Osteoarthritis

Topic Overview

Illustration of the skeletal system

What is osteoarthritis?

Osteoarthritis is a painful problem with the joints. Healthy joints help your body move, bend, and twist. Knees glide up and down stairs without creaking or crunching. Hips move you along on a walk without a complaint. But when you have arthritis, such simple, everyday movements can hurt. Using the stairs can be painful. Walking a few steps, opening a door, and even combing your hair can be hard.

Arthritis is mainly a disease of the spine, hip, hand, knee, and foot. But it can happen in other joints too. A joint is where two bones connect. And you have them all over your body.

Arthritis is most common in older people. Even though you can't cure arthritis, there are many treatments that can help with your pain and make it easier for you to move. And you can do things to keep the damage from getting worse.

What causes osteoarthritis?

The simplest way to describe arthritis is that it's wear and tear on the cartilage of your joints. Your joints have cushioning inside them called cartilage. This tissue is firm, thick, and slippery. It covers and protects the ends of bones where they meet to form a joint.

With arthritis, there are changes in the cartilage that cause it to break down. When it breaks down, the bones rub together and cause damage and pain. Experts don't know why this breakdown in cartilage happens. But aging, joint injury, being overweight, and genetics may be a part of the reason.

What are the symptoms?

  • Pain: Your joints may ache, or the pain may feel burning or sharp. For some people, the pain may come and go. Constant pain or pain while you sleep may be a sign that your arthritis is getting worse.
  • Stiffness: When you have arthritis, getting up in the morning can be hard. Your joints may feel stiff and creaky for a short time, until you get moving. You may also get stiff from sitting.
  • Muscle weakness: The muscles around the joint may get weaker. This happens a lot with arthritis in the knee.
  • Swelling: Arthritis can cause swelling in your joints, making them feel tender and sore.
  • Deformed joints: Joints can start to look like they are the wrong shape, especially as arthritis gets worse.
  • Reduced range of motion and loss of use of the joint: As your arthritis gets worse, you may not be able to fully bend, flex, or extend your joints. Or you may not be able to use them at all.
  • Cracking and creaking: Your joints may make crunching, creaking sounds.

How is osteoarthritis diagnosed?

Your doctor will want to make sure that your pain is caused by arthritis and not another problem. So first you'll need to describe your symptoms as best you can. Your doctor will ask you questions about your symptoms. Examples of questions include:

  • Is the pain burning, aching, or sharp?
  • Are your joints stiff in the morning? If yes, how long does the stiffness last?
  • Do you have any joint swelling?

Knowing these things will help your doctor make a diagnosis. If your joints are tender and swollen and the muscles are weak, this will also help your doctor confirm whether you have arthritis. You may also have X-rays to check your joints for damage. Your doctor may want to do blood tests or other tests to see if there are other causes for your pain.

How is it treated?

There are many treatments for arthritis, but what works for someone else may not help you. Work with your doctor to find what is best for you. Often a mix of things helps the most.

Your treatment may include:

  • Using pain medicine. If your pain is mild, over-the-counter pain medicines such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) may help. Commonly used NSAIDs include ibuprofen (such as Advil and Motrin), naproxen (such as Aleve), or aspirin (such as Bayer and Bufferin). But if these don't get rid of your pain, you may need a stronger prescription medicine. Because you'll likely take these medicines for a long time, you'll need to see your doctor for regular checkups.
  • Using heat or ice on the painful joint. Heat may help you loosen up before an activity. Ice is a good pain reliever after activity or exercise. Your doctor may give you gels or creams that you can rub on the joint to make it stop hurting. Having shots of medicine in the joint also helps some people.
  • Losing weight, if you're overweight. Losing weight may be one of the best things you can do for your arthritis. It helps take some of the stress off of your joints.
  • Exercising to strengthen your muscles. Having stronger thigh muscles, for example, can help reduce stress on your knees. Swimming, biking, and walking are good activities. But make sure you talk to your doctor about what kind of activity is best for you. You may also get help from a physical therapist.
  • Having surgery. If the pain in your joint gets really bad, you may decide to have surgery to replace the joint.

There are also some things you can do at home to help relieve your symptoms. For example, there are devices and tools that can take the stress and weight off of your joints and make it easier for you to hold objects, open and close things, and walk. Doorknob covers, tape, braces, splints, and canes may help.

You might also try changing activities or the way you do things to reduce the stress on the joint that hurts and allow you to move better. For example, walk instead of jog. Or use a sewing machine to make a quilt instead of making it by hand.

Frequently Asked Questions

Learning about osteoarthritis:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with osteoarthritis:

Health Tools Health Tools help you make wise health decisions or take action to improve your health.

