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FAQs:

What is Osteoarthritis?

Osteoarthritis is a degenerative joint disease that can affect the many tissues of the joint. It is by far the most common form of arthritis, affecting more than 32.5 million adults in the United States, according to the Centers for Disease Control and Prevention.

Historically, osteoarthritis (OA) was known as a “wear and tear” condition, generally associated with aging. But we know now that it is a disease of the entire joint, including bone, cartilage, ligaments, fat, and the tissues lining the joint (the synovium). Osteoarthritis can degrade cartilage, change bone shape, and cause inflammation, resulting in pain, stiffness, and loss of mobility.

OA can affect any joint, but typically affects hands, knees, hips, lower back, and neck. Its signs and symptoms typically show up more often in individuals over age 50, but OA can affect much younger people, too, especially those who have had a prior joint injury, such as a torn ACL or meniscus. It typically develops slowly over time, but after such an injury, it can develop much more rapidly, within just a few years. OA is not an inevitable aging disease; some people never develop it.

There is no cure for OA, but there are ways to manage OA to minimize pain, continue physical activities, maintain a good quality of life, and remain mobile.

What is Knee Osteoarthritis?

Osteoarthritis of the knee happens when the cartilage in your knee joint breaks down, enabling the bones to rub together. The friction makes your knees hurt, become stiff and sometimes swell. While osteoarthritis in the knee can’t be cured, there are many treatments to slow its progress and ease your symptoms. Surgery is an option for more severe forms of osteoarthritis.

Is Osteoarthritis Painful?

Osteoarthritis is a degenerative disease that worsens over time, often resulting in chronic pain. Joint pain and stiffness can become severe enough to make daily tasks difficult. Depression and sleep disturbances can result from the pain and disability of osteoarthritis.

What Age Does Osteoarthritis Usually Start?

Osteoarthritis usually affects people older than 55. However, there’s no set timeline or age restriction on when you might experience it. It also doesn’t start the way some health conditions do — there’s not usually an exact starting point your healthcare provider can precisely identify. It can take a long time for the cartilage in your affected joints to wear down enough to cause pain and stiffness. So, even if you first notice symptoms around age 55, that doesn’t mean osteoarthritis started exactly at that time.

What is the Best Osteoarthritis Treatment?

The best treatment for osteoarthritis will depend on several factors, such as the severity of your symptoms. For example, lifestyle changes and natural remedies may be enough to help manage stages 1 and 2 osteoarthritis. However, stages 3 and 4 osteoarthritis may require more invasive treatments, such as surgery.

What is the Difference Between Osteoarthritis and Rheumatoid Arthritis?

Osteoarthritis and rheumatoid arthritis (RA) share similar symptoms, but they’re two different conditions. Osteoarthritis is a degenerative condition, which means it increases in severity over time.

RA may also cause progressive joint damage over time if left untreated. However, RA is an autoimmune disorder. This means the immune system mistakenly attacks the healthy, soft lining (synovium) around your joints. As the immune system launches its assault, fluid buildup occurs within the joint. This causes stiffness, pain, swelling, and inflammation.

If you’re unsure which form of arthritis you may have, speak with a doctor. They can provide a proper diagnosis and develop a treatment plan for your condition.

How is Osteoarthritis Diagnosed?

A doctor diagnoses OA through a review of symptoms, physical examination, X-rays, and lab tests. A rheumatologist, a doctor who specializes in arthritis and other related conditions, can help if there are any questions about the diagnosis.

Can Osteoarthritis Be Reversed?

Osteoarthritis symptoms can usually be managed, although the damage to joints can't be reversed. Staying active, maintaining a healthy weight, and receiving certain treatments might slow the progression of the disease and help improve pain and joint function.

Is Osteoarthritis an Autoimmune Disease?

