Osteoarthritis: Easing Your Aching Joints

I remember a patient, let’s call her Sarah. She loved gardening, but lately, even kneeling to tend her roses brought a sharp, grinding pain to her knees. She’d brush it off, “Just getting older,” she’d say. But it was more than that. It was that wear-and-tear arthritis we call osteoarthritis, and it was starting to steal her joy. So many folks I see in my practice come in with similar stories – a new ache, a stiffness that wasn’t there before, making them wonder what’s going on with their joints.

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So, What Exactly Is Osteoarthritis?

It’s a question I hear a lot. Think of it like this: the smooth, slippery stuff that caps the ends of your bones in a joint – that’s cartilage. It’s like a natural cushion, a shock absorber, and it helps your bones glide past each other. With osteoarthritis (OA, as we sometimes shorten it), this cushion starts to wear down over time. Eventually, bones can rub more directly against each other. Ouch, right?

This can happen in any joint, really. But we see it most often in the:

Hands
Knees
Hips
Neck (your cervical spine)
Lower back (your lumbar spine)

Now, there are a couple of ways we look at it. Primary osteoarthritis is the most common – it’s that gradual wear and tear from, well, living life and using our joints. Then there’s secondary osteoarthritis, which pops up if a joint gets damaged directly, maybe from an old sports injury, a fall, or even another type of arthritis that has affected the cartilage.

And believe me, it’s common. Experts reckon a lot of adults over 55 have some signs of it on an X-ray, even if they don’t feel a thing. But a good number of people do feel those symptoms, and that’s when they usually come see me.

What Does Osteoarthritis Feel Like?

When osteoarthritis starts making itself known, you might notice a few things. It’s often a bit different for everyone, but common clues include:

Pain in a joint, especially when you’re moving it or after you’ve been active. It might be an ache, or sometimes sharper.
A feeling of stiffness, particularly first thing in the morning or after you’ve been sitting still for a while. It can take a bit to get “warmed up.”
Some swelling or tenderness around the joint. You might feel a bit of puffiness.
Noticing you can’t quite bend or straighten that joint as far as you used to – that’s what we call a decreased range of motion.
The joint might feel a bit wobbly, like it’s not as strong or stable as it once was.
Sometimes, though not always, the joint might even look a bit different, maybe a bit knobbier or slightly misshapen (joint deformity).

What’s Behind Osteoarthritis?

Why does this happen? Well, for that primary type, we don’t have one single culprit. It seems to be a mix of things, often just the natural process of our joints working hard for us over many, many years. Little by little, that cartilage can just wear thin.

Then there are things that can speed it up or cause that secondary type:

Big owies like sports injuries, bad falls, or even car accidents can damage a joint directly.
Some folks have conditions that make their joints a bit more vulnerable, like Ehlers-Danlos syndrome (a condition affecting connective tissues) or if their joints are naturally extra flexible (joint hypermobility syndrome).
And sometimes, other kinds of arthritis, like rheumatoid arthritis (an autoimmune condition), gout (caused by uric acid crystals), or psoriatic arthritis (linked to psoriasis), can damage the cartilage and lead to osteoarthritis down the line.

And are some people more likely to get it? Yes, a few things can increase the chances:

Getting older – it’s just more common after 55.
Being postmenopausal seems to play a role for some women.
Carrying extra weight (obesity, with a BMI over 30, or being overweight, BMI over 25) puts more stress on your joints, especially knees and hips.
Conditions like diabetes or high cholesterol (hyperlipidemia).
Certain autoimmune diseases that affect the joints.

How Do We Figure Out if It’s Osteoarthritis?

If you come to me with joint pain, the first thing I’ll do is listen. I’ll want to know when it started, what makes it better, what makes it worse. Then, a good physical exam is key – I’ll look at your joints, see how they move, and feel for any tenderness or swelling.

To get a clearer picture of what’s happening inside, we might suggest:

An X-ray is often the first imaging test. It can show us if the space in the joint has narrowed (a sign of cartilage loss) or if there are bony spurs, which can form with OA.
Sometimes, an MRI (magnetic resonance imaging) or a CT scan (computed tomography) can give us even more detail, especially about the soft tissues like cartilage, ligaments, and tendons.
We might also do some blood tests. Not to diagnose osteoarthritis itself, because there isn’t a blood test for that. But these can help us rule out other conditions that can cause similar joint pain, like rheumatoid arthritis or gout.

Managing Osteoarthritis: What Are Our Options?

Okay, so if it is osteoarthritis, what can we do? The big thing to know is there’s no magic cure to regrow that cartilage. But, and this is a big ‘but,’ there’s a LOT we can do to manage the symptoms, reduce pain, and keep you moving as comfortably as possible.