Health Tools help you make wise health decisions or take action to improve your health.


Decision Points focus on key medical care decisions that are important to many health problems. Decision Points focus on key medical care decisions that are important to many health problems.
  Arthritis: Should I have knee replacement surgery?
  Arthritis: Should I have shoulder replacement surgery?
  Osteoarthritis: Should I have hip replacement surgery?

Actionsets help people take an active role in managing a health condition. Actionsets are designed to help people take an active role in managing a health condition.
  Osteoarthritis: Exercising with arthritis

Cause

Osteoarthritis occurs when changes in cartilage cause the cartilage to break down faster than the body can produce it. When cartilage breaks down, the bones rub together and cause damage and pain. Experts don't know why this happens. But things like aging, joint injury, being overweight, and genetics may increase your risk.

In some cases, arthritis is caused by other conditions that damage cartilage.

For more information, see the What Increases Your Risk section of this topic.

Symptoms

Symptoms of osteoarthritis can range from mild to severe.

They may include:

  • Pain: Your joints may ache, or the pain may feel burning or sharp. For some people, the pain may come and go. Constant pain or pain while you sleep may be a sign that your arthritis is getting worse.
  • Stiffness: When you have arthritis, getting up in the morning can be hard. Your joints may feel stiff and creaky for a short time, until you get moving. You may also get stiff from sitting.
  • Muscle weakness: The muscles around the joint may get weaker. This happens a lot with arthritis in the knee.
  • Swelling: Arthritis can cause swelling in joints, making them feel tender and sore.
  • Deformed joints: Joints can start to look like they are the wrong shape, especially as arthritis gets worse.
  • Reduced range of motion and loss of use of the joint: As your arthritis gets worse, you may not be able to fully bend, flex, or extend your joints. Or you may not be able to use them at all.
  • Cracking and creaking: Your joints may make crunching, creaking sounds. This creaking may also occur in a normal joint, but in most cases, it doesn't hurt and doesn't mean that there is anything wrong with the joint.

Arthritis of the spine can also narrow the openings that make space for the spinal cord and for the nerves that branch off the spinal cord (spinal nerves). This is called spinal stenosis. It can lead to pressure on the spinal cord or spinal nerves. This pressure can cause pain, weakness, or numbness.

Some medical conditions can cause symptoms similar to osteoarthritis.

One Man's Story:

Photo of a man

Steve, 55

"I thought the stiffness and pain in my hip was just from the stress I was putting on my muscles. But when I changed my exercise routine or stopped working out, the pain was still there ... The pain would come and go. It wasn't a sharp pain, but a kind of ache that would keep me awake a lot. I could never stay in one position for very long."—Steve

Read more about Steve and how he learned to cope with arthritis.

What Happens

Osteoarthritis occurs when the cartilage that cushions your joints breaks down and wears away. When this happens, the bones rub together and cause damage and pain. In most cases, it takes years for cartilage to break down.

It's hard to know how fast arthritis may progress. The time it takes can vary from person to person. You may not have any symptoms for years, until the bones and tissues become damaged. Or symptoms may come and go, stay the same, or get worse over time.

Arthritis can cause problems in any joint in the body. But in most cases, you'll have symptoms in only one or two joints or groups of joints. Arthritis may cause problems in your hands, hips, knees, or feet, and sometimes in your spine. At first, you may only feel pain when you're active. As the disease gets worse, you may also feel pain when you're at rest.

If you have arthritis in your fingers, the joints at the tip or middle part of your fingers may get bigger and form bumps. These are known as Heberden's and Bouchard's nodes.

Even though there is no cure for arthritis, most people can manage their symptoms with medicine and lifestyle changes. But in a few people, arthritis may get so bad that they decide to have surgery to replace the worn joint or to fuse the bones together so that the joint won't bend. The surgical techniques and man-made joints that are available keep improving over time.

Learn about the complications of arthritis.

What Increases Your Risk

Things that can increase your risk for osteoarthritis are called risk factors. Some risk factors, such as your age or family history, can't be changed or prevented.

You may be able to reduce other risk factors for arthritis, such as your weight or certain health problems, by making lifestyle changes or taking medicine. For instance, making some changes to your diet and exercising can help you lose weight, if you need to. Or taking medicine or supplements may help boost low levels of essential vitamins or hormones that are important for bone and joint health.