Osteoarthritis is not. An autoimmune disease occurs when the body’s immune system attacks healthy cells. That’s exactly what happens with rheumatoid arthritis.  Osteoarthritis is caused by the wearing down of the cartilage that cushions the joints and keeps your bones from rubbing uncomfortably together.

What Happens If Osteoarthritis is Left Untreated?

Untreated osteoarthritis will continue to progress and worsen over time.  Arthritis cannot kill you, but it can cause serious pain and discomfort in your life.  The treatment of arthritis is a quality-of-life issue but is not life-threatening.  It is not a diagnosis that will shorten your life expectancy, but if ignored and left untreated, can make the rest of your years of life miserable.

This condition cannot paralyze you but will make the normal function of the joint worsen over time.  Untreated arthritis will add to the degradation of the structures in and around the joint leading to more and more pain and a loss of function.  The progression of arthritis may lead to requiring a total joint replacement.

How Fast Does Osteoarthritis Progress?

Experts confirm that once OA starts, it may take years to reach a severe stage. However, in extreme cases, OA progresses rapidly to complete the destruction of the cartilage within a few months. Some of the factors that determine the rate of OA progression include:

- The severity of your symptoms at the time of diagnosis

- The specific joints affected by the condition

- Your overall health

- Your physical activity and how much you use the affected joint

A recent study reveals that OA of the knee tends to progress faster in older persons and those with OA in more than one joint. It also progresses much faster in people with a high BMI. If you suspect you have osteoarthritis, you must visit your doctor immediately. Early diagnosis and treatment can help slow down the progression of OA.

Does Walking Worsen Osteoarthritis?

Learning how to reduce knee pain while walking can significantly improve your quality of life. Pain should not stop you from walking because walking helps to relieve osteoarthritis pain, according to WebMD. This is because walking allows more blood to flow to your joints. Other benefits of walking include:

- Improves your balance.

- Delivers nourishment to your cartilage.

- Strengthens your muscles and bones.

What Type of Doctor Treats Osteoarthritis?

As OA gets worse, your joint may no longer work well. You can’t do daily tasks like get dressed or open a jar. You can’t climb stairs or move around. If that happens, it’s time to see your doctor, physical therapist, or a specialist like:

- An orthopedic surgeon to replace a joint that no longer works

- Rheumatologists, who have special training in arthritis treatment

- Physiatrists, who specialize in rehabilitation can work with you to get your joint working again

- Podiatrists, who treat foot or ankle problems and do some minor foot surgeries

You may need a cane or walker to help you get around or to support your joints. Your physical therapist can prescribe the right one for you and show you how to use it.

An occupational therapist (OT) can help you adapt the way you do your job or get around the house. They can rearrange your home or office to suit your needs.

Classification of Osteoarthritis

A healthcare provider might classify osteoarthritis as one of two types:

1. Primary osteoarthritis is the most common form of osteoarthritis that develops in your joints over time. Experts think it’s usually caused by normal wear and tear of using your joints throughout your life.

2. Secondary osteoarthritis happens when something directly damages one of your joints enough to cause osteoarthritis. Injuries and traumas are common causes of secondary osteoarthritis. Other types of arthritis can damage the cartilage in your joints enough to cause osteoarthritis, too.

Types of Osteoarthritis

Osteoarthritis may affect different parts of your body. It most commonly affects the knees and hips, but it may occur in any joint. Other types of osteoarthritis include:

- hands osteoarthritis

- fingers osteoarthritis

- shoulder osteoarthritis

- spinal osteoarthritis

- cervical osteoarthritis (spondylosis)

Osteoarthritis is a progressive condition, which means symptoms may spread to other parts of your body. Having osteoarthritis in one part of your body may also increase your risk of developing the condition in other body parts, according to the Arthritis Foundation.

Stages of Osteoarthritis

Osteoarithis is a progressive condition that may be classified into four stages. This may depend on the severity of your symptoms and the degree of joint and cartilage damage. The four stages of osteoarthritis are:

Stage 1 (Mild): You may experience early symptoms of osteoarthritis, but your cartilage is still in good shape.

