Getting a grip on osteoarthritis

December 29, 2010 By Susan Levine, M.D., M.P.H.

Osteoarthritis—the most common form of arthritis—can creep up on you so quietly that you might not suspect you have it until opening a jar or taking a walk becomes a painful ordeal.

Osteoarthritis is a progressive disease that begins when cartilage, the soft connective tissue that cushions joints, starts to break down from simple use. Without proper cushioning, joint movement becomes painful, and bones compensate for cartilage loss by growing bony lumps or spurs, called osteophytes, along the sides. Joints most susceptible are the knees, hips, neck and spine, thumb and big toe.

Unlike other arthritic conditions, in its earliest stages osteoarthritis produces pain only with joint movement. A woman with osteoarthritis of the knee, for example, will experience discomfort only when she's walking. Bony lumps that develop on the end and middle joints of the finger, called Heberden's and Bouchard's nodes, respectively, are another telltale sign. Osteoarthritis even has a sound all its own. Without the cartilage buffer, crepitus, a distinctive grating noise, can be heard whenever an affected joint moves.
If your doctor suspects osteoarthritis he or she will likely order a blood test to distinguish osteoarthritis from similar disorders such as rheumatoid arthritis, bursitis or gout, and X-rays or an MRI (magnetic resonance imaging) of the actual joints.

Banishing the pain
Although there's no cure for osteoarthritis, the disease doesn't necessarily condemn you to a lifetime of pain. In fact, the condition is rarely crippling, and because symptoms come and go over the years, some patients manage with little or no treatment. Nonetheless, you can ease the discomfort with:

• Heating pads, hot-water bottles and soaking in a hot bath.
• Muscle-strengthening exercises to restore range of motion. Your doctor or physical therapist will prescribe a specific routine depending on the affected joints.
• Swimming and other water exercises that provide non-weight-bearing activity.
• Weight loss. It can't reverse osteoarthritis in joints already affected, but may delay deterioration in other joints.
• Perfect posture (shoulders back, stomach and buttocks tucked in and back straight) to relieve osteoarthritis of the spine.
• Surgery in severe cases.
• Aspirin and other anti-inflammatories; and steroid injections in severe cases.
Although osteoarthritis affects millions, there's no reason to accept it as a natural consequence of aging. Remember, cartilage doesn't ordinarily deteriorate as you get older, and staying slim and active can certainly help lower your risk of developing the disease.

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