Risk factors you may be able to change or prevent include:

  • Being overweight. Extra weight puts added stress on your joints and can change the normal shape of the joint.
  • Joint injury. A single major injury to a joint or several minor injuries can cause cartilage damage over time. Activities that put repeated stress on a joint include squatting, kneeling, or heavy lifting common to some sports and jobs.
  • Lack of exercise, which can cause your muscles and joints to get weak and stiff.
  • Low levels of estrogen in women, especially after menopause. Taking medicine or supplements may help increase estrogen levels.

Risk factors you can't change include:

  • Getting older. Age is not a direct cause of arthritis, but as you get older you're more likely to have symptoms. Still, not all older adults will have joint pain.
  • A family history of arthritis .
  • Loose or odd-shaped joints. Knees that bend outward (bowleg) or knees that bend toward each other (knock knees), for example, can cause an imbalance in the joints, because the cartilage wears down at an uneven rate.
  • A previous infection of the joint.
  • Other types of arthritis, such as rheumatoid arthritis or psoriatic arthritis.
  • Metabolic or endocrine problems that cause a buildup of iron (hemochromatosis), copper (Wilson's disease), or calcium (hyperparathyroidism) in the blood and tissues of the body.
  • Increased bone thickness . Bones that are too thick may not be able to absorb impacts well and protect cartilage from trauma.
  • Decreased nerve function . When the sensory nerves in your joints that allow your body to make tiny changes in posture are damaged, you're more likely to lose your balance. This problem is often seen in people who have nerve damage that may be caused by diabetes or low levels of vitamin B12.

When To Call a Doctor

Some medical problems have symptoms that are similar to osteoarthritis, so it's important that you get the right diagnosis. Call your doctor if you have:

  • Sudden, unexplained swelling, warmth, or pain in any joint.
  • Joint pain along with a fever or rash.
  • Pain so bad that you can't use your joint.
  • Mild joint symptoms that last more than 6 weeks and don't get better with home treatment.
  • Side effects from pain medicine. You can have side effects when you take large doses of aspirin or other pain medicine. Do not take more than the recommended dose of medicine without first talking to your doctor.

Watchful Waiting

If you have mild joint pain and stiffness, try home treatment first. If you don't feel better in 6 weeks, or if you develop other symptoms, call your doctor.

Who To See

Arthritis can be managed by:

Other health professionals may be part of the treatment team, such as:

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Exams and Tests

In most cases, your doctor can tell you if you have osteoarthritis and recommend treatment based on your symptoms and by doing a physical exam. Your doctor may also do some other tests to be sure that the diagnosis is correct or to rule out other other conditions that have similar symptoms.

These tests may include:

  • A joint fluid study . A sample of the fluid that cushions the joint is removed and sent to the lab to look for the cause of joint pain and swelling.
  • X-rays . Pictures of the bones in a joint, such as the hip or knee, are taken to look for cartilage damage.
  • An arthroscopy . A thin, lighted tube called an arthroscope is placed inside a small cut made near the joint. The doctor uses the scope to look for problems on the surfaces of the joint and the soft tissues that surround it. This test is not done very often.

Other tests may include a urine test and one or more blood tests, such as:

Treatment Overview

Even though there is no cure for osteoarthritis, treatment can help reduce your symptoms and make it possible for you to lead a full and active life.

The goals of treatment are to:

  • Reduce your pain and stiffness.
  • Keep your joints working and moving well.
  • Keep you from becoming disabled.
  • Prevent more damage to your joints.

Treatment is based on:

  • How bad your symptoms are.
  • How much your symptoms prevent you from doing your daily tasks.
  • How well other treatments have worked.
  • How much damage to the joint (or joints) you have.

Treatment for mild to moderate arthritis

In most cases, people who have mild to moderate arthritis can manage their symptoms for many years with a treatment plan that may include:

Some people who have arthritis also have depression. If you're depressed, be sure to tell your doctor. Treating depression may help reduce your pain and make it easier for you to do your daily tasks.1

The more you know about arthritis and what you can do to treat it and stay active, the less likely you are to have pain and become disabled. You may also be able to prevent any more damage to your joints.

Treatment if arthritis gets worse

If the pain and stiffness from arthritis don't get better or they get worse, your doctor may recommend:

If your pain is very bad, you may decide to have surgery to replace the joint. Or you may decide to have some other kind of surgery that can help keep your joints moving well and prevent your arthritis from getting worse.

Some types of surgery include:

For help deciding whether to have joint replacement surgery, see:

Click here to view a Decision Point. Arthritis: Should I have hip replacement surgery?
Click here to view a Decision Point. Arthritis: Should I have knee replacement surgery?
Click here to view a Decision Point. Arthritis: Should I have shoulder replacement surgery?

