The more you know: Osteoarthritis

The more you know: Osteoarthritis

By: Christopher L. Tracy, MD, FACP, FACR, board-certified rheumatologist/internal medicine.

Assistant Professor of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland

With there being over 100 types of arthritis, osteoarthritis is the most common form that is diagnosed. Historically referred to as wear and tear arthritis or degenerative arthritis, osteoarthritis is caused by a decrease in the amount of cartilage within a joint. As the disease progresses, bones within a joint area may even change shape.

Osteoarthritis most commonly affects the knees, hips, lower back, neck and certain fingers and toes. Symptoms of the disease can include pain, dysfunction in the affected area, stiffness and the appearance of small bony knobs in the finger joints. Typically, those diagnosed will experience symptoms worsening as they use the affected areas, especially at the end of the day. Patients with severe cases of the disease may even lose full function in the affected area.

Both men and women can get osteoarthritis. It normally affects those aged 45 and older. However, early osteoarthritis can occur in people with prior injuries such as an athlete who had a major knee injury while playing sports as a child. Other contributing factors that can increase the likelihood of developing the disease include advancing age, joint trauma, obesity and genetics.

It is important that if one believes they have osteoarthritis to have it properly diagnosed. Other diseases that cause joint pain may be mistaken for osteoarthritis thus causing unnecessary testing. Your primary care physician can help with diagnosing osteoarthritis. This includes a physical examination and sometimes imaging of the area to look for patterns associated with the bony changes associated with this disease. Rheumatologists can often help the primary care physician if there is clinical concern for inflammatory causes.

Unfortunately, osteoarthritis is incurable and a progressive disease. There are no known disease-modifying medications and so current treatment goals focus on managing pain. After establishing a definitive diagnosis, patients work with their provider to develop a treatment plan to manage the pain that may impair their function in and around the affected joint. These treatments can include the use of medications such as Tylenol or nonsteroidal medications such as ibuprofen. Others may require the use of injections such as corticosteroids or hyaluronic. In severe cases or if non-steroidal sparing options are needed, Cymbalta or narcotics are used as part of the treatment plan. Chronic pain specialists typically manage severe pain due to the substantial health risks associated with the medications used in the treatment interventions. If medicinal treatment is not working, the treating provider may suggest an orthopedic surgical referral to evaluate surgical options for treatment of the damaged joints.

There are lifestyle choices one can make to decrease their chances of being diagnosed with osteoarthritis. This includes maintaining a healthy weight and building muscle to lessen the stress on the joints associated with obesity.

If you or a loved one believe to be suffering from osteoarthritis, don’t delay care and talk with your primary care physician to help develop a treatment plan. Doing so can help alleviate pain and increase your quality of life and maintain the function of the affected joint or joints. Ask your treating provider if a rheumatologist may offer assistance with your care plan.

Christopher L. Tracy, MD, FACP, FACR is a board-certified rheumatologist at Pinehurst Medical Clinic.