What is Osteoarthritis?
Osteoarthritis, also known as a degenerative joint disease (DJD), is the most common form of arthritis. The disease usually develops slowly and primarily affects people over 55. Osteoarthritis can also occur from trauma or a joint injury.
Over time, the soft tissues and cartilage in the joint break down, causing joint pain, swelling, and stiffness. As it progresses, osteoarthritis symptoms will worsen and can limit daily activities such as walking, going upstairs, getting up from a chair, or gripping things with your hands.
Types of Osteoarthritis
The two main types of osteoarthritis are known as primary and secondary osteoarthritis:
- Primary osteoarthritis is the most common type affecting the fingers, thumbs, big toes, hips, knees, and spine
- Secondary osteoarthritis occurs when another disease or a medical condition damages the cartilage. Contributing factors include an injury or trauma to the joint, other inflammatory arthritis, e.g., rheumatoid or psoriatic, gout, or a genetic disorder such as Ehlers-Danlos syndrome (a group of conditions that affect the connective tissues.)
Signs & Symptoms of Osteoarthritis
The most common symptoms of osteoarthritis often develop slowly and worsen over time, beginning in a few joints. General symptoms of osteoarthritis include:
- Joint pain, either localized or widespread, may improve with some rest and can be worse at night
- Stiffness of the joint after resting for some time, especially in the morning
- Loss of flexibility resulting in limited joint movement or range of motion
- Swelling around the joint, especially after being active
- Changes to the joint and the feeling that the joint is loose or unstable
- Tenderness or swelling around the joint
- Depression from increased symptoms and a lack of sleep
Osteoarthritis can affect some joints differently:
- Hands – Changes to the shape of the joints and bony enlargements over time
- Knees –Grinding or scraping noises may occur when walking or moving. In more advanced cases, muscle and ligament weakness may cause the knee to buckle.
- Hips – Pain and stiffness in the hip joint, groin, inner thigh, or buttocks. Over time, you may lose some range of motion, and the pain can radiate or spread to the knees or back.
- Spine – Stiffness and pain in the neck and lower back. In advanced cases, some people may develop spinal stenosis, leading to other symptoms.
Stages of Osteoarthritis
Unlike other types of arthritis, pain and joint swelling increase slowly over time as the disease progresses through the osteoarthritis stages:
- Stage 0 – No signs of disease. The joint cartilage between your bones is healthy.
- Stage 1 – Cartilage starts to erode and growths on the end of your bones (bone spurs) could begin to form. It may hurt to bend and straighten your joint, but you may not feel it for years.
- Stage 2 – The space between your bones may get smaller as the cartilage reduces, you have bone spurs, and your joints begin to ache after being active.
- Stage 3 – There is less space in the joint from the loss of cartilage and you are experiencing more pain as you move. The bones change and become thicker, denser, and deformed. More bone spurs have developed, and fluid buildup has caused an increase in swelling.
- Stage 4 – There is little to no cartilage in your joint, bone spurs are much larger, and the ends of the bones are more rigid and deformed. This is the most extreme stage of the disease.
What Causes Osteoarthritis?
Osteoarthritis occurs when the cartilage and other surrounding tissue in the joint breaks down or wears away. Although not all older adults will develop osteoarthritis, age is a contributing factor. Other factors that can cause damage to the cartilage include:
- Congenital diseases that cause an imbalance in the joints
- Inherited conditions that cause a buildup of iron, calcium, or copper in the body
- Bone disorders that affect the joints
- Nervous system diseases or disorders that result in the loss of nerve function
Risk Factors for Osteoarthritis
The general risk factors and complications associated with osteoarthritis include:
- Aging – Risk of developing osteoarthritis increases with age
- Decreased estrogen – Postmenopausal women over the age of 55 have an increased risk of osteoarthritis, especially in the knee
- Diabetes – Elevated blood sugars increase free radicals in the body, causing oxidative stress that exceeds the resilience of the cartilage on a cellular level
- Hyperlipidemia – High cholesterol or elevated lipids contribute to the inflammatory response in the body, and oxidation of lipids can create deposits in the cartilage that affect the blood flow of the subchondral bone
- Obesity or being overweight – Creates excess pressure on the body, especially the knees, hips, joints of the feet, and lower back
- History of surgery or an injury to a specific joint
- Overuse or repetitive movements
- Joints that did not form correctly during development
- Family history – History of osteoarthritis or other inflammatory arthritis
How to Prevent Osteoarthritis
Although you cannot entirely prevent osteoarthritis, you can help reduce the daily stress on your body and your joints by:
- Eating right and maintaining a healthy body weight
- Controlling your blood sugar
- Being active daily, especially doing exercises that put the least amount of pressure on your joints, such as bicycling, swimming, and other water aerobics or activities
- Avoiding injury and trauma to your joints when exercising or playing sports
- Avoid bending the knee past 90 degrees
- Keep your feet as flat as possible during stretches
- Land with the knees bent when jumping
- Warm-up before sports, even less vigorous sports like golf
- Cool down after any kind of vigorous sport or activity
- Wear shoes that fit properly to provide extra stability and shock absorption
- Exercise on a soft surface and avoid running on concrete or asphalt
- Getting prompt medical treatment if you have suffered a joint injury to avoid further damage
- Paying attention to joint stiffness, swelling, and pain
- Maintaining a healthy posture to help decrease stress on the joints
Trust NewYork-Presbyterian for Osteoarthritis Care
If you are experiencing osteoarthritis symptoms such as consistent joint pain, swelling, or stiffness, contact the orthopedic experts at NewYork-Presbyterian to set up an appointment at one of our convenient locations near you.