Osteoarthritis

Osteoarthritis, the most common form of arthritis, is a chronic joint disease that affects mostly middle-aged and older adults. Osteoarthritis involves the breakdown of joint cartilage. Although it can occur in any joint, it usually affects the hands, knees, hips, shoulders, or spine. The disease is also known as degenerative arthritis or degenerative joint disease.

Symptoms of Osteoarthritis

The most common symptom of osteoarthritis is pain after overusing a joint or a long period of rest. Symptoms usually develop slowly over many years. While each person may experience osteoarthritis differently, common symptoms include the following:

• Joint pain
• Joint stiffness, especially after sleeping or inactivity
• Limited joint movement as the disease progresses
• Grinding of joints when moved (in more advanced stages of osteoarthritis) as the cartilage wears away

Causes of Osteoarthritis

Osteoarthritis can be classified as primary or secondary. Primary osteoarthritis has an unknown cause. Secondary osteoarthritis is caused by another disease, infection, injury, or deformity. As the cartilage in a joint wears down, the bone ends may thicken, forming bony growths or spurs that interfere with joint movement. In addition, bits of bone and cartilage may float in the joint space, and fluid-filled cysts may form in the bone.

Several risk factors are associated with osteoarthritis, including the following:

• Heredity: Slight joint defects, joint laxity, and genetic defects may contribute to osteoarthritis
• Obesity: Excessive weight can put undue stress on certain joints over time
• Injury or overuse: Significant injury to or overuse of a joint, such as the knee, can lead to osteoarthritis

Diagnosing Osteoarthritis

In addition to a complete medical history and physical examination, the most common way to diagnose osteoarthritis is by x-ray.

Treatments for Osteoarthritis

Your doctor will work with you to determine the best treatment plan based on your age, overall health, and medical history; the severity of your condition; and your tolerance for certain medications, procedures, or therapies.

The goals of treatment for osteoarthritis are to reduce joint pain and stiffness, and to improve joint movement. Treatment may include:

• Exercise: Aerobic exercise, stretching, and strengthening exercises may help reduce symptoms and pain
• Modalities: To help reduce pain
• Physical and occupational therapy: To help reduce joint pain, improve joint flexibility, and reduce joint strain. Splints and other assistive devices may also be used.  
• Weight maintenance: Nutritional counseling to prevent or reduce symptoms exacerbated by excessive weight
• Medication: Medications may include pain relievers (oral or topical) and anti-inflammatory medications
• Acupuncture
• Patient/family education
• Stress management and emotional support
• Joint immobilization and methods to protect the joint from further damage or degeneration
• Activity modification
• Use of assistive devices
• Injections that mimic normal joint fluid to lubricate the joints
• Injections to reduce inflammation and pain
• Orthobiologic injections to help stimulate a healing response
• Joint surgery to repair or replace a severely damaged joint

Rehabilitation After Joint Replacement

The goal of hip and knee replacement surgery is to improve the function of the joint. Full recovery after joint replacement usually takes about three to six months, depending on the type of surgery, the overall health of the patient, and the success of rehabilitation.

Rehabilitation programs after joint replacement may include the following:

• Exercises to improve mobility and physical fitness
• Walking retraining
• Pain management
• Nutritional counseling to improve weight control
• Use of assistive devices
• Patient and family education

Arthritis rehabilitation programs can be conducted on an inpatient or outpatient basis. Rehab is guided by a team of specialists, which may include the orthopedist/orthopedic surgeon, rheumatologist, physiatrist, primary care doctor, physical and occupational therapist, rehabilitation nurse, dietitian, and social worker.

Why Choose Columbia for Osteoarthritis Care

Our highly skilled physicians provide expert diagnosis and management of osteoarthritis symptoms. We focus on conservative management when possible, including exercise, lifestyle changes, medications, and selective use of injections when needed. In cases requiring surgery, we will refer you to a collaborating Columbia joint surgeon. Our physicians are particularly skilled with the use of musculoskeletal ultrasound as a diagnostic technique and as a guide for precise injections to achieve the maximum benefit.