Prevention

You can take steps to help prevent osteoarthritis. If you already have arthritis, these same steps may keep it from getting worse.

Try to:

  • Stay at a healthy weight or lose weight if you need to. Extra weight puts a lot of stress on the large, weight-bearing joints such as the knees, the hips, and the balls of the feet. Too much weight can also change the normal shape of the joint, which can increase your risk for arthritis. Experts estimate that every 1 lb (0.5 kg) of body weight adds about 4 lb (1.8 kg) of stress to the knee.2 This means that if you lost just 5 lb (2.3 kg), you could take 20 lb (9.1 kg) of stress off your knees.
  • Be active . A lack of exercise can cause your muscles and joints to become weak. But light to moderate exercise can help keep your muscles strong, reduce joint pain and stiffness, and slow the time it takes for arthritis to get worse. For example, if your quadriceps (the muscles in the front of your thigh) are weak, you may be more likely to get arthritis of the knee.3 For help getting active, see:
    Click here to view an Actionset.Osteoarthritis: Exercising with arthritis.
  • Protect your joints. When you can, try not to do tasks that put repeated stress on your joints, such as kneeling, squatting, or gripping. And try to use the largest joints or strongest muscles to do things. A single major injury to a joint or several minor injuries can damage cartilage over time. For example, young adults who have had a serious knee injury are more likely to get arthritis. But they can prevent any more damage to their knee by wearing a brace to keep the knee stable and changing the way they do the activity. In most cases, proper use of sports equipment and safe playing conditions can help prevent injuries. For ideas on how to protect your joints during exercise, see:
    Quick Tips: Exercising Safely With Arthritis.

Home Treatment

When you have osteoarthritis, you may find it hard to do your daily tasks. Your joints may ache or feel stiff, and they may hurt when you move.

Here are some things that you can do at home to help you feel better:

  • Rest. If your joints hurt a lot or are swollen, take a break. But try not to let too much time pass before you get moving again. A lack of activity can cause your muscles and joints to become weak.
  • Stay at a healthy weight . Being overweight puts extra stress on your joints. But losing weight can help. And when even a small amount of weight loss is combined with exercise, it often works better to reduce pain and get the joint working better again than if only weight loss or exercise is done.4
  • Exercise. Some people may be reluctant to exercise when they have arthritis, but it can help reduce pain and improve balance. For example:
    • Walking and lifting weights can help older adults who have arthritis improve their posture and balance, and prevent falls.5
    • People who take part in an exercise class and who also exercise at home have less pain when they walk. And they're more likely to keep exercising even after the class ends.6
    Try exercises that don't put a lot of stress on your joints such as swimming, biking, walking, water exercises, and lifting light weights. Make sure to talk to your doctor or physical therapist about what kind of activity is best for you. For help getting active, see:
    Click here to view an Actionset.Osteoarthritis: Exercising with arthritis.
  • Use assistive devices and orthotics . There are devices and tools that can take the stress and weight off of your joints and make it easier for you to hold objects, open and close things, and walk. For example, doorknob covers, tape, braces, splints, and canes may help. Learn more about:
  • Protect your joints. There are some things that you can do to protect your joints. For example:
    • Avoid tasks that put repeated stress on your joints, such as kneeling, squatting, or gripping.
    • Use the largest joints or strongest muscles to do things. For example, when you lift a heavy object off the floor, use your hip and knee muscles, not your back. Or when you carry a bag of groceries, use the palm of your hand or your forearm instead of grasping it with your fingers.
  • Change activities . If your joints hurt when you do an activity, try other ways of doing it that don't cause pain. For example, walk instead of jog. Or use a sewing machine to make a quilt instead of making it by hand.
  • Modify your home and work area . If you have a hard time moving around or if you get tired easily, try making some changes in your home and work area. For example, use a reacher to pick up things off the floor. Or for tasks that you would normally do standing up, use a tall stool instead so you can sit down.
  • Use heat and cold therapy , such as hot compresses, cold packs, or ice massage.
  • Use over-the-counter pain medicines, such as acetaminophen (for example, Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (for example, Advil and Motrin), naproxen (for example, Aleve), and aspirin (for example, Bayer and Bufferin).
  • Maintain good posture. Poor posture puts stress on your back and neck. The key to good posture is to keep the right amount of curve in your lower back. Too much curve (swayback) or too little (flat back) can cause problems. Having good posture can help reduce pain.
  • Wear comfortable and supportive shoes. If you have arthritis of the knee or back, wedged insoles or cushioned shoes may help reduce the stress on the joint by shifting weight off of it.

