Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of the bones wears down over time. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips, and spine. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips, and spine. Osteoarthritis symptoms can usually be managed, although the damage to joints can’t be reversed. Staying active, maintaining a healthy weight, and receiving certain treatments might slow the progression of the disease and help improve pain and joint function.
Affected joints might hurt during or after movement. Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:
- Pain. Affected joints might hurt during or after movement
- Stiffness. Joint stiffness might be most noticeable upon awakening or after being inactive.
- Tenderness. Your joint might feel tender when you apply light pressure to or near it.
- Loss of flexibility. You might not be able to move your joint through its full range of motion.
- Grating sensation. You might feel a grating sensation when you use the joint, and you might hear popping or crackling.
- Bone spurs. These extra bits of bone, which feel like hard lumps, can form around the affected joint.
- Swelling. This might be caused by soft tissue inflammation around the joint.
- Clicking or popping sound when a joint bends.
- Muscle weakness around the joint.
- Joint instability or buckling (as when a knee gives out).
Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates. Cartilage is a firm, slippery tissue that enables nearly frictionless joint motion.
Eventually, if the cartilage wears down completely, the bone will rub on the bone.
Osteoarthritis has often been referred to as wear and tear disease. But besides the breakdown of cartilage, osteoarthritis affects the entire joint. It causes changes in the bone and deterioration of the connective tissues that hold the joint together and attach muscle to bone. It also causes inflammation of the joint lining.
Factors that may contribute to the development of OA include
- Age. The risk of developing OA increases with age and symptoms generally, but not always, appear in people over 50.
- Musculoskeletal abnormalities. Malalignment of bone or joint structures can contribute to faster development of OA.
- Weak muscles. If muscles don’t provide adequate joint support, poor alignment can result, which can lead to OA.
- Genetics. People with family members who have OA are more likely to develop it.
- Gender. Women are more likely to develop OA than men.
- Environmental Factors. Modifiable environmental risk factors include things like someone’s occupation, level of physical activity, quadriceps strength, presence or absence of prior joint injury, obesity, diet, sex hormones, and bone density.
- Sex. Women are more likely to develop osteoarthritis, though it isn’t clear why.
- Obesity. Carrying extra body weight contributes to osteoarthritis in several ways, and the more you weigh, the greater your risk. Increased weight adds stress to weight-bearing joints, such as your hips and knees. Also, fat tissue produces proteins that can cause harmful inflammation in and around your joints.
- Joint injuries. Injuries, such as those that occur when playing sports or from an accident, can increase the risk of osteoarthritis. Even injuries that occurred many years ago and seemingly healed can increase your risk of osteoarthritis.
- Repeated stress on the joint. If your job or a sport you play places repetitive stress on a joint, that joint might eventually develop osteoarthritis.
- Bone deformities. Some people are born with malformed joints or defective cartilage.
- Certain metabolic diseases. These include diabetes and a condition in which your body has too much iron (hemochromatosis).
Osteoarthritis is a degenerative disease that worsens over time, often resulting in chronic pain. Joint pain and stiffness can become severe enough to make daily tasks difficult.
Depression and sleep disturbances can result from the pain and disability of osteoarthritis.
OA may affect different parts of the body in different ways.
- Hips. Pain in the groin area or buttocks and sometimes on the inside of the knee or thigh.
- Knees. A “grating” or “scraping” feeling when moving the knee.
- Fingers. Bony growths (spurs) at the edge of joints can cause fingers to become swollen, tender and red, sometimes with pain at the base of the thumb.
- Feet. Pain and tenderness in the big toe, with possible swelling in the ankles or toes.
Pain, reduced mobility, side effects from medications and other factors associated with osteoarthritis can lead to health complications that are not caused by the disease itself.
Obesity, Diabetes and Heart Disease
Painful joints, especially in the feet, ankles, knees, hip or back, make it harder to exercise. But physical activity is not only key to managing OA symptoms, it also can help prevent weight gain, which can lead to obesity. Being overweight or obese can lead to the development of high cholesterol, type 2 diabetes, heart disease and high blood pressure.
Research indicates people with OA experience more falls and risk of fracture than those without OA. Although study results vary, some research shows they may have up to 30% more falls and have a 20% greater risk of fracture. Having OA can decrease function, weaken muscles, affect overall balance, and make falls more likely, especially among those with OA in knees or hips. Side effects from pain medications, such as dizziness, can also contribute to falls.
