There’s a reason osteoarthritis (OA) is sometimes called “wear and tear” arthritis. The risk of OA increases with age. In fact, the older you are, the greater your likelihood of having the disease. By age 65, about 80 percent of all Americans will be affected by OA to some extent, although some may not realize they have it.

“Osteoarthritis is a degenerative condition that occurs when the cartilage between joints wears down,” explains Betsy Olson, PA-C, a physician assistant with Park Nicollet Clinic Rheumatology. Although it can affect any joints in the body, OA often strikes weight-bearing joints, such as the hips, knees and spine.

In healthy joints, cartilage is smooth and flexible, which enables it to act as a shock absorber. As we age, the protein in the cartilage degenerates. Worn cartilage can lead to uneven weight distribution, causing “aches and pains.” If the cartilage wears down completely, bone-on-bone friction can result. This can stimulate the production of more bone tissue, resulting in enlarged joints and knobby knuckles.

What causes osteoarthritis?
Age, injury, overuse, excess weight and heredity are some common risk factors for OA. “Genetics often is the most significant risk factor of all,” Olson says. “Some people are lucky and will have good joints into their 80s; others can experience osteoarthritis by the time they’re 35.”

Although pain is a symptom of OA, it is not always the most reliable. “We see people who have little pain, but an X-ray indicates they have severe osteoarthritis. Others may have significant pain, but barely noticeable X-ray evidence,” Olson explains. If doctors are unsure of the diagnosis, they may perform additional tests to rule out other rheumatic conditions, such as rheumatoid arthritis, lupus and gout.

Treatment options for every patient
Regardless of the cause or severity, doctors offer a variety of treatment options for osteoarthritis. For mild cases, they may recommend:

• getting more exercise (walking, swimming, light weight training), to help tone and strengthen the muscles and tendons around the joints
• losing weight to ease the strain on some weight-bearing joints, for those who are overweight
• over-the-counter pain medications, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, which treat pain and help decrease joint inflammation
• anti-inflammatory creams, which are rubbed directly on the joint to help reduce inflammation
• ice, which can help alleviate inflammation and pain
• nutritional supplements, such as glucosamine and chondroitin, may be helpful for some
• braces, which can help strengthen and stabilize joints, especially when custom fitted by an occupational or physical therapist

For moderate to severe cases, doctors may prescribe:

• cortisone injections (an anti-inflammatory steroid hormone)
• viscosupplement injections to lubricate the knees
• tramadol, another type of NSAID (recommended when traditional anti-inflammatories or acetaminophen don’t work)
• arthroscopic surgery to smooth rough cartilage, remove cartilage fragments and repair other joint problems
• partial joint surgery, such as removing the head of a bone to prevent friction
• total joint replacement surgery (generally for a knee, hip, shoulder, elbow or small hand joint)

“Our overall goal is to help patients maintain their quality of life by helping them manage their pain and remain mobile and independent,” Olson adds. “In some cases, we encourage people to prevent this condition by maintaining a healthy weight and getting regular, low-impact exercise.”

To find a doctor who can help with OA or other rheumatic conditions, call 952-993-5500, or visit parknicollet.com/rheumatology.