthritis affects the joints near the middle and base of the fingers.
4. Is there a drug that will cure or stop osteoarthritis?
There’s no medicine to put joints back together, and no way to medically stop the progression of osteoarthritis or return joints to a healthy state, says Matthew Husa, MD, assistant professor in the division of immunology and rheumatology at The Ohio State University Wexner Medical Center in Columbus.
Finding a drug treatment for osteoarthritis is a hot research pursuit right now, adds Samuels. Although there are highly effective medicines for rheumatoid arthritis, so far there are no comparable drugs for osteoarthritis.
5. How will osteoarthritis affect me in the long term?
Osteoarthritis usually progresses slowly, and in some people it never progresses beyond its initial stages, says Samuels. The Arthritis Foundation recommends staying active, maintaining a healthy weight, and avoiding injury or repetitive stress to help prevent your arthritis from worsening.
6. How do I manage arthritis symptoms?
Samuels recommends that his patients start with the over-the-counter (OTC) pain reliever Tylenol (acetaminophen). It’s generally safe, though it does come with some risk of liver damage. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and Cox-2 inhibitors, such as Celebrex, also relieve pain and inflammation. But these medications may cause side effects, says Samuels, including high blood pressure, bleeding ulcers, and kidney or heart problems — especially in older patients. He notes that topical versions of NSAIDs are safer than oral medications. You should discuss potential benefits and side effects of all OTC medicines with your physician before taking them.
Physical therapy is another way to manage osteoarthritis symptoms: It can help you develop stronger joints and muscles (especially around the knees). Occupational therapy can help strengthen the base of the thumb.
7. Will I need surgery for my osteoarthritis?
Joint replacement surgery is usually the last resort when other methods haven't worked to relieve pain and maintain joint function, says Dr. Husa.
Jan Tarasovic of Richmond, Virginia, ultimately resorted to surgery for osteoarthritis in her thumb. For 10 years, Tarasovic managed with ibuprofen, thumb splints, and cortisone shots as her arthritis slowly worsened. “It was so gradual, it wasn’t a disability at first,” she says. “The soreness would come and go. Then I was dropping things all the time. I couldn’t grasp large lids. It hurt when I used scissors or when I was knitting. I kept putting off surgery.”
Tarasovic was still in recovery at the time of this interview. She advises potential surgery patients to be sure they really understand the recovery process. “Clear your life as much as possible,” she says. “Things take a long time to do while you’re in recovery.”
8. What else can I do to manage symptoms?
Physical activity and eating a healthy diet are really important, says Husa. Obesity is a significant risk factor for knee and hand osteoarthritis, so diet and exercise can help you lose weight or maintain a healthy weight. Physical activity is also a great strategy for relieving pain and maintaining, or improving, function in the affected joints, according to the Arthritis Foundation. Use hot and cold therapies to relieve symptoms, and be sure to take rest breaks.
9. Are you sure I have osteoarthritis?
Other types of arthritis, like rheumatoid arthritis, psoriatic arthritis, and gout, can also cause joint pain or stiffness. If you’re experiencing joint pain, be sure to find a reputable specialist so you can get the most accurate diagnosis.
10. Where can I get additional help or support?
The Arthritis Foundation and the American College of Rheumatology both offer educational materials, tools, and resources for arthritis patients and caregivers. CreakyJoints is another source for helpful information and support for people with arthritis and their families.