Osteoarthritis is the most common form of degenerative joint disease, and is a leading cause of disability in people over 50 years of age. It is can be a very debilitating form of arthritis in that it tends to affect the load-bearing joints, especially the hips and knees, that are crucial for normal movement.

Osteoarthritis occurs when the cartilage cushioning the joints breaks down and causes the bones to rub together, inducing a change in shape. Osteoarthritis is found most frequently in people over age 50, although it can occur at any age. It most commonly affects joints in the knees, hips, shoulders, elbows, ankles, and hands. There are currently close to 10 million Americans living with osteoarthritis.

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Hips and knees are at higher risk for developing osteoarthritis because they bear a large portion of the body’s weight and are subject to everyday wear and tear.

Symptoms often begin with joint stiffness and discomfort and can be alleviated with periods of rest. Without treatment, the tissue surrounding the joint can become increasingly inflamed, and eventually lose some or almost all range of motion.

Although the changes in the joint are irreversible, for most people symptoms can be successfully managed and rarely progress to the point of requiring surgery to replace the joint. In fact, while severe osteoarthritis may predispose to having pain, it is possible to have "bone-on-bone osteoarthritis" and not experience any pain at all.

Physicians diagnose osteoarthritis using a combination of medical history, evaluation of symptoms, and various imaging scans that can help assess the progression of the disease. They may also do a series of physical evaluations to examine the alignment of the hips or knees and to determine the extent of joint immobility.

Treatment for osteoarthritis is usually nonoperative, and includes one or a combination of:

  • Rest
  • Anti-inflammatory and non-prescription pain medications
  • Physical therapy for specific exercises.

For overweight patients, doctors will usually recommend a weight-loss program to help alleviate pressure on the damaged joints. If symptoms persist then there are various injection alternatives that often provide significant relief. Injection treatment may include steroids to address the inflammation and/or hyaluronic acid injections to help lubricate the joint.

Injections are generally not done in isolation but rather as part of a comprehensive treatment strategy that incorporates exercises to stretch and strengthen specific muscles to help unload the affected joint or joints. In some instances, if patients have tried injections and physical therapy but continue to have significant pain that limits their quality of life, then surgery may be considered.

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Written by Grant Cooper, MD
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