Common risk factors for developing osteoarthritis include:
- Being overweight
- Female gender - the condition is more common and more severe in women
- Heredity - the condition, particularly where it affects the hands and fingers, tends to run in families.
Signs and symptoms
Pain is the most common symptom of osteoarthritis. It is usually made worse by moving the joint or placing weight on it, and it is usually relieved by rest. As the condition progresses and inflammation develops, pain may become constant.
Stiffness of the affected joint is often noticed first thing in the morning, and after resting.
Swelling, which is sometimes warm to touch, may be noticeable in an arthritic joint.
Deformity can occur with osteoarthritis due to bone growths and cartilage loss. Bone growths in the end joints of the fingers are called Heberden’s nodes. Bouchard’s nodes are bone growths in the middle joints of the fingers. Degeneration of knee cartilage can result in the outward curvature of knees (bow-leggedness).
Crepitus (a crackling sound or grating feeling) may be noticed when an arthritic joint is moved. This is caused by bone rubbing against bone or roughened cartilage.
Maintaining a healthy body weight will reduce stress on the arthritic joints.
Exercise can assist with weight loss, the maintenance of muscle strength and the mobility of arthritic joints. Activity at a level that does not cause pain is not thought to worsen osteoarthritis. Non weight-bearing exercises such as swimming or aqua jogging in a heated pool may be beneficial, as may gentle forms of exercise or stretching such as yoga and tai chi.
Physiotherapists can advise on appropriate exercises to improve mobility, increase muscle strength and decrease pain with the aim of improving function and maintaining independence. Heat or ultrasound treatment may also be used to relieve pain and relax muscles.
If activities of daily living become difficult, occupational therapists can provide advice on suitable home adaptations and special devices. These may include handrails, tap or bottle turners, large pegs, tongs or other gadgets. Equipment to assist mobility may include a walking stick or walking frame.
Medications can play an important role in the management of pain caused by osteoarthritis. There are different classes of medications that have proven useful. These include simple pain relievers (eg: paracetamol), non-steroidal anti-inflammatory drugs (NSAID's) and corticosteroids (eg: prednisone). A class of NSAID called COX-2 inhibitors eg: celecoxib (Celebrex) has proven effective in the management of osteoarthritis pain. However some medications in this class have been linked to an increased risk of heart attacks and stroke. For advice on suitable pain relief medications please consult a medical practitioner who can prescribe and monitor appropriate medication.
Supplements such as glucosamine and chondroitin sulphate have been reported to relieve the pain of osteoarthritis in some clinical studies but not others. It is advisable to consult a medical practitioner before taking these supplements.
Alternative therapies such as acupuncture and massage may relieve symptoms in some people.
The role of diet in the management of osteoarthritis is largely unproven. There are claims that some specific diets (eg: elimination diets) can help to relieve the symptoms of osteoarthritis but research has yet to back up these claims. It is recommended that a healthy balanced diet is followed as this can assist with overall wellbeing and with maintaining a healthy body weight. Some dietary supplements, such as certain fish oils and Evening Primrose Oil, are thought to have mild anti-inflammatory properties and have been reported to relieve symptoms in some people.
When medications, exercise or physiotherapy do not provide adequate relief of symptoms, a synovial fluid supplement may be injected into the joint. Synovial fluid is a clear, sticky, viscous solution that lubricates, protects and supports joints. In osteoarthritis this fluid does not function effectively. Synovial fluid supplements can reduce joint cartilage damage and delay the need for joint replacement surgery. Synvisc is one such supplement and is used to treat some cases of osteoarthritis of the knee.
When osteoarthritis has caused extensive joint damage and produces severe pain, joint replacement surgery may be necessary. The most common procedures are hip joint replacement and knee joint replacement. However, partial or complete replacement of the shoulder, elbow, wrist, finger, ankle and toe joints are also possible in some cases. The surgery is performed by an orthopaedic surgeon and can greatly reduce the symptoms of osteoarthritis in the affected joint. This allows greater mobility and an improved quality of life.
In osteoarthritis of the knee, if one side of a knee joint has more damage than the other, a bone realignment (knee osteotomy) might be helpful. In this procedure, a surgeon cuts across the bone either above (thigh bone) or below (shin bone) the knee, and either removes or adds a wedge of bone. A knee osteotomy shifts a person’s body weight off the damaged part of the knee.
Arthritis New Zealand
Post: P.O. Box 10-020 The Terrace, Wellington 6143
Phone: 0800 663 463
Arthritis New Zealand (Date unknown). More about OA [Web Page]. Wellington: Arthritis New Zealand. http://www.arthritis.org.nz/oacampaign/more-about-oa/ [Accessed: 27/02/17]
Meszaros, L. (2006). Osteoarthritis. The Gale Encyclopedia of Medicine. Third Edition. Jacqueline L. Longe, Editor. Farmington Hills, MI: Thompson Gale.
Ministry of Health (2016). Arthritis [Web Page]. Wellington: Ministry of Health. http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/arthritis [Accessed: 27/02/17]
Schiller, A.L. & Teitelbaum, S.L. (1999). Bones and Joints. In E. Rubin & J.L. Farber (eds.) Pathology (3rd ed.) (pp1337-1413). Philadelphia, PA: Lippincott-Raven Publishers.
Last Reviewed – February 2017