(Degenerative Joint Disease; Arthritis, Osteo-)
Osteoarthritis is a progressive, degenerative joint disease characterized by chronic inflammation of the joint lining. People with osteoarthritis usually have joint pain and limited movement of the affected joint.
Joints Affected by Osteoarthritis
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Healthy cartilage is a cushion between the bones in a joint. With osteoarthritis, the cartilage wears away over a long period of time, causing bones to rub together. The exact cause is unclear, but it may be a combination of genetics and the environment.
Osteoarthritis is more common in older adults. Factors that may increase your chance of osteoarthritis include:
- Excess body weight
- Family history of osteoarthritis
- Certain endocrine, metabolic, or neuropathic disorders, and avascular necrosis
- Having an injury or surgery to the joint surface, especially the cartilage
- Having an occupation or doing physical activities that put stress on joints
Osteoarthritis usually affects the hands, feet, spine, hips, and knees. Common symptoms include:
- Mild to severe pain in a joint, especially after overuse or long periods of inactivity, such as sitting for a long time
- Creaking or grating sound in the joint
- Swelling, stiffness, limited movement of the joint, especially in the morning
- Deformity of the joint
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
- Blood tests
Images may be taken of your bodily structures. This can be done with:
There is no treatment that stops cartilage loss or repairs damaged cartilage or bones of the joint. When cartilage wears away, bone on bone friction causes pain and inflammation. The goal of treatment is to reduce joint pain and inflammation, and to improve joint function.
Options may include:
Losing weight can lessen the stress on joints affected by osteoarthritis. The more weight lost, the greater the benefit. Consider talking to a dietitian who can help you with meal planning.
Exercise and Physical Therapy
Strengthening the muscles supporting an arthritic joint (particularly the knee, lower back, and neck) may decrease pain and absorb energy around the joint. For example, if you have arthritis in the knee, exercise and strength training can also help improve knee function. Swimming and water aerobics are good options. They do not put stress on the joint.
Another option is transcutaneous electrical nerve stimulation (TENS). With TENS, you are connected to a machine. The machine sends electrical signals through the skin to nerves. This type of therapy may decrease pain in some people.
If you have knee osteoarthritis, manual therapy, including massage therapy and manipulation, may be helpful.
Medications may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Cyclooxgenase-2 (COX-2) inhibitors
- Topical pain medications that are applied to the skin
- Opioids and similar medications
- Viscosupplementation injection
- Corticosteroid injection
Heat and Ice
Applying heat with hot water bottles, warm soaks, paraffin, or heating pads helps joints and muscles move more easily. It can also lessen pain. Using ice packs after activity can also help.
Glucosamine and chondroitin are two commonly used supplements. But, research has shown that these are not beneficial for most people with osteoarthritis. Talk with your doctor before taking any herbs or supplements.
Mechanical Aids and Assistive Devices
Shoes with shock-absorbing
soles may provide some relief while you are doing daily activities or exercising. Splints or braces help to properly align joints and distribute weight. Knee and wrist joints may benefit from elastic supports. Canes, crutches, walkers, and orthopedic shoes can help with advanced osteoarthritis in the lower body.
If you are having difficulty getting around due to arthritis pain, your doctor might recommend that you install handrails and grips throughout your home. These are useful in the bathroom and shower. You may need elevated seats, including toilet seats, if you’re having difficulty rising after sitting.
Some doctors report that acupuncture has been successful in reducing the pain of osteoarthritis. However, the evidence is not consistent.
Surgery may be needed for joints with severe damage. It may be done to remove loose pieces of bone or cartilage from joints or reposition bones to redistribute stress on the joint. Some may need to have the joint replaced with an artificial joint.
To help reduce your chance of osteoarthritis:
- Maintain a healthy weight.
- Do regular, gentle exercise, such as walking, stretching, swimming, or yoga.
- Avoid repetitive motions and risky activities that may contribute to joint injury, especially after age 40.
- With advancing age, certain activities may have to be stopped or modified. It is important to continue to be active, so find an activity that suits you.
The Arthritis Foundation http://www.arthritis.org
Updated May 21, 2014. Accessed June 29, 2015.
Hochberg MC, Altman RD, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-474.
Fernandes L, Hagen KB, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013;72(7):1125-1135.
Living with arthritis. Arthritis Foundation website. Available at:
Accessed June 29, 2015.
Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Disorders website. Available at:
Updated April 2015. Accessed June 29, 2015.
Sinusas, K. Osteoarthritis: Diagnosis and treatment. Am Fam Physician. 2012;85(1):49-56.
van den Berg WB. Pathophysiology of osteoarthritis. Joint Bone Spine. 2000;67:555-556.
10/21/2008 DynaMed’s Systematic Literature Surveillance
Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2008;CD004376.
12/11/2009 DynaMed’s Systematic Literature Surveillance
Rutjes WJ, Nuesch E, Sterchi R, et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst Rev. 2009;(4):CD002823.
10/15/2010 DynaMed’s Systematic Literature Surveillance
Wandel S, Jüni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010;341:c4675.
10/26/2010 DynaMed’s Systematic Literature Surveillance
Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
11/15/2010 DynaMed’s Systematic Literature Surveillance
US Food and Drug Administration. FDA clears Cymbalta to treat chronic musculoskeletal pain. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm232708.htm. Updated November 4, 2010. Accessed June 29, 2015.
11/29/2010 DynaMed’s Systematic Literature Surveillance
French HP, Brennan A, White B, Cusack T. Manual therapy for osteoarthritis of the hip or knee: a systematic review. Man Ther. 2011;16(2):109-117.
7/15/2013 DynaMed’s Systematic Literature Surveillance
Dilek B, Gözüm M, Sahin E, et al. Efficacy of paraffin bath therapy in hand osteoarthritis: a single-blinded randomized controlled trial. Arch Phys Med Rehabil. 2013 Apr;94(4):642-9.
6/18/2014 DynaMed’s Systematic Literature Surveillance
MQIC guideline on medical management of adults with osteoarthritis. Available at: http://www.guideline.gov/content.aspx?id=47806. Updated August 1, 2013. Accessed June 29, 2015.
9/3/2014 DynaMed’s Systematic Literature Surveillance
Zhou ZY, Liu YK, et al. Body mass index and knee osteoarthritis risk: A dose-response meta-analysis. Obesity (Silver Spring). 2014 Jul [Epub ahead of print].
Last Updated: 9/3/2014