Osteoarthritis
This is the joint disease of sports stars, such as football
great Joe Montana -- and of just about anyone who is over 65. Starting at about age
45, many people begin to show signs of cartilage damage in their joints. Eventually,
most of us will have some sort of osteoarthritis. It is also called degenerative
joint disease or degenerative arthritis.
The severity of this condition varies greatly. It may cause you no more than some mild
aches, or it can be disabling. Those who have stressed their joints playing sports or
on the job may develop osteoarthritis earlier, or in a more severe form.
What happens in your joints
The ends of the bones in the joints are covered by a firm, rubbery
material called cartilage that acts as a cushion and provides a smooth gliding surface
for joint motion. Synovial fluid, made up mostly of a substance called hyaluronic acid,
lines the joints, acting as a shock absorber and lubricant.
As we age, cartilage begins to lose its flexibility and becomes more vulnerable to
damage from overuse or injuries. How fast this happens varies; some families may pass
along genes that cause cartilage to break down earlier. Repeated injuries, such as
those from playing very active sports or doing heavy labor, such as construction work,
can also cause cartilage breakdown.
As the cartilage cushion is worn away, the joint is put under increased stress. This
causes further cartilage destruction. Bones begin to thicken or change shape and joint
spaces narrow, causing inflammation and pain. In severe cases, all of the cushioning
cartilage may be destroyed. Bone comes in direct contact with other bone, causing pain
and limiting movement in the joint.
Symptoms you may notice
Pain is the major symptom of osteoarthritis and cartilage loss.
Some people also experience swelling and inflammation. Others may feel no pain, even
though X-rays show joint damage. Doctors find that the amount of joint damage isn't
always connected to the amount of pain a person feels.
Osteoarthritis usually affects the joints of the knees, hips, hands, neck, and lower
back. You may also get osteoarthritis in the joint of your big toe (bunion), or bony
spurs on your fingers, called Heberden's nodes at the end joints, and Bouchard's nodes
at the middle joints of the fingers.
Osteoarthritis generally
Begins after age 40, and develops gradually over many years
Affects only a few joints initially
Is painful only in the affected joints, and is relieved when you rest
Is mild when you awake, increasing throughout the day as you use your joints
Symptoms and signs are
Pain in the affected joints
Stiffness and a decreased range of motion
Gradual enlargement of the joints
Crackling or grating sounds when you move your joints
Swelling and inflammation in the joints (in some people)
How osteoarthritis is diagnosed
Your family doctor can usually pinpoint this condition by taking a
medical history, examining your joints, and listening to you describe your symptoms.
Laboratory tests may rule out other diseases that call for aggressive treatment, such
as infectious arthritis or rheumatoid arthritis.
X-rays and other imaging tests can confirm joint damage including:
Narrowing of the joint-space
Scarring of bone surfaces within joints
Bone spurs
Cysts near the joint surfaces
Risk factors
The joint deterioration in osteoarthritis is part of the normal
wear-and-tear of aging. But some conditions can increase your risk of getting it
earlier or making it worse.
Being overweight, which puts stress on joints
Repeated injuries or stress to the joint from playing sports or working at your job
Repeated stress from poor habits of moving or using your joints (body mechanics)
Heredity -- a cartilage abnormality or defect in your bone structure could be inherited
Double-jointedness (or very flexible joints)
Weakened muscles that don't support the joints
Infections or diseases of the synovium (joint lining)
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