Stage 2 (Moderate): You may experience sharp, acute symptoms. Your cartilage is showing signs of wear and tear.

Stage 3 (Advanced): You may experience constant osteoarthritis symptoms, especially when you apply weight to the affected joint. The joint cartilage is also almost completely gone.

Stage 4 (Severe): This is the most severe form of osteoarthritis. You may experience:

- severe pain, stiffness, and inflammation

- decreased range of motion

- joint instability, such as sudden locking or buckling

- other symptoms, such as muscle weakness, bone spurs, and joint deformity

During stage 4 osteoarthritis, you’ll likely need surgery to reduce your symptoms and increase mobility, function, and quality of life.

Symptoms of Osteoarthritis

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

1. Pain. Affected joints might hurt during or after movement.

2. Stiffness. Joint stiffness might be most noticeable upon awakening or after being inactive.

3. Tenderness. Your joint might feel tender when you apply light pressure to or near it.

4. Loss of flexibility. You might not be able to move your joint through its full range of motion.

5. Grating sensation. You might feel a grating sensation when you use the joint, and you might hear popping or crackling.

6. Bone spurs. These extra bits of bone, which feel like hard lumps, can form around the affected joint.

7. Swelling. This might be caused by soft tissue inflammation around the joint.

Causes of Osteoarthritis

Factors that may contribute to the development of OA include 

1. Age. The risk of developing OA increases with age and symptoms generally, but not always, appear in people over 50. 

2. Joint injury. A bone fracture or cartilage or ligament tear can lead to OA, sometimes more quickly than in cases where there is not an obvious injury.

3. Overuse. Using the same joints over and over in a job or sport can result in OA.

4. Obesity. Excess weight adds stress and pressure on a joint, plus fat cells promote inflammation.

5. Musculoskeletal abnormalities. Malalignment of bone or joint structures can contribute to faster development of OA.

6. Weak muscles. If muscles don’t provide adequate joint support, poor alignment can result, which can lead to OA.

7. Genetics. People with family members who have OA are more likely to develop it.

8. Gender. Women are more likely to develop OA than men.

9. Environmental Factors. Modifiable environmental risk factors include things like someone’s occupation, level of physical activity, quadriceps strength, presence or absence of prior joint injury, obesity, diet, sex hormones, and bone density.

Risk Factors of OA

Factors that can increase your risk of osteoarthritis include:

1. Older age. The risk of osteoarthritis increases with age.

2. Sex. Women are more likely to develop osteoarthritis, though it isn't clear why.

3. Obesity. Carrying extra body weight contributes to osteoarthritis in several ways, and the more you weigh, the greater your risk. Increased weight adds stress to weight-bearing joints, such as your hips and knees. Also, fat tissue produces proteins that can cause harmful inflammation in and around your joints.

4. Joint injuries. Injuries, such as those that occur when playing sports or from an accident, can increase the risk of osteoarthritis. Even injuries that occurred many years ago and seemingly healed can increase your risk of osteoarthritis.

5. Repeated stress on the joint. If your job or a sport you play places repetitive stress on a joint, that joint might eventually develop osteoarthritis.

6. Genetics. Some people inherit a tendency to develop osteoarthritis.=

7. Bone deformities. Some people are born with malformed joints or defective cartilage.

8. Certain metabolic diseases. These include diabetes and a condition in which your body has too much iron (hemochromatosis).

Conditions Similar to Osteoarthritis

Scientists have identified more than 100 types of arthritis. Osteoarthritis can cause similar symptoms as many other forms of arthritis or other musculoskeletal problems, including:

1. Rheumatoid arthritis: Rheumatoid arthritis occurs when your immune system attacks healthy cells in your joints.

2. Psoriatic arthritis: Psoriatic arthritis develops in some people with psoriasis, an autoimmune condition that causes scaly rashes.

