Osteoarthritis

Osteoarthritis occurs when the cartilage, the firm, rubbery tissue that cushions your bones at the joints, breaks down and wears away. This causes the bones rub together resulting in pain, swelling and stiffness around the joint.

As OA worsens, bony spurs or extra bone may form around the joint. The ligaments and muscles around the joint may become weaker and stiffer.

Before age 55, OA occurs equally in men and women. After age 55, it is more common in women.

Other factors can also lead to OA:

• OA tends to run in families.
• Being overweight increases the risk of OA in the hip, knee, ankle, and foot joints. This is because extra weight causes more wear and tear.
• Fractures or other joint injuries can lead to OA later in life. This includes injuries to the cartilage and ligaments in your joints.
• Jobs that involve kneeling or squatting for more than an hour a day, or that involve lifting, climbing stairs or walking increase the risk of OA.
• Playing sports that involve direct impact on the joint (such as football), twisting (such as basketball or soccer) or throwing also increase the risk of OA.

Medical conditions that can lead to OA include:

• Bleeding disorders that cause bleeding in the joint, such as hemophilia
• Disorders that block the blood supply near a joint and lead to avascular necrosis
• Other types of arthritis, such as chronic gout, pseudogout or rheumatoid arthritis

Symptoms

Symptoms of OA usually appear in middle age. Almost everyone has some symptoms by age 70.

Pain and stiffness in the joints are the most common symptoms. The pain is often worse after exercise and when you put weight or pressure on the joint.

With OA, your joints may become stiffer and harder to move over time. You may notice a rubbing, grating or crackling sound when you move the joint.

“Morning stiffness” refers to the pain and stiffness you feel when you first wake up in the morning. Stiffness due to OA usually lasts for 30 minutes or less. It improves after activity, allowing the joint to “warm up.”

During the day, the pain may get worse when you are active and feel better when you are resting. As OA gets worse, you may have pain even when you are resting. And it may wake you up at night.

Some people might not have symptoms, even though x-rays show the changes of OA.

Exams and Tests

A physical exam can show:

• Joint movement that causes a crackling (grating) sound, called crepitation
• Joint swelling (bones around the joints may feel larger than normal)
• Limited range of motion
• Tenderness when the joint is pressed
• Normal movement is often painful

Blood tests are not helpful in diagnosing OA.

An X-ray will likely show:

• Loss of the joint space
• Wearing down of the ends of the bone
• Bone spurs

Treatment

While OA cannot be cured, your OA symptoms can be controlled through a number of methods including over-the-counter medications, supplements and physical therapy. In severe cases of OA,  surgeries like joint replacements may be an option.

Outlook (prognosis)

Your movement may become limited over time. Doing everyday activities, such as personal hygiene, household chores, or cooking may become a challenge. Treatment usually improves function.