Osteoarthritis

Osteoarthritis (OA), also called “Degenerative Joint Disease” (DJD), is basically arthritis due to aging.ย  The cartilage that lines our joints, preventing bone from rubbing against bone, wears away over the years.ย  Without cartilage, bones get closer, making it harder to move joints.ย  If bone rubs on bone, pain can be very bad.ย 

OA usually begins in the 50’s, gets worse in the 70s.  Some people get it sooner, some later, some never.  Most people get some arthritis with age, but not enough to be truly disabling.  Some, however, experience constant pain.

The main joints affected are the hips, knees, fingers, and spine.ย  Women are at more risk than men.ย  Other risks include obesity, previous trauma, lack of exercise, and high-impact sports performed by serious athletes (not recreational exercise).ย  Anyone with another type of joint disease (e.g. Rheumatoid Arthritis) is also at risk.

OA develops gradually.  However, occasionally inflammation occurs and the joints get red, hot and swollen.  In such cases, clinicians are led to suspect another joint disease.  But all blood tests come out normal, and x-rays only show OA.

We diagnose osteoarthritis of the spine by x-ray, and by ruling out other causes of back pain.ย  In the elderly, the main conditions not to miss are bone diseases, especially bone cancer.ย  That can often be seen on x-ray.ย  However, if a patient has pain & tenderness to tapping on just one bone, & the x-ray is normal, we may want to do other tests like a bone scan or MRI.

Treatment involves pain control; medicines (over-the-counter and/or prescription), injections, and physical therapy can help.  But the only way to cure OA is joint-replacement surgery (knee or hip, also shoulders).  However, there are risks as with any type of operation, & these are the only joints it works well for.  Patients have to decide when their pain has simply become too much.

People with other joint diseases, like Rheumatoid Arthritis, get osteoarthritis a lot earlier than other people.ย  I’ve seen 25-year-olds with severe disease who needed surgery.ย  But that’s uncommon.

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