3. Bursitis: Bursitis is inflammation of a fluid-filled sac called a bursa that surrounds your joint.

4. Tendonitis: Tendonitis is inflammation of a tendon that connects one of your muscles to bone.

5. Gout: Gout causes flare-ups of joint pain due to the buildup of uric acid crystals in your body. It most often affects your big toe.

6. Avascular necrosis: Avascular necrosis is the death of bone tissue due to the temporary or permanent loss of its blood supply.

How to Prevent Osteoarthritis

The best way to prevent osteoarthritis is to maintain good overall health, including:

- Avoiding tobacco products.

- Doing low-impact exercise.

- Following a diet plan that’s healthy for you.

- Always wear your seatbelt.

- Wearing proper protective equipment for any activity, sport, or work you’re doing.

- Visiting a healthcare provider for regular checkups and as soon as you notice any changes in your joints.

How Osteoarthritis is Treated

Your healthcare provider will help you find treatments that relieve your osteoarthritis symptoms. There’s no cure for arthritis, and you can’t regrow the cartilage in your affected joints. Your provider will help you find ways to manage your symptoms when you’re experiencing them. The most common treatments for osteoarthritis include:

1. Medication: Over-the-counter (OTC) pain relievers can help reduce pain and inflammation. You might need medication you take by mouth or topical pain relievers (creams, ointments, or patches you put on your skin near your affected joints).

2. Exercise: Moving your joints can relieve stiffness and strengthen the muscles around them. Low-impact activities like swimming, water aerobics, and weight training can all help. Your provider might recommend that you work with a physical therapist.

3. Supportive devices: Wearing shoe inserts or a brace can support and stabilize your joints. Using a cane or walker can take pressure off your affected joints and help you move safely.

4. Heat and cold therapies: Applying heat or cold to your affected joints might help relieve pain and stiffness. Your provider will tell you how often (and for how long) you should apply a heating pad, ice packs, or a cool compress.

5. Complementary therapy: Complementary therapies may work alongside other treatment options. Examples of complementary medicine include acupuncture, massage, meditation, tai chi, and dietary supplements. Talk to your provider before you start taking any herbal or dietary supplements.

6. Surgery: Most people don’t need surgery to treat osteoarthritis. Your provider might recommend surgery if you’re experiencing severe symptoms and other treatments haven’t worked. You might need a joint replacement (arthroplasty). Your provider or surgeon will tell you what to expect.

How to Prevent or Treat Osteoarthritis Naturally

Learn all you can about your condition and how to manage it, especially about how lifestyle changes can affect your symptoms. Exercising and losing weight if you're overweight are important ways to lessen the joint pain and stiffness of osteoarthritis.

1. Exercise. Low-impact exercise can increase your endurance and strengthen the muscles around your joints, making your joints more stable. Try walking, bicycling, or water aerobics. If you feel new joint pain, stop. New pain that lasts for hours after you exercise probably means you've overdone it, not that you've caused damage or that you should stop exercising. Try again a day or two later at a lower level of intensity.

2. Lose weight. Carrying extra weight increases the stress on your weight-bearing joints, such as your knees and your hips. Even minor weight loss can relieve some pressure and reduce your pain. Talk to a dietitian about healthy ways to lose weight.

Other things to try include:

3. Movement therapies. Tai chi and yoga involve gentle exercises and stretches combined with deep breathing. Many people use these therapies to reduce stress in their lives, and research suggests that tai chi and yoga might reduce osteoarthritis pain and improve movement. Make sure the yoga you choose is a gentle form and that your instructor knows which of your joints are affected. Avoid moves that cause pain in your joints.

4. Heat and cold. Both heat and cold can relieve pain and swelling in your joints. Heat, especially moist heat, can help muscles relax and ease pain. Cold can relieve muscle aches after exercise and decrease muscle spasms.