One Woman's Story:

Photo of an older woman

Bev, 76

"Gardening books and magazines always have wonderful ideas and innovations that you can use. For instance, I've cut off sections of the rubber insulation that is used to cover water pipes and slipped them over any of the garden tools that I'm going to use, because it gives me a little more cushion and a little extra width for my tools."—Bev

Read more about Bev and how she learned to cope with arthritis.

Coping and support

Living with arthritis can be stressful. At times you may feel overwhelmed, tired, and angry. And you may worry about what your life may be like as your condition gets worse. These feelings are normal. But there are a lot of ways to cope with arthritis. For example, ask for help when you need it, keep a positive attitude, and join a support group.

If you are caring for someone who has arthritis, be sure to take time to care for yourself and find ways to manage stress. Being a caregiver is not easy. But it can be rewarding, especially when you know that your care makes a positive difference in someone's life.

For more information on coping and support, see the topics:

Medications

Medicine can help reduce your symptoms of osteoarthritis and allow you to do your daily activities.

The goal of medicine is to:

  • Get rid of pain with few side effects.
  • Keep your joints working and moving well. If pain keeps you from moving your joints, it can cause the ligaments, tendons, and muscles that move your joints to shorten and become tight and weak.

The type of medicine depends on how bad your pain is. For instance:

  • For mild to moderate pain, you can try over-the-counter pain medicine such as acetaminophen (for example, Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (for example, Advil and Motrin), naproxen (for example, Aleve), and aspirin (for example, Bayer and Bufferin).
  • For moderate to severe pain, you may need stronger pain medicine such as opioids.

Medication Choices

Medicines used to treat arthritis include:

Medicine that you put on your skin (topical) may relieve pain for a short time.7 These include topical NSAIDs, capsaicin, and pain-relieving creams.

What To Think About

Before you take medicine

Here are a few things to think about:

  • Medicine doesn't cure arthritis or slow the time it takes for cartilage to break down. But it can help reduce pain and stiffness, which can make it easier for you to move.
  • Medicine should be used along with other treatments, such as exercise and physical therapy, to help keep your joints working and moving well.
  • If you have certain health problems, you may not be able to take some kinds of pain medicine. Be sure to tell your doctor if you have a history of bleeding in your stomach or another part of your digestive tract. And tell your doctor if you have a stomach ulcer, kidney problems, or heart failure, or if you take a blood-thinner medicine.

Effects of medicines

Medicines that work for some people don't work for others. Be sure to let your doctor know if the medicine you're taking doesn't help. You may need to try several kinds of medicines to find one that works for you.

Here are a few things to think about:

  • The medicine you take may cause side effects. Your doctor may suggest that you first try acetaminophen, because it has fewer side effects than any other pain medicine used for arthritis.
  • Most studies suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) work better than acetaminophen for arthritis. But for some people, acetaminophen may work as well as NSAIDs for mild to moderate joint pain. And studies show that acetaminophen is better than no treatment.8
  • If you can't take NSAIDs, and if other treatments haven't worked, your doctor may prescribe opioids. When taken as prescribed, they can be a safe and effective way to relieve pain.
  • Because you'll likely take medicine for a long time, you'll need to see your doctor for regular checkups to look for any side effects that may develop from long-term use. He or she may prescribe medicine that can help prevent stomach ulcers, which may develop when you take pain medicine every day.

Surgery

In most cases, people can manage their osteoarthritis symptoms with medicine and lifestyle changes. But if these treatments don't help, you may decide to have surgery.

Surgery may be an option if:

  • You have very bad pain.
  • You have lost a lot of cartilage.
  • You have tried medicine and other treatments, but they haven't helped.
  • Your overall health is good.

The goal of surgery is to:

  • Reduce pain.
  • Improve how well the joint works and moves.

One Man's Story:

Photo of a man

Steve, 55

"I wasn't sure about having surgery since I was so young. I had heard that an artificial hip could give out in 10 to 20 years ... But when the medicine I was taking stopped working, I figured I had gone as far as I could go with this, and decided to go ahead with the surgery ... It's a strange feeling to be able to walk without a limp and to walk up and down stairs without grabbing onto the railing."—Steve

Read more about Steve and how he learned to cope with arthritis.

