Osteoarthritis

This is the breakdown of cartilage in the joints. This is followed by chronic inflammation of the joint lining. Healthy cartilage is a cushion between the bones in a joint. This condition usually affects the hands, feet, spine, hips, and knees. People with this condition usually have joint pain and limited movement of the affected joint.

• Increasing age
• Excess body weight
• Family history
• Certain endocrine, metabolic, or neuropathic disorders, avascular necrosis
• Having an injury or surgery to the joint surface, especially the cartilage
• Having an occupation or doing physical activities that put stress on joints

• Mild-to-severe pain in a joint, especially after overuse or long periods of inactivity, such as sitting for a long time
• Creaking or grating sound in the joint
• Swelling, stiffness, limited movement of the joint, especially in the morning
• Deformity of the joint

• X-ray to see internal bony structures
• CT scan to look at the extent of the arthritis
• Arthrocentesis to rule out other causes of arthritis
• Blood tests to rule out other causes of arthritis

• Strengthening, endurance, and flexibility exercises
• Manual therapy
• Electrical stimulation (ESTIM)
• Heat or cold packs

• Maintain a healthy weight.
• Do regular, gentle exercise, such as walking, stretching, swimming, or yoga.
• Avoid repetitive motions and risky activities that may contribute to joint injury, especially after age 40.
• With advancing age, certain activities may have to be stopped or modified. It is important to continue to be active, so find an activity that suits you.

• American College of Rheumatology

http://www.rheumatology.org

• The Arthritis Foundation

http://www.arthritis.org

• The Arthritis Society

http://www.arthritis.ca

• Seniors Canada

http://www.seniors.gc.ca

• American College of Rheumatology Subcommittee on Osteoarthritis. Recommendations for the medical management of osteoarthritis of the hip and knee. 2000 update. Arthritis Rheum. 2000;43:1905-1915.
• Jordan K, Arden N, et al. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. 2003;62:1145-1155.
• Osteoarthritis. Arthritis Foundation website. Available at: http://www.arthrit... . Accessed September 3, 2013.
• Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Disorders website. Available at: http://www.niams.nih.gov/Health_Info/Osteoarthritis/default.asp . Updated July 2010. Accessed September 3, 2013.
• Sinusas, K. Osteoarthritis: Diagnosis and treatment. Am Fam Physician. 2012;85(1):49-56.
• van den Berg WB. Pathophysiology of osteoarthritis. Joint Bone Spine. 2000;67:555-556.
• 10/21/2008 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2008;CD004376.
• 12/11/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Rutjes WJ, Nuesch E, Sterchi R, et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst Rev. 2009;(4):CD002823.
• 10/15/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Wandel S, Jüni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010;341:c4675.
• 10/26/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
• 11/15/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: US Food and Drug Administration. FDA clears Cymbalta to treat chronic musculoskeletal pain. US Food and Drug Administration website. Available at: http://www.fda.gov... . Updated April 19, 2013. Accessed July 23, 2013.
• 11/29/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: French HP, Brennan A, White B, Cusack T. Manual therapy for osteoarthritis of the hip or knee: a systematic review. Man Ther. 2011;16(2):109-117.
• 7/15/2013 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Dilek B, Gözüm M, Sahin E, et al. Efficacy of paraffin bath therapy in hand osteoarthritis: a single-blinded randomized controlled trial. Arch Phys Med Rehabil. 2013 Apr;94(4):642-9.