The most common cause of joint pain is osteoarthritis (OA), a chronic (long term) disease characterized by a loss of cartilage and bony spur (osteophyte) formation in joint spaces. Normally cartilage cushions the joints preventing adjacent bones from contacting each other. The cartilage can’t be repaired. Bony spur formations rub together causing pain and inflammation.
The specific cause of OA is unknown; however it is not just a disease of aging, but rather the result of a combination of factors including genetics and joint degeneration. Symptoms of OA typically include joint pain with movement, limited range of motion, joint swelling or joint stiffness after periods of inactivity. This pain usually occurs within minutes, and can last hours. As OA progresses, pain can occur during rest or sleep.
Joints most affected by OA include the knee, hip, and joints in the hand closest to the fingertips, the thumb, and the spine in both the neck and lower back regions. Besides aging other risk factors include obesity, muscle weakness, joint overuse or repetitive use, joint trauma, and joint instability. OA is also more prominent in females than males.
Diagnosis of OA is primarily confirmed by x-ray showing narrowing of the joint spaces, cartilage loss and spur formation. A doctor will also perform a comprehensive physical exam, paying close attention to joint tenderness, limited range of motion, joint deformity and enlargement, swelling and crackling sounds heard in joints. A doctor may order additional laboratory tests to rule out other potential causes of arthritis.
The goal for treating OA is to control pain and minimize. Treatment options depend on the progression of the disease and the severity of pain, and may include lifestyle changes, medications or surgery.
At early stages of OA, pain can be alleviated with conservative treatment; primarily rest and over-the-counter analgesics such as acetaminophen and non-steroidal anti-inflammatory drugs such as ibuprofen. For severe cases of pain and inflammation, more selective anti-inflammatory and opioid medications can be prescribed.
For certain joints, steroid and hyaluronic acid injections may help for the temporary control of pain. If OA progresses to the point where surgical intervention is necessary, joint replacement, arthroscopy, or an osteotomy, in which bone is removed from the joint, may be beneficial. Surgery always involves certain risks. If diagnosed with OA, a pain management specialist can help navigate the proper course of treatment.
The best way to treat OA is to prevent progression of the disease through lifestyle changes with regular exercise, a proper diet and weight management.
- Osteoarthritis – PainDoctor.com
- Brasington, R.; et al. (2010). Osteoarthritis. First Consult. MD Consult Web site, Core Collection. Retrieved from mdconsult.com.ezproxy1.library.arizona.edu/das/pdxmd/.
- Kalunian, K.C. (2010). Surgical therapy of osteoarthritis. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA.
- Kalunian, K.C. (2011). Risk factors for and possible causes of osteoarthritis. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA.
- Kalunian, K.C. (2007). Diagnosis and classification of osteoarthritis. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA.
- Kalunian, K.C. (2011). Pharmacologic therapy of osteoarthritis. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA.