For decades, scientists believed that osteoarthritis was caused by long-term wear and tear on the joints. While there is a connection to usage injuries that happen throughout a lifetime, doctors now perceive osteoarthritis as a disease of the joints, most commonly the spine, hands, feet, knees, and hips.
Also referred to as degenerative joint disease or degenerative arthritis, osteoarthritis affects approximately 27 million people in the U.S. making it the most common chronic condition of the joints. In fact, osteoarthritis has historically been one of the costliest conditions in terms of social security disability payments due to extended absence from work, second only to chronic heart disease.
While osteoarthritis can affect people of any age, it is most commonly found among people over 65 years old, affecting between 70 and 90 percent of patients over 75. Also, while osteoarthritis affects men and women equally, women are twice as likely to have the condition affect their hands and knees as they age compared to men.
The biology of osteoarthritis
Osteoarthritis is a disease that affects mostly cartilage, a rubbery tissue that covers the ends of each bone within a joint. When the cartilage inside the joints starts to disintegrate, it causes pain and swelling, as well as reduced range of motion. As osteoarthritis continues to progress, small pieces of bone or cartilage can chip off and float around within the joint. Over time, bone tissue can start to break down and develop growths known as spurs. Eventually, the cartilage wears away and bone rubs against bone, leading to even more pain and damage to the joint.
In addition to the pain and discomfort, osteoarthritis can cause lifestyle changes that have debilitating health effects. For example, the pain, inability to move around, and side effects of medication can lead to a sedentary lifestyle that results in weight gain. Not only does this make it more likely a patient will develop chronic heart disease, hypertension, or diabetes, the weight gain further aggravates the stress on the joints and causes even more pain.
Another problem for people who have osteoarthritis is that the condition makes it more likely for patients to suffer from falls. This is partially due to the weakening of muscles, a direct result of getting less exercise. Plus, the side effects of some medications used for pain relief can include dizziness and poor balance, which makes falling down more likely. Statistically, people who have osteoarthritis are 30 percent more likely to fall and 20 percent more likely to fracture a bone when they do fall.
Occasional soreness and stiffness of the joints is a normal part of aging. However, if these symptoms seem to be persistent or extreme, it’s a good idea to talk to your physician. Symptoms you should look for include:
- Extreme soreness or lack of flexibility, especially in the hips, knees, and lower back.
- Stiffness or a limited range of motion that improves after moving around a little.
- Swelling around any of the joints.
- Pain that gets worse after physical activity or toward the end of the day.
- A cracking or clicking sound when the joint bends from use.
In addition to age, risk factors include obesity, overuse of the joint, a past joint injury, and even genetics. For example, some inherited traits may include slight defects in how bones fit together at the joint, causing cartilage to wear faster than normal. Carrying extra weight is also a problem because it puts added pressure on the feet, knees, and hips. Over time, this can cause cartilage to break down faster.
While there is no cure for osteoarthritis, there are treatments that can help manage symptoms, such as pain, stiffness, swelling, and lack of flexibility. One of these treatments is physical activity. Simply moving around a little or going for a walk in your neighborhood can help keep weight down while strengthening the muscles around the affected joint. Slow, gentle stretching exercises are also effective at reducing pain and improving flexibility.
Safe, effective pain medications, both prescription and over the counter, may also help manage symptoms. However, it is very important that you speak to your physician about this because some prescription pain medications, especially opioids, are highly addictive and can cause severe health problems if they are abused.