Osteoarthritis

FastFacts OAisthemostcommonformofjointdiseaseinhumansandisaleadingcauseofdisability amongtheelderly. Ittypicallyoccursinthehandjoints,spine,hipsandknees. Itiscausedbycartilagebreakdownandsubsequentbonychangesofthejoints. Althoughthejointchangesareirreversible,onlyasmallnumberofpatientswillprogressto thepointthatrequiresjointreplacementsurgery. OAsymptomscanvarygreatlyamongpatients.Yourrheumatologistcanmakethediagnosis andprescribeappropriatetreatmentrecommendationsforyou. Whatisosteoarthritis? Osteoarthritis(OA)isaslowlyprogressivejoint diseasetypicallyseeninmiddleagetoelderlypeople. Itoccurswhenthejointcartilagebreaksdown, causingtheunderlyingbonetofail.OAsymptoms includejointpain,stiffness,knobbyswelling,cracking noiseswithjointmovementsanddecreasedfunction. Ittypicallyaffectsthejointsofthehandsandspine andweightbearingjointssuchasthehipsandknees. Whogetsosteoarthritis? OAtypicallyoccursinpatientsage40andabove. However,someriskfactorsmightcauseittooccur sooner(seebelow).Itaffectspeopleofallracesand gender. Inosteoarthritis,thecartilagebetweenthe Whataretheriskfactorsforosteoarthritis? bonesinthejointbreaksdown,andbony Olderage enlargementoccurs. FamilymemberswithOA
Osteoarthritis Page1

Obesity Jointtraumaorrepetitiveuseofjoints

Howisosteoarthritisdiagnosed? OAusuallyisdiagnosedbyhavingtypicalsymptomsandphysicalexaminationasdescribedabove.In somecases,imagingstudiesmaybeusefultotelltheextentofdiseaseortohelpruleoutotherjoint problems. Howisosteoarthritistreated? Thegoaloftreatmentistoreducepainandimprovefunctionofthe affectedjoints.Thiscanbeachievedwithacombinationofphysical measures,drugtherapyand,sometimes,surgery. PhysicalmeasuresExercise,supportdevicesandthermaltherapyare usefulinOA.Someformsofunprovenalternativetreatmentsuchas spa,massage,acupunctureandchiropracticmanipulationcanhelp relievepainforashortduration,butusuallyarecostlyandrequire repeatedtreatments. DrugTherapyAvailableformsofdrugtherapyincludetopicalandoral agents.Topicaldrugs,whichincludecapsaicincream,lidocaine,and diclofenacgel,canbeapplieddirectlyontheskinoverlyingtheaffected joints.Oralpainrelieverssuchasacetaminophen,andnonsteroidal antiinflammatorydrugs(NSAIDs)arecommonlyusedasfirstline treatment.Formoreseriouspain,strongermedications,suchas narcotics,mayberequired.Jointinjectionswithcorticosteroidsora formoflubricantcalledhyaluronicacid(HA)derivativeshaveproven effectiveforsomepatients.
Thecirclesonthisfigureindicate thejointisseriouslydamaged,orthepatientisinintractablepainand jointsthatarecommonlyaffected experiencingsignificantlossoffunction. byosteoarthritis.

SurgeryArthroscopyand/orjointreplacementisconsideredwhen

SupplementsManyoverthecounternutritionalsupplementshave beenusedfortreatmentofOA,butmostlackgoodresearchdatatosupporttheireffectivenessand safety.Amongthemostwidelyusedareglucosamine/chondroitinsulfate,calciumandvitaminD,and omega3fattyacids.Toensuresafetyandavoiddruginteraction,consultyourdoctororpharmacist beforeusinganyoftheseagents,especiallyincombinationwithprescribeddrugs. Livingwithosteoarthritis ThereisnocureforOA,butyoucanmanagehowitimpactsyourlifestyle.Forinstance,givingproper positioningandsupporttotheneckandbackduringsittingorsleeping;adjustingfurniture,suchas raisingachairortoiletseat;andavoidingtraumaandrepetitivemotionsofthejoint,especiallyfrequent bending,aregreatstarts.
Osteoarthritis Page2

Addingregularexercisetoyourdailyactivitieswillimprovemusclestrength.Exercisesthatincrease strengthofthequadricepsmuscles(thefrontthighmuscles)alsocanhelpdecreasekneepainand reducesubsequentdisabilityassociatedwithosteoarthritis.Workingwithaphysicaloroccupational therapistcanhelpyoulearnthebestexercisesandchooseappropriateassistivedevicesforyourjoints. WeightlossinobesepeoplecanreducepainandprogressionofOA.Achievingandkeepinganideal weightwillmakeadifferenceinyouroverallcomfortlevels. Pointstoremember OAisthemostcommonformofarthritisandcanoccurtogetherwithothertypesofarthritis. Evaluationbyyourdoctorwillhelpconfirmthediagnosisanddevelopanappropriatetreatment planforyourcondition. ThegoaloftreatmentinOAistoreducepainandimprovefunction. Atpresent,thereisnoavailabletherapythatcanreversethedamageofOAinthejoint,but manystudiesareunderway. Tofindarheumatologist Formoreinformationaboutrheumatologists,clickhere. Learnmoreaboutrheumatologistsandrheumatologyhealthprofessionals. Formoreinformation TheAmericanCollegeofRheumatologyhascompiledthislisttogiveyouastartingpointforyourown additionalresearch.TheACRdoesnotendorseormaintaintheseWebsites,andisnotresponsiblefor anyinformationorclaimsprovidedonthem.Itisalwaysbesttotalkwithyourrheumatologistformore informationandbeforemakinganydecisionsaboutyourcare. ArthritisFoundation ww.arthritis.org
UpdatedAugust2009 WrittenbyThitinanSrikulmontree,MD,andreviewedbytheAmericanCollegeofRheumatologyPatientEducation TaskForce. Thispatientfactsheetisprovidedforgeneraleducationonly.Individualsshouldconsultaqualifiedhealthcare providerforprofessionalmedicaladvice,diagnosesandtreatmentofamedicalorhealthcondition. 2010AmericanCollegeofRheumatology

Osteoarthritis

Page3