Osteoarthritis is not a single disease but rather the end result of a variety of disorders leading to the structural or functional failure of 1 or more of your joints. Osteoarthritis involves the entire joint including the nearby muscles, underlying bone, ligaments, joint lining (synovium), and the joint cover (capsule). Osteoarthritis also involves an advancing loss of cartilage. The cartilage tries to repair itself, the bone remodels, the underlying (subchondral) bone hardens, and bone cyst form. This process has several phases.


The stationary phase of disease progression in osteoarthritis involves the formation of osteophytes or joint space narrowing.

Osteoarthritis progresses further with obliteration of the joint space.

The appearance of subchondral cysts (cysts in the bone underneath the cartilage) indicates the erosive phase of disease progression in osteoarthritis.

The last phase in the disease progression involves bone repair and remodeling.


Causes of Osteoarthritis:


Endocrine: People with diabetes may be prone to osteoarthritis. Other endocrine problems also may promote development, including acromegaly, hypothyroidism, hyperparathyroidism, and obesity.


Posttraumatic: Traumatic causes can be further divided into macrotrauma or microtrauma. An example of macrotrauma is an injury to the joint such as a bone break causing the bones to line up improperly (malalignment), lose stability, or damage cartilage. Microtrauma may occur over time (chronically). An example of this would be repetitive movements or the overuse noted in several occupations.


Inflammatory joint diseases: This category would include infected joints, chronic gouty arthritis, and rheumatoid disease.


Metabolic: Diseases causing errors of metabolism may cause osteoarthritis. Examples include Paget's disease and Wilson disease.


Congenital or developmental: Abnormal anatomy such as unequal leg length may be a cause of osteoarthritis.


Symptoms of Osteoarthritis:


Pain: Aching pain, stiffness, or difficulty moving the joint may develop in 1 or more joints. The pain may get worse with overuse and may occur at night. With progression of this arthritis, the pain can occur at rest.


Specific joints are affected.

Fingers: Bone enlargements in the fingertips (first joint) are common. These are called Heberden nodes. They are usually not painful. Sometimes they can develop suddenly and are painful, swollen, and red. This is known as nodal osteoarthritis and occurs in women older than 45 years.

Hip: The hips are major weight-bearing joints. Involvement of the hips may be seen more in men. Farmers, construction workers, and firefighters have been found to have an increased incidence of hip osteoarthritis. Researchers think that a heavy physical workload contributes to OA of the hip and knee.

Knees: The knees are also major weight-bearing joints. Repetitive squatting and kneeling may promote osteoarthritis.

Spine: Osteoarthritis of the spine can cause bone spurs or osteophytes, which can pinch or crowd nerves and cause pain and potentially weakness in the arms or legs.


Treatment of Osteoarthritis:


Weight loss: One study suggested that, for women, weight loss may reduce the risk for osteoarthritis in the knee.


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Exercise: Regular exercise may help to strengthen the muscles and potentially stimulate cartilage growth. Avoid high-impact sports. The following types of exercise are recommended: range of motion, strengthening, and aerobic.

Diet: Antioxidant vitamins C and E may provide some protection. Vitamin D and calcium are recommended for strong bones. The recommended daily dose of calcium is 1000-1200 mg. The current guideline for vitamin D is 400 IU per day. Avoid more than 1200 IU of vitamin D per day.

Heat: Hot soaks and warm wax (paraffin) application may relieve pain.

Orthoses: These assistive devices are used to improve function of moveable parts of the body or to support, align, prevent, or correct deformities. Splints or braces help with joint alignment and weight redistribution. Other examples include walkers, crutches or canes, and orthopedic footwear.


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