Medical history, a physical examination and lab tests help to make up the OA diagnosis.
A primary care doctor may be the first person you talk to about joint pain. The doctor will review your medical history, symptoms, how the pain affects activities, as well as your medical problems and medication use. He or she will also look at and move your joints, and may order imaging. These tests help to make the diagnosis:
- Joint aspiration. After numbing the area, a needle is inserted into the joint to pull out fluid. This test will look for infection or crystals in the fluid to help rule out other medical conditions or other forms of arthritis.
- X-ray. X-rays can show joint or bone damage or changes related to osteoarthritis.
- MRI. Magnetic resonance imaging (MRI) gives a better view of cartilage and other parts of the joint.
There is no cure for OA, but medication, assistive devices and other therapies that don’t involve drugs can help to ease pain. As a last resort, a damaged joint may be surgically fused or replaced with one made of a combination of metal, plastic and/or ceramic.
Pain and anti-inflammatory medicines for osteoarthritis are available as pills, syrups, patches, gels, creams or injectables. They include:
- Analgesics. These are pain relievers and include acetaminophen and opioids. Acetaminophen is available over the counter (OTC); opioids must be prescribed by a doctor.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These are the most commonly used drugs to ease inflammation and pain. They include aspirin, ibuprofen, naproxen and celecoxib, available either OTC or by prescription. The OTC versions help with pain but not inflammation.
- Counterirritants. These OTC products contain ingredients like capsaicin, menthol and lidocaine that irritate nerve endings, so the painful area feels cold, warm or itchy to take focus away from the actual pain.
- Corticosteroids. These prescription anti-inflammatory medicines work in a similar way to a hormone called cortisol. The medicine is taken by mouth or injected into the joint at a doctor’s office.
- Platelet-rich plasma (PRP). Available from a doctor by injection, this product is intended to help ease pain and inflammation. This is not approved by the Food & Drug Administration and evidence is still emerging, so discuss it with your doctor before trying it.
- Other drugs. The antidepressant duloxetine (Cymbalta) and the anti-seizure drug pregabalin (Lyrica) are oral medicines that are FDA-approved to treat OA pain.
Movement is an essential part of an OA treatment plan. Getting 150 minutes of moderate-to-vigorous exercise per week should be the goal, according to the U.S. Department of Health and Human Services. A good exercise program to fight OA pain and stiffness has four parts:
- Strengthening exercises build muscles around painful joints and helps to ease the stress on them.
- Range-of-motion exercise or stretching helps to reduce stiffness and keep joints moving.
- Aerobic or cardio exercises help improve stamina and energy levels and reduce excess weight.
- Balance exercises help strengthen small muscles around the knees and ankles and help prevent falls.
Talk to a doctor or physical therapist before starting a new exercise program.
Excess weight puts additional force and stress on weight-bearing joints, including the hips, knees, ankles, feet and back, and fat cells promote inflammation. Losing extra weight helps reduce pain and slow joint damage. Every pound of weight lost removes four pounds of pressure on lower-body joints.
Physical Therapies and Assistive Devices
Physical therapists, occupational therapists and chiropractors can provide:
- Specific exercises to help stabilize your joints and ease pain.
- Information about natural treatments and products that can ease pain.
- Instruction to make movement easier and to protect joints.
- Braces, shoe inserts or other assistive devices.
Joint surgery can improve pain and function. Joint replacement surgery replaces damaged joints to restore mobility and relieve pain. Hips and knees are the joints most commonly replaced. An orthopedic surgeon can determine the best procedure based on how badly damaged the joint is.
Practicing these habits can slow down OA, keep you healthier overall and delay surgery as long as possible. It is important to pursue a number of different self-care approaches simultaneously. They are listed below.
Maintain a Healthy Weight
Excess weight worsens OA. Combine healthy eating with regular exercise to maintain a healthy weight.
Control Blood Sugar
Many people have diabetes and OA. Having high glucose levels can make cartilage stiffer and more likely to break down. Having diabetes causes inflammation, which also weakens cartilage.
