Osteoarthritis is a painful condition in which gradual wear and tear leads to inflammation and degeneration of your joints, such as the knees, hip, and shoulder—hence its nickname, wear and tear arthritis. Specifically, the cartilage within a joint begins to break down and the underlying bone begins to change. This can occur due to aging, but also use. Osteoarthritis can cause considerable pain and disability, but many treatments are available.
7 Risk Factors for Developing Osteoarthritis
Wear and Repair
Cartilage undergoes a normal cycle of breakdown and repair. As the joint surface wears away, your body attempts to replace it using an inflammatory response.
The fundamental problem of osteoarthritis is thought to be the imbalance between natural degradation and the fresh cartilage production. As the joint swells, new boneis created to increase the surface area of the joint. Osteoarthritis results from the body's inability to compensate for the lost cartilage.
This is partly normal wear and tear and partly disease process. Since the cartilage is not replaced effectively, the joint lining wears thin.
A Deeper Loss
While osteoarthritis was once thought to be confined to the cartilage surface, it is now known that it goes deeper, affecting the entire joint. All of the cartilage can be lost and you can develop damage to the bone, resulting in the formation of bone spurs, and inflammation of the soft tissues.
Is It Inevitable?
Osteoarthritis tends to affect older people, but researchers don't yet fully understand why some people develop arthritic changes in their 40s and 50s while others live long lives with few joint problems.
People once thought that osteoarthritis was simply due to the demands they placed on their joints throughout life, attributing their joint deterioration to the activities of their youth. Research has taught us, though, that it's not that simple. Many avid runners and competitive athletes have no problems with arthritic joints, while others have severe arthritis.
Healthcare providers now understand that osteoarthritis is not an inevitable part of aging. It seems as though a combination of different factors leads to the development of osteoarthritis in individuals.
In different people, different factors may play a vital role but it is unusual to have just one underlying problem that causes osteoarthritis.
What Causes Osteoarthritis?
Treatments for osteoarthritis are directed at controlling the inflammatory response and maximizing your body's ability to compensate for joint wear and tear.
Medications serve the dual purpose of helping to reduce inflammation and pain. Your healthcare provider may consider:
- Anti-inflammatory medications: Non-steroidal anti-inflammatory medications, also called NSAIDs, are oral medications that help control the cycle of inflammation and reduce pain. Common NSAIDs (both over-the-counter and prescription) include Motrin/Advil (ibuprofen), Naprosyn/Aleve (naproxen sodium), and Celebrex (celecoxib).
- Cortisone injections: Cortisone is a natural anti-inflammatory molecule produced by your adrenal glands. Injecting a synthetic form of the hormone into an affected joint delivers a very high dose of anti-inflammatory medication right where it's needed. While not a pain killer itself, cortisone can reduce discomfort by way of reducing inflammation.
Physical therapystrengthens the muscles around the joint, relieving some of the burden on the cartilage and bone.
Synvisc (hylan G-F 20), also called hyaluronic acid, may also be considered. It contains substances that are secreted by cartilage cells and help give your joint fluid a slippery quality.
By injecting this substance into the knee, some people believe you are replacing thisvital component of joint fluid.
Synvisc is conditionally approved for osteoarthritis by the U.S. Food and Drug Administration (FDA), but it's considered a treatment or therapy as opposed to a drug.
Long-term studies have yet to show any clearbenefit of Synvisc; however, many patients believe that it is effective. Studies have shown that patients who are treated with Synvisc are more likely to go longer before needing a knee replacement.
Choices you make every day can also have a big impact in managing osteoarthritis:
- Weight loss: Weight lossdecreases the burden the joint must carry, especially when it comes to the hips, knees, and feet.
- Activity modification: Limiting certain activities that increase your pain and inflammation may be necessary. You may be able to substitute other activities, though. For example, aquatic exercise is gentler on the joints than, say, jogging or a typical weight circuit at the gym.
