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Am Fam Physician. 2004;69(5):1211-1212

What is arthritis?

Arthritis is the name for inflammation of the joints. Arthritis causes pain and usually limits movement of the joints that are affected. There are many kinds of arthritis. Osteoarthritis is the most common.

What causes osteoarthritis?

The exact cause is not known. You may be at increased risk of osteoarthritis if it runs in your family. Osteoarthritis seems to be related to the wear and tear we put on our joints over the years. But wear and tear alone do not cause osteoarthritis.

What happens when a joint is affected by osteoarthritis?

Normally, a smooth layer of cartilage acts as a pad between the bones of a joint. Cartilage helps the joint move easily and comfortably. In some people, the cartilage gets thinner as the joints are used. This is the start of osteoarthritis. Over time, the cartilage wears away, and the bones rub against each other.

Bones may even start to grow too thick on the ends where they meet to make a joint, and bits of cartilage and bone may come loose and get in the way of movement. This can cause pain, joint swelling, and stiffness.

Who gets osteoarthritis?

Osteoarthritis is more common in older people because they have been using their joints for a longer time. Using the joints to do the same task over and over, or simply using them over time can make osteoarthritis worse.

Some younger people also can get osteoarthritis. Athletes are at risk because they use their joints so much. People who have jobs that require the same movement over and over also are at risk. If you injure a joint, you have a greater risk of arthritis in that joint later on. Excess weight can cause arthritis in the knees, hips, and spine.

Is there a treatment?

There is no cure for osteoarthritis, but the right plan can help you stay active, protect your joints from damage, limit further injury, and control pain. Your doctor will help you create the right plan for you.

Tips on staying active

  • Lose weight if you are overweight.

  • Exercise regularly for short periods.

  • Use canes and other special devices to protect your joints if you have problems.

  • Avoid lifting heavy things.

  • Avoid overusing your joints.

  • Do not pull on objects to move them—push them instead.

  • Take your medicine the way your doctor tells you to.

  • Use heat or cold to reduce pain or stiffness.

Will my osteoarthritis get worse?

Osteoarthritis does tend to get worse over time. But you can do many things to help yourself.

It is important to stay as active as possible. When joints hurt, people tend not to use them, and the muscles get weak. This can cause stiff muscles and make it harder to get around. This causes even more pain. Ask your doctor to discuss pain control with you so that you can stay active and avoid this problem.

Will medicine help?

Medicines you can buy without a prescription can help you feel better. These are medicines that reduce inflammation—such as aspirin, ibuprofen (one brand name: Motrin), ketoprofen (brand name: Orudis), or naproxen (brand name: Aleve). You can also use pain-relievers like acetaminophen (one brand name: Tylenol). Talk to your doctor if you have to use these medicines more than occasionally. Your doctor might prescribe a pain medicine for you or decide if you might take one of the medicines used to treat certain kinds of arthritis (one brand name: Vioxx). These medicines can help by reducing inflammation, swelling, and pain in the joints, but not everyone can take them.

Medicine should be used wisely. You only need the amount that makes you feel just good enough to keep moving. Using too much medicine may increase the risk of dangerous side effects. Do not believe false “cures” that are advertised in magazines or newspapers.

Can special devices really help?

Yes. Special devices like canes and different ways of doing things can help people with arthritis stay independent for a lot longer. These devices help protect your joints and keep you moving. For example, if you learn to use a cane the right way, you can reduce the amount of pressure your weight puts on your hip joints when you walk by up to 60 percent. Your doctor can refer you to someone who can help you choose the right kind of cane.

Special devices for people with arthritis

  • Canes, walkers, and splints

  • Shoe inserts, wedges, or pads

  • Special fasteners (such as hook and loop tape) on clothing

  • Large grips for tools and utensils (wrap foam or fabric around items with narrow handles, like pens)

  • Wall-mounted jar openers

  • Electric appliances, such as can openers and knives

  • Moveable shower heads

  • Bath seats and grab bars for the bathtub

Will special exercises really help?

Yes. Exercise keeps your muscles strong and helps you stay flexible. Exercises that do not strain your joints are best. To avoid pain and injury, choose exercises that can be done a little at a time with rest time in between.

Try an “aquacise” program available through your local swimming pool or community center. These programs use special movements in the swimming pool, where much of your body's weight is held up by the water.

Should I use heat to ease pain?

Using heat may reduce your pain and stiffness. Heat can be applied with warm baths, hot towels, hot water bottles, or heating pads. Ice packs also can help, and you can try alternating heat treatment with ice packs.

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