Osteoarthritis

Osteoarthritis is a disease affecting the joints. It is very treatable. It is rarely deforming or crippling, although it can be painful if not treated. Osteoarthritis is very common and affects almost everybody as they get older. The older you get, the more likely you are to have it, and around eight out of ten people over the age of 50 are affected. In the hand, it typically affects the base of the thumb first then the finger joints. Women are affected more than men.
Osteoarthritis can be thought of as “wear and tear” arthritis. It is not the same as rheumatoid arthritis, which is an autoimmune disease that is very deforming and can be crippling. Osteoarthritis does not deform the hands in the way that rheumatoid arthritis does. What are the symptoms of osteoarthritis?
The hallmarks of osteoarthritis are joint stiffness, swelling, and pain. This often improves with light activity, but is usually worse again after forceful gripping or pinching, or after a period of rest.
Who gets osteoarthritis?
Many people think osteoarthritis should come from a long history of hard work, but hard labor does not seem to be very related. Osteoarthritis can be due to trauma such as an old fracture, but it is usually just due to the effects of aging coupled with some hereditary contribution.
How is osteoarthritis diagnosed?
The diagnosis is made by listening to the patient and by examining the patient. Most patients will have a history of slowing increasing pain, stiffness, and swelling over a period of years. Sometimes there is a fairly sudden onset of symptoms, usually associated with a single episode of trauma (typically a fall) or a period of overuse (weeding the garden, say, or packing to move). An x-ray examination confirms the diagnosis. Often there will be no correlation between the amount of pain and the severity of the arthritis as shown by the x-ray.
What does the x-ray show?
The x-ray typically shows some joint space narrowing, that is, the white shape of the bones are closer together than they normally are. The bone along the joint is usually whiter (called “sclerosis”) and may have little points of bone growing out (called “osteophytes”). There may be holes in the bone (called “cysts”) and the bones may be starting to slide out of alignment (called “subluxation”). I will review your x-rays with you and explain exactly what I see.
How is osteoarthritis treated?
My treatment includes:
- Diagnosis
- Patient education
- Activity modification
- Anti-inflammatory medication
- Steroid injection
- Surgery