Surgery Choices

Types of surgery for arthritis include:

  • Arthrodesis . This joins (fuses) two bones in a damaged joint so that the joint won't bend. Doctors may use it to treat arthritis of the spine, ankles, hands, and feet. In rare cases, it's used to treat the knees and hips.
  • Arthroscopy can help relieve pain for a short time and allow the joints to move better. In some cases, the relief lasts a long time. Arthroscopy may help delay surgery to replace the joint that hurts. But it doesn't seem to help the arthritis itself.9 It may work best for people who have pain or a hard time moving when their joints become “locked” or stuck because of loose cartilage or bone fragments. See a picture of arthroscopy.
  • Hip resurfacing surgery . This is most often done in younger, more active people who have pain and disability caused by a badly damaged hip. It's not known how well this surgery works in the long-term. But the results are positive up to about 8 years after people have had the surgery.10 One large study suggests that this surgery works well. But the study also says that the risk of needing to have the surgery again is slightly more than with a standard hip replacement.11
  • Joint replacement. This is done when other treatments haven't worked and damage to the joint can be seen on X-rays. It involves surgery to replace the ends of bones in a damaged joint. The surgery creates new joint surfaces. Learn more about:
  • Osteotomy . This is done to correct certain defects in the hip and knee. In most cases, it's done in active people younger than 60 who have mild arthritis and want to delay surgery to replace their hip or knee.
  • Small joint surgery . This is used if pain in the joints of the hands or feet is so bad that a person can't use those joints. In some cases, doctors will replace joints in the toe. But this is rarely done in young, active people.

A newer procedure for arthritis of the knee uses a small cup shaped like a "C." It's placed in the joint space of the inner knee and acts as a cushion for the joint. It may help delay surgery to replace the knee.

What To Think About

Before deciding to have surgery

Surgery for arthritis is a choice. This is called elective surgery. If you're in poor health or have certain health problems, you may not be able to have surgery. Your doctor can help you decide if surgery is right for you.

Here are some things to consider if you're thinking about surgery:

  • After surgery, most people are able to go back to doing their daily tasks and sports with less pain.
  • You will need several months of physical therapy to get the best use of your joint.
  • Replacement joints typically last 10 to 20 years. You may need another surgery if the new joint wears out.

Get some general information on joint replacement.

For help deciding whether to have joint replacement surgery, see:

Click here to view a Decision Point. Arthritis: Should I have hip replacement surgery?
Click here to view a Decision Point. Arthritis: Should I have knee replacement surgery?
Click here to view a Decision Point. Arthritis: Should I have shoulder replacement surgery?

If you decide to have surgery

In the days or weeks before your surgery, it's a good idea to make plans for your return home.

Here are some steps you can take:

  • Arrange for someone to drive you home and to help you after your surgery, especially if you live alone or provide care for another person. You won't be able to drive until you're no longer taking pain medicines and you can move and react easily.
  • If your surgery will be on your hip, knee, or foot, you may need to avoid stairs for a short time. Be sure there is a bed for you to sleep in that isn't on the second floor of your home, so you won't have to go up or down stairs. If your bed is low, you might want to raise it up with extensions under the legs of the bed or even with an extra mattress on top.
  • You may need handrails on the stairway into the house, grab bars in the bathroom, and a raised toilet seat. And you should remove any extra clutter, furniture, cords, small rugs, or torn carpet to prevent falls.
  • Be sure you have tools to help with daily tasks. These include long-handled sponges, shower stools, and shoehorns. Get clothing that has elastic waistbands and simple fasteners. Buy slip-on shoes or shoes that fasten with Velcro.

Other Treatment

Nearly 4 out of 10 people use some form of complementary and alternative medicine to treat certain health problems, including osteoarthritis.12 Some people use these treatments along with or, in some cases, in place of standard care to help relieve their arthritis symptoms.

Some of these treatments may help you move more easily and deal with the stress and pain of arthritis. But not much is known about how safe they are or how well they may work.

Be sure to tell your doctor if you're using a complementary or alternative therapy or if you're thinking about trying one. He or she can discuss the possible benefits and potential side effects of these treatments and whether any of these treatments may interfere with your standard care. For example, some diet supplements and herbal medicines may cause problems if you take them with another medicine.

Other Treatment Choices

Complementary and alternative medicines that some people may use for arthritis include:

  • Dietary supplements . For example:
    • Glucosamine and chondroitin. Many people take these supplements, either alone or together, for arthritis. Some people believe they help. But some medical research doesn't show that they slow the time it takes for cartilage to break down or that they relieve pain or stiffness.13, 14, 15 The supplements are safe for most people, but they cost money and may not help you. Talk to your doctor if you think you might want to try glucosamine or chondroitin.
    • Avocado/soybean (ASU) extract may reduce pain.
    • Vitamin B3 may ease pain and stiffness.
    • S-adenosylmethionine (SAM-e) may ease pain and stiffness.
    • Boron may reduce pain and swelling.
  • Physical therapies. For example:
    • Acupuncture involves putting very tiny needles into your skin at certain places on your body to relieve pain. Research has shown that, for most people, acupuncture doesn't help arthritis symptoms. But some people find that it helps relieve their pain for a short time.16, 17
    • Capsaicin is a cream that you put on your skin for pain relief.
    • Pulsed electromagnetic field therapy uses magnets to produce an electrical pulse that may help cartilage grow.
    • Transcutaneous electrical nerve stimulation, or TENS, uses a mild electrical current to reduce pain.
    • Mind/body control, such as yoga, tai chi, and qi gong, can help reduce stress and relax your mind and muscles.
    • Magnetic bracelets. Some people believe magnetic bracelets help relieve pain. But in most cases, studies show that wearing a magnetic bracelet to reduce pain doesn't work any better than a placebo.

