What Is Osteoarthritis?

Osteoarthritis is the most common type of arthritis and affects people of all ages. It occurs when the cartilage cushioning the ends of bones wears down over time. The cartilage can become damaged by wear and tear, aging, injury or other factors.

The bones rub against each other instead of riding smoothly on top of the cartilage. Eventually, a person with osteoarthritis may develop bone spurs (osteophytes) or have joint space narrowing (i.e., narrowing of the joint space). Osteoarthritis can affect any joint in the body but is more common in weight-bearing joints such as those in your knees, hips and back.

As the cartilage wears down over time, bones begin to rub together with less cushioning between them. This creates pain and stiffness, making it difficult to move your joints.

Osteoarthritis can’t be cured, but symptoms can be managed with medications, physical therapy and changes to your daily routine.

How Does It Feel?

If you have OA, you may feel pain or stiffness in your knees that gets worse with activity and improves with rest. For some people, the pain can be severe enough to keep them from doing many of the things they would like to do.

The most common symptoms of OA are:

Pain, which often occurs in the joint where the cartilage has worn away. The pain is usually worse when you bend, straighten or twist your knee or other joint.

Stiffness in your joints that increases with time, activity and cold weather.

Swelling around your joints. This is common in people with severe arthritis of their hands or feet who wear splints for support all day every day; it’s less common in those with arthritis of their knees or hips.

How Is It Diagnosed?

OA can be difficult to diagnose because its symptoms can be similar to those of other conditions.

Rheumatologists (doctors who specialize in joint disease) and other doctors who specialize in diagnosing and treating OA may use one or more of the following tests to help confirm a diagnosis:

Physical exam. Your doctor will examine your joints and look for signs of pain and swelling. He or she also might perform an X-ray or MRI scan.

X-rays. X-ray images reveal whether you have osteoarthritis, but they’re not always considered reliable for diagnosing the condition. Some people with OA don’t develop changes on their X-rays until later in life, while others with severe OA may not show any signs on their X-rays at all.

MRI scans (magnetic resonance imaging). These scans produce detailed pictures of your bones and soft tissues inside your body that help doctors evaluate cartilage damage, inflammation, and other aspects of OA.

Blood tests. Blood tests can identify antibodies that indicate inflammatory conditions such as rheumatoid arthritis (RA), which is an autoimmune disorder that causes chronic inflammation of the joints.

How Can a Physical Therapist Help?

Physical therapists are highly trained in the treatment of arthritis and other joint conditions. They use hands-on therapies, such as heat and cold, to reduce inflammation and pain. They also teach patients exercises they can do at home to help manage their condition and keep it from getting worse.

Physical therapists can also help you make changes in your lifestyle that will ease the pain of OA. If you have trouble walking or climbing stairs, for example, a therapist may recommend that you use a cane or walker when you’re out of bed or away from home.

You may need to work with a physical therapist before going under anesthesia for surgery on a joint affected by OA — especially if the surgeon plans to replace or repair the joint with artificial parts (such as metal or plastic). A therapist can help prevent injury or complications during surgery by teaching you how to use any new joints after surgery.

Can This Injury or Condition Be Prevented?

In most cases, osteoarthritis is not preventable. However, there are some things you can do to reduce your risk of developing the condition:

• Stay active. Exercise that involves moving large muscle groups is best for bone health. Activities such as walking, dancing and cycling are good choices for people with osteoarthritis.
• Lose weight if you’re overweight or obese. Excess weight puts additional stress on your joints, which can make osteoarthritis worse over time.
• Avoid high-impact sports if you have a history of joint injuries.
• Eat a healthy diet rich in fruits and vegetables, whole grains and low-fat dairy products to ensure proper nutrition for healthy bones and joints.
• Quit smoking to decrease your risk of developing osteoarthritis

What Kind of Physical Therapist Do I Need?

Physical therapy (PT) focuses on improving mobility and reducing pain with exercise, stretching and manual therapy (massage). Some PTs specialize in treating specific conditions like osteoarthritis. Your doctor can help you find a good PT who’s experienced with treating your condition.

If you need surgery for your osteoarthritis, your doctor may recommend physical therapy after surgery to help regain flexibility and strength following the procedure. This type of physical therapy can also help people who have had joint replacements or other surgeries that involve replacing damaged joints with artificial ones (prostheses).