Osteoarthritis

Description

Symptoms

The pain of osteoarthritis almost always begins gradually, progressing slowly over many years. People under 40 may have the condition with no symptoms at all. Osteoarthritis is commonly identified by the following symptoms:

• The most common symptom of osteoarthritis in any joint is pain that worsens during activity and that gets better during rest. It should be noted, however, that stiffness also tends to follow periods of inactivity, such as sleep or sitting, which can last for more than an hour or it can be eased by stretching and exercise. As the disease advances, the pain may occur even when the joint is at rest and can keep a sufferer awake at night.
• Pain is generally described as aching, stiffness, and loss of mobility.
• The pain may behave like a roller coaster, with bad spells followed by periods of relative relief.
• Pain seems to increase in humid weather.
• Some people experience muscle spasm and contractions in the tendons.
• Osteoarthritis in the knee may cause a crackling like noise (called crepitus) when moved.

Fatigue and general weakness are not signs of osteoarthritis.

Symptoms by Location

Fingers. Osteoarthritis of the fingers occurs most often in older women and may be inherited within families. It often affects areas where the following bony knobs form in the joints:

• Most commonly osteoarthritis forms in the first joint below the tips (known as Heberden's nodes).
• Less commonly it forms in the next joint down (Bouchard's nodes).

Click the icon to see an image of osteoarthritis.

Gelatinous cysts, which sometimes go away on their own, may also form in the finger joints. Osteoarthritis also frequently damages the base of the thumb.

Knees. Osteoarthritis is particularly debilitating in the weight-bearing joints of the knees. Here, 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. 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. It may develop in the shoulder joint itself (medically called 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.