- Diet: Specific dietsand dietary supplements have been studied, but little has been proven. In small studies, antioxidants have been shown to decrease theprogression of osteoarthritis, but this has not been proven in larger studies, and they have not been shown to change the overall incidence of osteoarthritis.Vitamin Dhas also been shown to decrease the progression of osteoarthritis. These data suggest that although diet may play an important role in preventing the progression of the disease, other factors may be more vital.
Replacement, Resurfacing, and Regeneration
Cartilage can be replaced, resurfaced, and regenerated via various techniques, and those procedures help some people delay or avoid total joint replacement surgeries. Much of this work is in its early stages, though, so healthcare providers are continuing to look for better methods.
Glucosamine and Chondroitin
The supplements glucosamine and chondroitin became popular for joint pain years ago. The two substances are "building blocks" of cartilage, so it made logical sense. Early studies appeared to yield promising results.
However, as researchers looked into them further, mixed results and large amounts of poor-quality evidence led glucosamine and chondroitin to fall out of favor with many in the medical community. The two just don't appear to do much in the way of alleviating osteoarthritis symptoms or joint pain in general.
Some researchers have called for higher-dose studies of glucosamine, saying that's what's needed to prove its benefits. Others say a form of glucosamine called prescription patented crystalline glucosamine sulfate is superior to other forms.
An important consideration with any treatment is whether the potential benefits outweigh the risks. With studies showing little or no benefit and possible risks, such as negative interactions with medications such as the blood-thinner Coumadin (warfarin), the medical community has largely stopped recommending these supplements.
Effective Treatments for Osteoarthritis
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National Institutes of Health: National Center for Complementary and Integrative Health. Glucosamine and chondroitin for osteoarthritis.
Osteoarthritis (OA) is the most common form of arthritis. Some people call it degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, and knees. With OA, the cartilage within a joint begins to break down and the underlying bone begins to change.What causes wear and tear of cartilage? ›
Inflammation, breakdown, and eventual loss of cartilage in the joints is known as osteoarthritis. Lack of movement – the joints need to move regularly to remain healthy. Long periods of inactivity or immobility increase the risk of damage to the cartilage.What does osteoarthritis do to cartilage? ›
Osteoarthritis causes the cartilage in a joint to become stiff and lose its elasticity, making it more susceptible to damage. Over time, the cartilage may wear away in some areas, greatly decreasing its ability to act as a shock absorber. As the cartilage deteriorates, tendons and ligaments stretch, causing pain.Can wear and tear arthritis be cured? ›
Osteoarthritis is a long-term condition and cannot be cured, but it doesn't necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are also available to reduce the symptoms. Mild symptoms can sometimes be managed with simple measures including: regular exercise.Does osteoarthritis destroy cartilage? ›
Osteoarthritis is a very common degenerative condition that can get worse over time. The degeneration that occurs with this condition wears down the cartilage that cushions your joints. This condition can damage cartilage in any joint in your body, but is most often found in your knees, hips, and hands.
'Wear and tear' is a term often used to excuse the source of various joint aches and pains that we all suffer with from time to time. This description is often used instead of the more precise explanation of osteoarthritis.What is the best treatment for osteoarthritis? ›
Pills. NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling.What causes wear and tear? ›
Causes of wear and tear
The main causes of wear are first mechanical constraints like abrasion or erosion, and second chemical reactions weakening the material like corrosion.
Whatever the cause, relapsing polychondritis is thought to be an autoimmune disease – a disease where the immune system attacks healthy tissue. In this case the immune system targets the cartilage.What causes cartilage damage? ›
The main causes of cartilage damage are wear and tear (simply put, just getting older), repetitive actions (particularly twisting, jumping and deep knee bends) or a traumatic injury (such as forceful wrenching or a direct impact).
What causes osteoarthritis? The use of a joint leads to wear and eventual degeneration of the cartilage that cover the bones where they meet in the joint. This loss of protective cartilage causes the joint inflammation known as osteoarthritis, as bone starts to rub directly against bone.