Our goal is to ease that pain and stiffness. Here’s what often helps:

Medication: Simple over-the-counter (OTC) pain relievers like acetaminophen (like Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can be a good start. Sometimes we might prescribe stronger options, or even recommend topical pain relievers – these are creams, gels, ointments, or patches you put right on the skin over the sore joint.
Movement is Medicine: I know, it sounds counterintuitive when it hurts to move! But gentle, regular exercise is so important. It strengthens the muscles around the joint, which gives it more support and can actually reduce pain. Think low-impact things like swimming, water aerobics, cycling, or gentle weight training. A physical therapist can be your best friend here – they can assess your specific needs and design an exercise program just for you.
Supportive Gear: Little things can make a big difference. Shoe inserts (orthotics) can help with foot, knee, or hip alignment and cushioning. A brace can give a wobbly knee or ankle some stability and confidence. And don’t be shy about using a cane or walker if it helps take pressure off an affected joint and keeps you moving safely and with less pain.
Hot and Cold Therapies: Simple, but often effective! Applying heat (like with a heating pad or warm compress) can soothe stiffness and relax muscles. Applying cold (like with an ice pack or cool compress) can help numb acute pain and reduce swelling. We can chat about when to use which, and for how long.
Thinking Beyond Pills (Complementary Therapies): Some folks find relief with therapies like acupuncture, massage, or gentle mind-body practices such as tai chi or meditation. If you’re thinking about dietary supplements (like glucosamine or chondroitin), please talk to me or your primary healthcare provider first. It’s important to make sure they’re safe for you and won’t interfere with any other medications or conditions.
Surgery as a Later Option: Most people with osteoarthritis never need surgery. But if the pain is severe, constant, and significantly impacting your quality of life, and other treatments haven’t provided enough relief, then joint replacement surgery (what we call arthroplasty) can be a very effective option. This is most common for hips and knees. If we get to that point, we’ll talk through everything in detail, and I’d refer you to a good orthopedic surgeon to discuss if it’s right for you.

We’ll discuss all these options and figure out what’s best for your specific situation and lifestyle.

Living with Osteoarthritis: What to Expect Day-to-Day

Living with osteoarthritis often means finding a long-term plan to manage those flare-ups and keep symptoms at bay. It’s about teamwork – you and your healthcare team finding that right mix of treatments and strategies.

The really important thing? Keep moving as much as you comfortably can. I know it can be tough when things are sore. But if pain stops you from being active, it can, unfortunately, open the door to other health worries like heart disease, diabetes, and even some types of cancer. So if you’re finding it tough to stay active, please let me know. We can always re-evaluate your treatment plan and try different approaches.

You might need to tweak your routine a bit. An occupational therapist can be incredibly helpful here. They are healthcare providers who specialize in helping people manage physical challenges in daily life. They might recommend:

Adaptive equipment, like special grips for opening jars if your hands are affected, or tools with longer handles.
Techniques for doing hobbies, sports, or other activities more safely and with less strain on your joints.
Tips for reducing joint pain during those inevitable arthritic flare-ups.

Can We Prevent Osteoarthritis?

While we can’t stop the clock or change our family history, there are definitely things that can help lower your risk of developing osteoarthritis or perhaps delay its onset:

Avoid tobacco products. Smoking is just not good for any part of your body, including your joints.
Stick to low-impact exercise like walking, swimming, or cycling. These are kinder to your joints than constant high-impact pounding.
Follow a diet plan that’s healthy for you to maintain a healthy weight. Extra pounds put extra stress on weight-bearing joints like your knees and hips.
Simple safety stuff: always wear your seatbelt in the car. Wear proper protective equipment for any activity, sport, or work you’re doing that might put your joints at risk.
Visit your healthcare provider for regular checkups and as soon as you notice any new, persistent changes in your joints. Early attention can make a difference.

Key Things to Remember About Osteoarthritis

Alright, that was a lot of information! If you remember just a few things about osteoarthritis, let it be these:

Osteoarthritis is common, especially as we get older, and it’s about the wear and tear of that protective cartilage in our joints.
Typical signs include pain in a joint (especially with movement), stiffness (often worse in the morning or after rest), some swelling, and maybe noticing you can’t move the joint as freely as before.
While there’s no cure to regrow cartilage, many effective treatments can manage symptoms – from lifestyle changes and gentle exercise to medications and, if needed, supportive devices or surgery.
Staying active (in a joint-friendly way!), maintaining a healthy weight, and protecting your joints from injury are really key.
Don’t just “tough it out.” If you have ongoing joint concerns, please talk to your doctor. We’re here to help you find ways to feel better.

When you see your doctor, it’s good to have some questions ready. Things like:

Is this definitely osteoarthritis, or could it be something else?
Which of my joints are actually affected?
What treatment options do you think are best for my situation?
Will I need surgery at some point?
Would working with a physical therapist or occupational therapist help me?

A common question I get is, “Doc, at what age does osteoarthritis usually start?” It typically affects people older than 55. However, there’s no set timeline. It can take a long time for the cartilage in your joints to wear down enough to cause pain and stiffness. So, even if you first notice symptoms around age 55, that doesn’t mean osteoarthritis started exactly at that time – the process might have been happening quietly for years.

Dealing with joint pain can be frustrating, I truly get it. It can change how you do things, and that’s tough. But you’re not alone in this, and there are many ways we can work together to help you feel better and stay as active and engaged in life as possible. We’ll find a path forward.