Other treatments to consider

Here are some other treatments for arthritis:

  • Ultrasound uses sound waves to produce heat in the tissues of the body for pain relief.
  • Diathermy uses heat to increase blood flow for pain relief and quick healing.
  • Taping uses tape that sticks to the knee to help keep the kneecap in place and relieve pain. You can do taping at home. But first have your doctor or physical therapist show you the right way to put it on.
  • Braces can help shift weight off the part of your knee that hurts. It's not clear how well these work, but there isn't a lot of risk in trying them.

One Woman's Story:

Photo of an older woman

Bev, 76

"After I have a massage and acupuncture, I feel like a new person. I encourage people to find out what treatments others have tried and what things have worked for them. I'm a believer in other people's ideas. Obviously, what works for one person may not work for another, but unless you try it, you'll never know if it'll help."—Bev

Read more about Bev and how she learned to cope with arthritis.

What To Think About

There are many treatments for arthritis, but what works for someone else may not work for you. You may need to try several different treatments to find what works for you.

Most studies on arthritis have focused on the knee. So it's hard to know if treatments that work for the knee might also work for other joints such as the hands, hip, or spine.

Experts are testing new medicines and methods that they hope will one day help prevent, reduce, or repair cartilage damage. For example, they're looking at cartilage transplants and the use of stem cells to grow new cartilage. So far, therapies to repair cartilage have only been studied in younger people with small, well-defined holes in their knee cartilage. This isn't a common problem for most older adults who have arthritis of the knee.

Other Places To Get Help

Organizations

American College of Rheumatology
1800 Century Place
Suite 250
Atlanta, GA  30345
Phone: (404) 633-3777
Fax: (404) 633-1870
Web Address: www.rheumatology.org
 

The American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP, a division of ACR) are professional organizations of rheumatologists and associated health professionals who are dedicated to healing, preventing disability from, and curing the many types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members of the ACR are physicians; members of the ARHP include research scientists, nurses, physical and occupational therapists, psychologists, and social workers. Both the ACR and the ARHP provide professional education for their members.

The ACR Web site offers patient information fact sheets about rheumatic diseases, about medicines used to treat rheumatic diseases, and about care professionals.


Arthritis Foundation
1330 West Peachtree Street
Suite 100
Atlanta, GA  30309
Phone: 1-800-283-7800
Web Address: www.arthritis.org
 

The Arthritis Foundation provides grants to help find a cure, prevention methods, and better treatment options for arthritis. It also provides a large number of community-based services nationwide to make living with arthritis easier, including self-help courses; water- and land-based exercise classes; support groups; home study groups; instructional videotapes; public forums; free educational brochures and booklets; the national, bimonthly consumer magazine Arthritis Today; and continuing education courses and publications for health professionals.


National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health
1 AMS Circle
Bethesda, MD  20892-3675
Phone: 1-877-22-NIAMS (1-877-226-4267) toll-free
(301) 495-4484
Fax: (301) 718-6366
TDD: (301) 565-2966
E-mail: niamsinfo@mail.nih.gov
Web Address: www.niams.nih.gov
 

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is a governmental institute that serves the public and health professionals by providing information, locating other information sources, and participating in a national federal database of health information. NIAMS supports research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases and supports the training of scientists to carry out this research.

The NIAMS Web site provides health information referrals to the NIAMS Clearinghouse, which has information packages about diseases.


National Institutes of Health Senior Health
9000 Rockville Pike
Bethesda, MD  20892
Phone: (301) 496-4000
E-mail: custserv@nlm.nih.gov
Web Address: www.NIHSeniorHealth.gov
 

This Web site for older adults offers aging-related health information. The Web site's senior-friendly features include large print, simple navigation, and short, easy-to-read segments of information. A visitor to this Web site can click special buttons to hear the text aloud, make the text larger, or turn on higher contrast for easier viewing.