Maintain Range of Motion
Movement is medicine for joints. Make a habit of putting your joints through their full range of motion, but only up to the point where it doesn’t cause more pain. Gentle stretching, raising and lowering legs from a standing or seated position, daily walks and hobbies such as gardening can help. But listen to your body and never push too hard.
Make sure to warm up and cool down when doing exercise. If you play sports, protect joints with the right gear. Use your largest, strongest joints for lifting, pushing, pulling, and carrying. Watch your step to prevent falls. Balance rest and activity throughout the day.
Find ways to reduce or avoid stress through meditation, listening to music, connecting with friends and family, doing fun activities, and finding ways to relax and recharge.
Choose a Healthy Lifestyle
Eating healthy food, balanced nutrition, not smoking, drinking in moderation, and getting good sleep will help you to feel your best.
The four stages of osteoarthritis are:
- Stage 1 – Minor
- Minor wear-and-tear in the joints
- Little to no pain in the affected area
- Stage 2 – Mild
- More noticeable bone spurs
- The affected area feels stiff after sedentary periods
- Patients may need a brace
- Stage 3 – Moderate
- Cartilage in the affected area begins to erode
- The joint becomes inflamed and causes discomfort during normal activities
- Stage 4 – Severe
- The patient is in a lot of pain
- The cartilage is almost completely gone, leading to an inflammatory response from the joint
- Overgrowth of bony spurs (osteophytes) may cause severe pain
- joint tenderness.
- increased pain and stiffness when you have not moved your joints for a while.
- joints appearing slightly larger or more “knobbly” than usual.
Prevalence of self-reported osteoarthritis, by age and sex, 2017–18
Massage Therapy Helps Relieve Pain for Osteoarthritis
Massage therapy is an alternative treatment used to relieve pain. There are more than 80 types of massage therapy, in which healthcare providers manipulate the muscles and other soft tissues using varied techniques.1
About Massage Therapy
Massage therapists mostly use their hands and fingers—although some therapists also use their forearms, elbows, or even their feet—to manipulate the patient’s soft tissues. Soft tissues are those that support and surround body structures and include muscle, fat, tendons, and ligaments. The amount of pressure used and the direction of movement differ among therapists and the area being massaged.
The goal of massage therapy is to relax muscles and other soft tissues, increase the blood and oxygen being delivered to the massaged area, warm the affected area, and relieve pain.
Some of the best-known types of massage include:
- Swedish massage: The therapist focuses on using long strokes, kneading, and friction on the muscles. Joints are moved to promote flexibility.
- Deep tissue massage: The therapist uses deep finger pressure, focusing on muscles that are tight or knotted.
- Trigger point massage: The therapist focuses pressure on trigger points in myofascial tissue (the tough membranes that wrap, connect, and support muscles) and uses other strokes as well. Trigger points represent a source of radiating pain.
- Shiatsu massage: The therapist applies rhythmic pressure with their fingers to body parts linked to vital energy, called qi.
A massage therapy session usually lasts 30–60 minutes, though some sessions may be shorter or longer. Chronic pain patients often are advised to complete a series of sessions.
Depending on the location of the muscles being massaged, you may either be seated for a chair massage or you may be asked to lie on a padded table. Typically, oil or powder is used to allow the therapists’ hands to glide over your skin.
Risks Regarding Massage Therapy
Certain precautions must be taken before getting massage therapy. Though there are few serious risks, there are certain individuals who should not get massage therapy.
People with the following conditions are not suitable candidates for massage therapy:3
- Deep vein thrombosis (blood clot)
- Bleeding disorders or those taking a blood thinner
- Damaged blood vessels
- Osteoporosis (weak and brittle bones)
- Recent fractures (broken bones)
- Open wounds
- Damaged nerves
- Infection and inflammation in the area to be massaged
Additionally, anyone with recent surgery should not get a massage. If you have a skin condition (either contagious, like warts or herpes, or noncontagious, like psoriasis) that could be aggravated by touch or pressure, massage is not recommended for you.
If you are pregnant, have cancer, have fragile skin, have heart problems, dermatomyositis (a rare disease causing muscle inflammation and a rash), or have a history of physical abuse, discuss massage therapy with your healthcare provider before signing up.
If you are interested in exploring massage therapy as a possible treatment for osteoarthritis, contact Pro Massage.
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*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. The information provided is for educational purposes only and is not intended as a diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.