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.
- Joint cartilage is a layer of tissue present at the joint surfaces that sustains joint loading and allows motion. It is gel-like, porous, and elastic. Normal cartilage provides a durable, low-friction, load-bearing surface for joints.
- Articular surface is the area of the joint where the ends of the bones meet, or articulate, and function like a ball bearing.
- Bone remodeling is a process in which damaged bone attempts to repair itself. The damage may occur from either an acute injury or as the result of chronic irritation such as that found in osteoarthritis.
- Collagen is the main supportive protein found in bone tendon, cartilage, skin, and connective tissue.
- Osteophytes are bony outgrowths or lumps, especially at the joint margins. They are thought to develop in order to offload the pressure on the joint by increasing the surface area on which your weight is distributed.
- Synovium is a membrane found within the joints that secretes a fluid that lubricates tissues where friction would otherwise occur.
- Subchondral bone is the part of bone under the cartilage.
Self-Care at Home
Lifestyle changes may delay or limit osteoarthritis symptoms.
- Weight loss: One study suggested that, for women, weight loss may reduce the risk for osteoarthritis in the knee.
- 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 andcalcium 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.
- Over-the-counter (OTC) medications
- Acetaminophen (Tylenol) is the first drug recommended for osteoarthritis.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for arthritis pain. These include aspirin, ibuprofen (Motrin or Advil), naproxen(Aleve), and ketoprofen (Orudis).
- Newer OTC preparations include chondroitin and glucosamine sulfate, which are natural substances found in the joint fluid. Chondroitin is thought to promote an increase in the making of the building blocks of cartilage (collagen and proteoglycans) as well as having an anti-inflammatory effect. Glucosamine may also stimulate production of the building blocks of cartilage as well as being an anti-inflammation agent. Glucosamine was found to increase blood sugar in animal studies, so people with diabetes should consult their doctor first. A recent study showed that glucosamine slowed progression of osteoarthritis in the knee.
- Arthritis self-help course: The Arthritis Foundation offers an educational program on the causes and treatment of arthritis. Exercise, nutrition, relaxation, and pain management programs are covered as well as ways to communicate with your doctor. Completion of the program reduced pain by 20% and doctor visits by 40%.