The site was developed by the National Institute on Aging (NIA) and the National Library of Medicine (NLM), both part of the National Institutes of Health (NIH). NIHSeniorHealth features up-to-date health information from NIH. Also, the American Geriatrics Society provides independent review of some of the material found on this Web site.


Related Information

References

Citations

  1. Lin EHB, et al. (2003). Effect of improving depression care on pain and functional outcomes among older adults with arthritis: A randomized controlled trial. JAMA, 290(18): 2428–2434.
  2. Messier SP, et al. (2005). Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis and Rheumatism, 52(7): 2026–2032.
  3. Subcommittee on Osteoarthritis Guidelines, American College of Rheumatology (2000). Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis and Rheumatism, 43(9): 1905–1915.
  4. Messier SP, et al. (2004). Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: The arthritis, diet, and activity promotion trial. Arthritis and Rheumatism, 50(5): 1501–1510.
  5. Messier SP, et al. (2000). Long-term exercise and its effect on balance in older, osteoarthritic adults: Results from the Fitness, Arthritis, and Seniors Trial (FAST). Journal of the American Geriatrics Society, 48(2): 131–138.
  6. McCarthy CJ, et al. (2004). Supplementing a home exercise programme with a class-based exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis. Rheumatology, 43(7): 880–886.
  7. Lozada CJ (2009). Management of osteoarthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 2, pp. 1563–1577. Philadelphia: Saunders Elsevier.
  8. Towheed TE, et al. (2006). Acetaminophen for osteoarthritis. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.
  9. Laupattarakasem W, et al. (2008). Arthroscopic debridement for knee osteoarthritis (Review). Cochrane Database of Systematic Reviews (3).
  10. Daniel J, et al. (2004). Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. Journal of Bone and Joint Surgery, 86-B(2): 177–183.
  11. Sibanda N, et al. (2008). Revision rates after primary hip and knee replacement in England between 2003 and 2006. Public Library of Science Medicine, 5(9): 1398–1408.
  12. Barnes PM, et al. (2008). Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Report #12. Hyattsville, MD: National Center for Health Statistics.
  13. Reichenbach S, et al. (2007). Meta-analysis: Chondroitin for osteoarthritis of the knee or hip. Annals of Internal Medicine, 146(8): 580–590.
  14. Rozendaal RM, et al. (2008). Effect of glucosamine sulfate on hip osteoarthritis. Annals of Internal Medicine, 148(4): 268–277.
  15. Sawitzke AD, et al. (2008). The effect of glucosamine and/or chondroitin on the progression of knee osteoarthritis. Arthritis and Rheumatism, 58(10): 3183–3191.
  16. Foster NE, et al. (2007). Acupuncture as an adjunct to exercise-based physiotherapy for osteoarthritis of the knee: Randomised controlled trial. BMJ. Published online August 15, 2007 (doi:10.1136/bmj.39280.509803.BE).
  17. Manheimer E, et al. (2007). Meta-analysis: Acupuncture for osteoarthritis of the knee. Annals of Internal Medicine, 146(12): 868–877.

Other Works Consulted

  • American Academy of Orthopaedic Surgeons (2007). Activities after a hip replacement. Available online: http://orthoinfo.aaos.org/topic.cfm?topic=A00356&return_link=0.
  • American Academy of Orthopaedic Surgeons (2008). Treatment of Osteoarthritis of the Knee (Non-arthroplasty): Full Guideline. Available online: http://www.aaos.org/Research/guidelines/OAKguideline.pdf.
  • American Academy of Orthopaedic Surgeons. Activities after a knee replacement. Available online: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=275&topcategory=Knee.
  • Archibeck MJ, White RE Jr (2003). What's new in adult reconstructive knee surgery. Journal of Bone and Joint Surgery, 85-A(7): 1404–1411.
  • Boureau F, et al. (2004). The IPSO study: Ibuprofen, paracetamol study in osteoarthritis. A randomised comparative clinical study comparing the efficacy and safety of ibuprofen and paracetamol analgesic treatment of osteoarthritis of the knee or hip. Annals of the Rheumatic Diseases, 63(9): 1028–1034.
  • Brosseau L, et al. (2003). Intensity of exercise for the treatment of osteoarthritis. Cochrane Database of Systematic Reviews (2).
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  • Oesch PR, Bachmann S (2009). Introduction to physical medicine and rehabilitation. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 1, pp. 1023–1033. Philadelphia: Saunders Elsevier.
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Credits

Author Eileen Ellig
Editor Katy E. Magee, MA
Associate Editor Michele Cronen
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Last Updated April 17, 2009

Last Updated: April 17, 2009

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