Osteoarthritis: Pain, Treatment and Causes

By Med-Fit Content Team  .  Last Updated Tuesday, 1st August 2023

What is Osteoarthritis?

Osteoarthritis, also known as degenerative joint disease (DJD), is a widespread condition that can affect any joint in the body. Among the joints, those bearing the most weight, such as the knees and feet, are especially vulnerable, as well as the ones frequently engaged in daily activities, like those in the hands.

In a healthy joint, a smooth and tough tissue coating called cartilage covers the bones, allowing seamless movement between them. However, in osteoarthritis, this cartilage gradually thins and becomes rougher, leading to reduced joint flexibility and smoothness of motion.

When cartilage experiences wear and tear, the body initiates repair processes to mend the damage. In many cases, these repairs successfully restore normal joint function without causing pain or stiffness. As we age, nearly everyone will experience some degree of osteoarthritis in their joints, even though they may not be aware of it.

Nevertheless, there are instances when the repair processes are not entirely effective, resulting in changes to the joint structure that can trigger symptoms like pain, swelling, and limited mobility. For instance, bony growths known as osteophytes may form at the joint's edges, restricting movement or causing friction with surrounding tissues. Additionally, the lining of the joint capsule may thicken and produce excess fluid, leading to joint swelling. Over time, the supporting tissues surrounding the joint may also stretch, causing reduced joint stability.

Osteoarthritis stands as the most prevalent form of arthritis, with its likelihood increasing as we age. The changes associated with osteoarthritis typically develop slowly over many years, although there can be occasional exceptions. Inflammation and joint injuries contribute to bony changes, degradation of tendons and ligaments, and breakdown of cartilage, culminating in joint pain, swelling, and deformities.

There are two primary types of osteoarthritis:

  • Primary osteoarthritis, which is the most common type, affects multiple joints and is particularly prominent in the fingers, thumbs, spine, hips, knees, and big toes.

  • Secondary osteoarthritis occurs in conjunction with pre-existing joint abnormalities resulting from injuries, repetitive or sports-related activities, inflammatory arthritis like rheumatoid arthritis or psoriatic arthritis, infectious arthritis, genetic joint disorders like Ehlers-Danlos syndrome, or other conditions.

What Causes Osteoarthritis

Osteoarthritis, a diverse and complex disease, is not solely attributed to "wear and tear" but has multiple contributing factors, some modifiable and others non-modifiable. Age plays a role, yet not all older adults experience osteoarthritis, and not all who do, suffer associated pain. 

Inflammatory and metabolic risks, especially in the context of diabetes and elevated cholesterol, can elevate the incidence of osteoarthritis.
The genetic component is evident in primary osteoarthritis like nodular OA of the hands and secondary cases associated with genetic disorders like hypermobility of joints. 

Chronic inflammation and joint destruction in conditions like inflammatory and infectious arthritis can lead to secondary osteoarthritis. Additionally, previous injuries, including sports-related and repetitive motions, can contribute to its development.

While the precise mechanisms behind cartilage loss and bone changes remain unknown, recent advancements shed some light. Suspected culprits include complex signaling processes during joint inflammation and defective repair mechanisms in response to injury, gradually eroding cartilage within the joints and impairing joint mobility and function, ultimately leading to pain with activity.

As we age, the natural aging of tissues surrounding the joints can evolve into osteoarthritis. This condition involves the loss of protective cartilage in the joint, accompanied by the development of bony growths and slight inflammation, resulting in the hallmark symptoms of pain, stiffness, and swelling.

