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Osteoarthritis - Symptoms

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of the most common form of arthritis.

Alternative Names

Arthritis - osteoarthritis

Symptoms:

The pain of osteoarthritis typically begins gradually after age 40 and progresses slowly over many years. Younger people with the condition may have no symptoms at all. Osteoarthritis is commonly identified by the following symptoms:

  • Pain that worsens during activity and gets better during rest. This is the most common symptom of osteoarthritis. As the disease advances, the pain may occur even when the joint is at rest.
  • Pain is generally described as aching, stiffness, and loss of mobility. The symptoms are often worse when resuming activities after periods of no activity.
  • The pain may be intermittent, with bad spells followed by periods of relative relief.
  • Pain seems to increase in humid weather.
  • Some people have muscle spasm and contractions in the tendons.
  • Some people feel a grating sensation when the joint is used. Osteoarthritis in the knee may cause a crackling-like noise (called crepitus) when the affected knee is moved.

Symptoms by Location

Hand. Osteoarthritis of the hand occurs most often in older women and may be inherited within families. The following joints are most frequently affected:

  • Distal interphalangeal (DIP) joint. The first joint below the fingertips is the most common location of osteoarthritis of the hand. These joints can develop bony growths known as Heberden's nodes.
  • Carpometacarpal (CMC) joint. The joint at the base of the thumb, where the thumb joint connects with the wrist, is the second most common location.
  • Proximal interphalangeal (PIP) joint. The middle joints of the fingers can also develop osteoarthritis. These joints may develop small, solid lumps (nodules) known as Bouchard's nodes.


Click the icon to see an image of osteoarthritis.

Osteoarthritis of the hand may predict the later development of osteoarthritis in the hip or knee.

Knee. Osteoarthritis is particularly debilitating in the weight-bearing joints of the knees. The meniscus, the cartilage pad between the joint formed by the thighbone and the shinbone, plays an important role in protecting this joint. It acts as a shock absorber. The joint is usually stable until the disease reaches an advanced stage when the knee becomes enlarged and swollen. Although painful, the arthritic knee usually retains reasonable flexibility.



Click the icon to see an image of the knee joint.

Hips. About 1 in 4 people develop hip arthritis over the course of their lifetime. Being obese increases the risk. Osteoarthritis frequently strikes the weight-bearing joints in one or both hips. Pain develops slowly, usually in the groin and on the outside of the hips, or sometimes in the buttocks. The pain also may radiate to the knee, confusing the diagnosis. Those with osteoarthritis of the hip often have a restricted range of motion (particularly when trying to rotate the hip) and walk with a limp, because they slightly turn the affected leg to avoid pain.



Click the icon to see an image of the hip joint.

Spine. Osteoarthritis may affect the cartilage in the disks that form cushions between the bones of the spine, the moving joints of the spine itself, or both. Osteoarthritis in any of these locations can cause pain, muscle spasms, and diminished mobility. In some cases, the nerves may become pinched, which also produces pain. Advanced disease may result in numbness and muscle weakness. Osteoarthritis of the spine is most troublesome when it occurs in the lower back or in the neck, where it can cause difficulty in swallowing.



Click the icon to see an image of the spine.

Shoulder. Osteoarthritis is less common in the shoulder area than in other joints, but it may develop in the shoulder joint (the glenohumeral joint). In such cases, it is most often associated with a previous injury, and patients gradually develop pain and stiffness in the back of the shoulder. Osteoarthritis also can develop in the acromioclavicular (AC) joint, which is between the shoulder blade and the collarbone. However, it rarely causes symptoms in this location.

Resources

References

Brouwer RW, Raaij van TM, Bierma-Zeinstra SM, et al. Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev. 2007;(3):CD004019.

Cepeda MS, Camargo F, et al. Tramadol for osteoarthritis: a systematic review and metaanalysis. J Rheumatol. 2007;34(3):543-555.

Das A, Neher JO, Safranek S. Clinical inquiries. Do hyaluronic acid injections relieve OA knee pain? J Fam Pract. 2009 May;58(5):281c-e.

Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD004376.

Gregory PJ, Sperry M, Wilson AF. Dietary supplements for osteoarthritis. Am Fam Physician. 2008;77(2):177-184.

Gutierrez GP. Managing osteoarthritis: what's best for your patient? J Fam Pract. 2008 Oct;57(10):644-50.

Hamel MB, Toth M, Legedza A, et al. Joint replacement surgery in elderly patients with severe osteoarthritis of the hip or knee: decision making, postoperative recovery, and clinical outcomes. Arch Intern Med. 2008;168(13):1430-1440.

Harris ED Jr., Barnett GD, Budd RC, et al., eds. Kelley's Textbook of Rheumatology, 7th ed. Philadelphia, PA: Saunders; 2005.

Hernández-Molina G, Reichenbach S, Zhang B, Lavalley M, Felson DT. Effect of therapeutic exercise for hip osteoarthritis pain: results of a meta-analysis. Arthritis Rheum. 2008 Sep 15;59(9):1221-8.

Hunter DJ. In the clinic: Osteoarthritis. Ann Intern Med 2007;147(3):ITC8-1-ITC8-16.

Lane NE. Clinical practice. Osteoarthritis of the hip. N Engl J Med. 2007;357(14): 1413-1421.

Lange AK, Vanwanseele B, Fiatarone Singh MA. Strength training for treatment of osteoarthritis of the knee: a systematic review. Arthritis Rheum. 2008 Oct 15;59(10):1488-94.

Laupattarakasem W, Laopaiboon M, Laupattarakasem P, et al. Arthroscopic debridement for knee osteoarthritis. Cochrane Database Syst Rev. 2008;(1):CD005118.

Leopold SS. Minimally invasive total knee arthroplasty for osteoarthritis. N Engl J Med. 2009 Apr 23;360(17):1749-58.

Manheimer E, Linde K, Lao L, et al. Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med. 2007;146(12):868-877.

Rozendaal RM, Koes BW, van Osch GJ, et al. Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial. Ann Intern Med. 2008;148(4):268-277.

Sun BH, Wu CW, Kalunian KC. New developments in osteoarthritis. Rheum Dis Clin N Am. 2007;(33):-135-148.

Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16(2):137-162.

  • Reviewed last on: 6/23/2009
  • Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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