5. Capsaicin. Topical capsaicin, a chili pepper extract, applied to your skin over an arthritic joint might help. You might have to apply it three to four times a day for several weeks before you see a benefit. Some people can't tolerate the irritation. Wash your hands well after applying capsaicin cream.

6. Braces or shoe inserts. Shoe inserts or other devices might help reduce pain when you stand or walk. These devices can support your joint to help take pressure off it.

7. Assistive devices. Assistive devices can help relieve stress on your joints. A cane or walker takes weight off your knee or hip as you walk. Hold the cane in the hand opposite the leg that hurts. Tools for gripping and grabbing may make it easier to work in the kitchen if you have osteoarthritis in your fingers. Check catalogs or medical supply stores or ask your doctor or occupational therapist about assistive devices.

Alternative Medicine for Osteoarthritis

Complementary and alternative medicine treatments that have shown promise for osteoarthritis include:

1. Acupuncture. Some studies indicate that acupuncture can relieve pain and improve function in people who have knee osteoarthritis. During acupuncture, hair-thin needles are inserted into your skin at precise spots on your body.

2. Glucosamine and chondroitin. Studies have been mixed on these nutritional supplements. A few have found benefits for people with osteoarthritis, while most indicate that these supplements work no better than a placebo. Glucosamine and chondroitin can interact with blood thinners such as warfarin (Jantoven, and cause bleeding problems.

3. Avocado-soybean unsaponifiables. This nutritional supplement — a mixture of avocado and soybean oils — is widely used in Europe to treat knee and hip osteoarthritis. It acts as an anti-inflammatory, and some studies have shown that it can slow or even prevent joint damage.

4. Omega-3 fatty acids. Omega-3s, found in fatty fish and fish oil supplements, might help relieve pain and improve function. Talk to your doctor about supplements you're considering.

Types of Surgery for Osteoarthritis

When osteoarthritis pain is not controlled with other treatments, or when the pain prevents you from participating in your normal activities, you may want to consider surgery. There are several types of surgery for osteoarthritis. They include:

1. Arthroscopy to clean out the damaged cartilage or repair tissues. It is most commonly performed on the knee and shoulder. Recent evidence has questioned its effectiveness for osteoarthritis.

2. Joint replacement surgery to replace the damaged joint with an artificial one. Joint replacement surgery should be considered when the severity of the joint pain significantly interferes with a person’s function and quality of life. Even under the best of circumstances, surgery cannot return the joint to its normal state (artificial joints do not have all of the motion of a normal joint), but movement and function are significantly improved. In addition, an artificial joint will greatly diminish pain. The two joints most often replaced are the hip and the knee. Artificial joints are now also available to replace shoulders, fingers, elbows, and ankles to treat severe pain that has not responded to other treatments.

3. Joint fusion to remove the damaged joint and fuse the two bones on each side of the joint. This is done more often in areas in which joint replacement is not effective.

Complications of Osteoarthritis

Osteoarthritis may lead to a variety of physical, mental, and emotional complications if left untreated. A common complication of osteoarthritis is increased stiffness in your joints, which could lead to impaired balance and mobility. According to the Arthritis Foundation, this may significantly increase your risk of falling, which could lead to minor or severe injuries. Other possible complications of osteoarthritis may include:

- poor sleep

- weight gain as a result of pain or limited mobility

- anxiety

- depression

- osteonecrosis, or bone death

- erosion of the ligaments and tendons

- hairline (stress) fractures

- hemarthrosis, or bleeding near the joints

8 Foods to Avoid If You Have Osteoarthritis

Below are eight foods that are associated with increased inflammation that people with osteoarthritis should limit or avoid:

1. Sugar

Added sugar is present in many processed foods, like baked goods, sugar-sweetened beverages, and candy. Condiments like barbeque sauce also contain large amounts of added sugar. Research has associated excessive sugar intake with increased inflammation and a higher likelihood of becoming obese, which can undermine the health of your joints.

2. Salt

Salt is an important part of a healthy diet because it helps your body function properly. Too much salt can cause you to retain too much fluid. This, in turn, can increase inflammation and swelling in the joints. Most dietary sodium (about 70%) comes from processed and prepared foods. So an easy way to keep your sodium intake in check is to check the nutrition labels on the food you buy. Use the "% of daily value" (DV) column as a tool as you shop. Five percent DV or less of sodium is low; 20% or more is too high.

3. Saturated Fat and Trans Fats

A diet high in saturated fat is associated with increased inflammation in the body. Foods that are high in saturated fat include butter, red meat, processed meats, full-fat dairy, fast food, fried foods, and coconut. Small amounts of trans fatty acids naturally occur in some animal products. It can also be artificially created during processing and is used to add texture, and flavor, and extend shelf life. Trans fat increases "bad cholesterol" levels (low-density lipoprotein, or LDL). It has been closely linked with systemic inflammation.7

4. Refined Carbs

During processing, fiber and nutrients are removed from grains, leaving them without most of their nutritional value. White flour and rice are simple carbs, which are more easily digested and absorbed into the bloodstream, causing spikes in blood sugar. Many foods with refined grains—such as breakfast cereals, baked goods, snacks, and sweets—are highly processed with added sugar, salt, and fat. They all spell bad news for people with osteoarthritis.

5. Omega-6 Fatty Acids

There are two main polyunsaturated fatty acids in the diet: omega-3 fatty acids and omega-6 fatty acids. Each has a different effect on the body. Omega-3 fatty acids produce anti-inflammatory properties while Omega-6 fatty acids are pro-inflammatory. In general, Americans tend to consume too many omega-6 fatty acids and too few omega-3 acids. If you have osteoarthritis, you can reverse this habit by consuming more soybeans, corn, safflower oil, sunflower oil, canola oil, poultry, and seeds. Instead of red meat, satisfy your need for protein with more dairy-, legume-, and nut-based portions. (Nuts and legumes are similar, but legumes store their seeds in pods, like peas and green beans.)

6. Dairy

Full-fat dairy products are high in saturated fats and are associated with increased levels of inflammation.6 Cheese, whole milk, cream, and butter are all high in saturated fat. In addition to being high in fat, some dairy products—like ice cream, sweetened yogurt, and chocolate milk—are also high in sugar. The combination of being high in fat and sugar makes these types of dairy products more inflammatory.

7. Alcohol

Chronic alcohol intake is associated with systemic inflammation that damages the body over time. The CDC recommends a moderate alcohol intake to reduce short- and long-term health risks, or no more than one drink per day for women and two drinks per day for men. Some alcoholic drinks are also high in sugar, which adds to their inflammatory effect.

8. MSG

Monosodium glutamate (MSG) is a food additive that acts as a flavor enhancer. It is often used in Chinese food, soups, processed meats, and canned foods. Some research studies have hinted at a possible relationship between MSG and negative health effects like headaches, sweating, nausea, inflammation, and weakness. Research is inconclusive about the effects of MSG. But if you're experiencing a lot of inflammation, you could try limiting MSG in your diet and then watch closely for any changes in how you feel.

What to Look for in an Osteoarthritis Specialist Near Me

The right rheumatologist for you may depend on your specific needs and communication style. Here are some tips to help you find the best specialist for you:

1. Consider the doctor’s personality and how well it meshes with yours.

2. Find a doctor you can relate to and communicate effectively with.

3. Look for a doctor you can build a long-term relationship, since some rheumatic diseases may develop into chronic conditions.

4. Consider having a loved one or friend join you at an appointment so they can help you decide if the doctor is a good fit.

Sources:

Arthritis Foundation

CDC

Mayo Clinic

Cleveland Clinic

Healthline

Celebration Foot and Ankle

Dr. Burke Ortho

Very Well Health

Health Match

Cano Health

WebMD

Everyday Health