The exact causes of osteoarthritis are not fully understood, but certain factors increase the risk of its development, including joint injuries, other conditions like:
  • rheumatoid arthritis
  • gout
  • family history
  • age (typically affecting adults aged 45 or older)
  • obesity

What is the best treatment for Osteoarthritis

Currently, there is no cure for osteoarthritis, but effective management of mild to moderate symptoms involves a combination of pharmacologic and nonpharmacologic treatments. Medical interventions and recommendations include:

  • Medications: This includes topical pain medicines and oral analgesics, such as nonsteroidal anti-inflammatory medications (NSAIDs), which can help alleviate pain and inflammation.
  • Hot and Cold Packs: Using intermittent hot and cold packs locally can provide relief and reduce inflammation.
  • Knee Ice Packs: Cold Therapy on your Knees constricts blood vessals which is likely to help reduce stiffness and inflammation, however customers usually build a hot and cold therapy to soothe joints, whilst ensuring their mobility is not hindered. The Ice Pack for Knees certainly helps with the cold therapy. 
  • Physical Therapy: These therapies can aid in strengthening muscles, improving joint flexibility, and enhancing overall function.
  • Weight Loss: For overweight individuals, shedding excess pounds can significantly reduce the stress on weight-bearing joints.
  • Healthy Eating and Managing Diabetes: Adopting a healthy diet and effectively managing diabetes and cholesterol levels can positively impact osteoarthritis management.
  • TENS Machines: Transcutaneous electrical nerve stimulation (TENS) machines can be beneficial for pain relief in individuals with arthritis.
  • Intra-articular Injection Therapies: Injections of steroids or hyaluronic acid "gel" into the affected joints may be employed to alleviate pain and improve joint function.
  • Complementary and Alternative Medicine: Some patients find relief through the use of vitamins, supplements, and other alternative strategies.

Surgery may be considered when other treatments prove ineffective or in advanced cases of osteoarthritis. The goals of treatment are to decrease joint pain and stiffness, delay further progression of the condition, improve mobility and function, and enhance the overall quality of life.

What are the symptoms of Osteoarthritis?

Osteoarthritis is a gradual and progressive condition that presents various noticeable signs:
  • Pain: Joints affected by osteoarthritis may ache during or after movement, and discomfort can persist even at rest.
  • Stiffness: Morning stiffness in the joints or after periods of inactivity is a common feature.
  • Tenderness: Gentle pressure applied to or near the affected joint may result in tenderness.
  • Reduced Flexibility: Difficulty in moving the joint through its full range of motion can be experienced.
  • Grating Sensation: Joint movements might produce a grating sensation, accompanied by popping or crackling sounds.
  • Bone Spurs: Hard lumps of extra bone, known as bone spurs, may form around the affected joint.
  • Swelling: Soft tissues around the joint may become inflamed, leading to swelling.

Osteoarthritis typically begins slowly, often affecting one or a few joints initially. Symptoms commonly include joint pain, which may improve with rest but worsen at night in later stages. Morning joint stiffness, lasting less than 30 minutes, is another characteristic sign. As the condition progresses, joint changes can restrict mobility, and swelling may occur after significant activity.

The symptoms of osteoarthritis can vary depending on the joints involved:
  • Hands: Finger joints may develop bony enlargements and shape changes over time.
  • Knees: During movement, grinding or scraping noises might be heard, and weakness in muscles and ligaments can lead to knee instability.
  • Hips: Pain and stiffness may be felt in the hip joint, groin, inner thigh, or buttocks. Over time, hip movement may become limited.
  • Spine: Stiffness and pain in the neck or lower back can occur, and some individuals may develop spinal stenosis.

As osteoarthritis symptoms advance, everyday activities become increasingly challenging, impacting tasks like stepping up, using the toilet or a chair, gripping objects, or walking longer distances.

The pain and other symptoms associated with osteoarthritis can also lead to fatigue, sleep disturbances, and feelings of depression. Effective management and treatment are crucial to address these challenges and improve the overall quality of life for individuals with osteoarthritis.

What’s the difference between Osteoarthritis and Rheumatoid Arthritis

Arthritis encompasses various types, with osteoarthritis and rheumatoid arthritis being the most common. Though their symptoms may appear similar, distinguishing between them is crucial to determine the appropriate treatment.

Osteoarthritis arises when the smooth cartilage joint surface wears out, typically affecting an isolated joint and typically occurring later in life. On the other hand, rheumatoid arthritis is an autoimmune disease, wherein the immune system mistakenly attacks the body's own synovial membrane that protects the joints. 

Rheumatoid arthritis often targets multiple joints simultaneously, and its symptoms include:
  • Symmetrical nature of the disease, with arthritis affecting both sides of the body (e.g., both hips).
  • Fever, anemia, fatigue, and loss of appetite.
Comparing the characteristics of rheumatoid arthritis and osteoarthritis:

Speed of onset:
  • Rheumatoid arthritis: Relatively rapid onset, occurring over weeks to months.
  • Osteoarthritis: Slow progression, developing over years.

Joint symptoms:
  • Rheumatoid arthritis: Painful, swollen, and stiff joints.
  • Osteoarthritis: Joints ache, may be tender, but generally have little or no swelling.

Pattern of affected joints:
  • Rheumatoid arthritis: Often affects both small and large joints on both sides of the body (symmetrical involvement), like both hands, wrists, elbows, or balls of feet.
  • Osteoarthritis: Typically starts on one side and may spread to the other. Often limited to specific joints, such as finger joints close to fingernails, thumbs, large weight-bearing joints (hips, knees), or the spine.

Duration of morning stiffness:
  • Rheumatoid arthritis: Morning stiffness usually lasts longer than 1 hour.
  • Osteoarthritis: Morning stiffness usually lasts less than 1 hour, with stiffness recurring at day's end or after activity.

Presence of systemic symptoms affecting the whole body:
  • Rheumatoid arthritis: Frequent fatigue and a general feeling of being ill.
  • Osteoarthritis: Systemic symptoms are absent.

Distinguishing between these two types of arthritis is essential for proper diagnosis and management to ensure effective treatment and improved quality of life for individuals with arthritis.

Osteoarthritis of the Knee 

As mentioned earlier, OA is the most common form of arthritis and occurs even in younger people however, the chance of OA developing rises quite considerably after the ages of 50.

Some symptoms of Osteoarthritis of the knee include:

  • Feeling the warmth in and around the joint
  • Swelling around the joint
  • Pain that increases more when you’re active
  • Decreased mobility of the knee – could become quite difficult getting in and out cars

Osteoarthritis of the Hands

Osteoarthritis can usually affect three parts of the hand, such as:

  • The middle joint of the finger
  • The joint closest to the fingertip
  • The base of the thumb

Around half of all women and a ¼ of all men will experience some form of stiffness and pain in their hands, that’s most likely OA and likely to be experienced more so by 85 years old. The protective part of the cartilage on the ends of your bones begin to break down and eventually wear away – this means over time the bones begin rubbing together and causing quite a bit of pain.

Osteoarthritis of the Feet 

There are many points in your foot and ankles that can be affected by osteoarthritis – as there are 33 joints in the foot alone, the big toe is the part of the foot that is commonly affected by OA. The body is known to go through processes of repairing joints, changing their shape or general structure naturally, however when this happens in one or more of your joints, this is normally related to Osteoarthritis.

If left untreated, Osteoarthritis can at times cause further problems in your feet. These types of other problems include:

  • Bunions – Osteoarthritis and Hallux Rigidus can cause your big toe to lean towards the other toes, this is normally known as a bunion or a hallux valgus. When you have a bunion, a bony lump begins to form on your big toe and this may also come with red swollen skin over it – this results in hard skin being formed around the affected area.
  • Corns and Calluses – These usually appear on your feet when certain areas are exposed to pressure or potentially when skin repeatedly rubs against something. Corns are hard small lumps on the skin and calluses are patches of thicker skin that feel very rough; however these two conditions can be caused by other possible problems with your feet.
  • Hallux Rigidus – This condition usually occurs when Osteoarthritis is left untreated with cartilage wearing away, and this can usually result in bones in your feet joining together. Hallux Rigidus is usually when this type of situation happens in the big toe – which makes your big toe far more difficult to move and you may have trouble walking.