Osteoarthritis: Causes, Symptoms, and Treatment and Care Options

Osteoarthritis is a common joint disease, particularly among older adults. It can affect many areas of the body, including the knees, hips, fingers, and spine. Common symptoms include joint pain, stiffness, and reduced range of motion, which may affect everyday activities such as walking, climbing stairs, standing up, sitting down, and performing routine tasks.

Although osteoarthritis is a chronic condition, appropriate exercise, weight management, and treatment based on the severity of symptoms can help relieve pain, maintain mobility, and support a better quality of daily life.

What Is Osteoarthritis?

Osteoarthritis is a joint disease caused by changes and gradual deterioration of tissues within the joint over time. It does not involve only the wearing away of cartilage but may also affect the cartilage, bone, synovial tissue, ligaments, and other structures surrounding the joint.

Cartilage is the tissue that covers the ends of bones. It helps bones move smoothly against one another and provides cushioning during movement. When osteoarthritis develops, these tissues may change or become damaged, leading to pain, swelling, stiffness, and reduced joint mobility.

As the condition progresses, the shape of the joint may change, and bony growths known as osteophytes or bone spurs may develop around the edges of the joint. In some people, these changes may contribute to joint deformity or greater difficulty using the affected joint.

Osteoarthritis commonly affects the knees, hips, finger joints, the base of the thumb, and the spine, particularly the neck and lower back.

Why Osteoarthritis Can Affect Daily Life

Symptoms of osteoarthritis usually develop gradually and may become more noticeable over time. In the early stages, some people may experience pain only when using the affected joint, such as after walking for a long period or performing repetitive activities.

As symptoms progress, joint stiffness may become more noticeable, range of motion may decrease, and certain activities may become more difficult, including climbing stairs, standing up from a chair, squatting, or walking long distances.

Pain may cause some people to reduce their level of physical activity. Over time, this can contribute to weakness in the muscles surrounding the joint and may place additional strain on the affected area. For this reason, osteoarthritis management focuses not only on reducing pain but also on maintaining muscle strength and mobility.

Causes and Risk Factors of Osteoarthritis

Osteoarthritis is no longer considered simply the result of joint use or normal aging. Several factors may contribute to the development of the condition or increase the likelihood of developing it.

• Age — The risk of osteoarthritis increases with age because tissues within the joints naturally change over time. However, osteoarthritis does not occur in every older adult, and younger people can also develop the condition, particularly when other risk factors are present.
• Overweight or Obesity — Excess body weight increases the load placed on weight-bearing joints, particularly the knees and hips. In addition, fatty tissue can produce substances associated with inflammatory processes in the body, which may contribute to changes within the joints.
• Previous Joint Injury — People who have previously injured a joint, such as through ligament or meniscus damage, a fracture near the joint, or a sports-related injury, may have a higher risk of developing osteoarthritis in that area later in life.
• Repetitive Joint Use — Occupations or activities that repeatedly place stress on certain joints over long periods may increase the load on those joints and may contribute to the risk of osteoarthritis, especially when other risk factors are also present.
• Joint Structure — Abnormalities in joint shape or alignment, such as congenital structural differences or bone alignment that causes uneven weight distribution, may result in certain parts of the joint carrying greater loads than normal.
• Genetics — People with family members who have certain types of osteoarthritis may have a higher risk of developing the condition, suggesting that genetic factors may also play a role.

Symptoms of Osteoarthritis to Watch For

Symptoms of osteoarthritis usually develop gradually and may vary depending on the location of the affected joint. Common symptoms include:

• Joint pain during activity or after prolonged use
• Joint stiffness after waking up or after a period of inactivity
• Reduced range of motion
• Swelling or tenderness around the joint
• A grinding, cracking, or grating sensation during movement
• A feeling of joint instability or giving way in some people
• Weakness of the muscles surrounding the joint
• Changes in joint shape as the condition becomes more advanced

Symptoms may differ depending on the affected area. Knee osteoarthritis may cause pain while walking or climbing stairs, while hip osteoarthritis may cause pain around the hip, groin, or thigh. Osteoarthritis of the hands may cause finger joints to become enlarged or deformed over time.

When Should You Go to the Hospital?

Joint pain is not always caused by osteoarthritis. Certain symptoms may be associated with other conditions that require prompt medical assessment. Seek medical care urgently if you experience any of the following:

Treatment and Management of Osteoarthritis

The main goals of osteoarthritis treatment are to reduce pain, maintain or improve joint mobility, and help patients continue their daily activities as normally as possible.

Treatment approaches vary from person to person depending on the affected joint, severity of symptoms, age, underlying medical conditions, current medications, and the impact of the condition on daily life.

1. Exercise
   Exercise is an important part of osteoarthritis management because it helps strengthen the muscles around the joint, maintain flexibility, and support joint movement.
   Low-impact activities such as walking, cycling, swimming, or water-based exercise may be suitable for some patients. Strengthening and stretching exercises may also help support joint function when performed appropriately.
   People who are not regularly active should begin gradually. Those with significant pain or limitations in movement should consult a doctor or physical therapist before beginning an exercise program.
2. Weight Management
   For people who are overweight or have obesity, reducing body weight to an appropriate level may help decrease the load placed on weight-bearing joints, particularly the knees and hips.
   Weight management should generally involve dietary adjustments together with physical activity appropriate for the individual's overall health.
3. Physical Therapy and Assistive Devices
   A physical therapist can recommend exercises to improve strength and joint mobility, as well as provide guidance on how to move and use the body appropriately during everyday activities.
   Some patients may benefit from assistive devices such as walking sticks, canes, or joint supports, which may improve stability and reduce stress on certain joints.
4. Medication
   Some patients may require medication to manage pain. Options may include topical medications, pain relievers, or nonsteroidal anti-inflammatory drugs.
   Certain medications require caution, particularly in people with kidney disease, heart disease, stomach problems, high blood pressure, or those taking several regular medications. Patients should therefore consult a doctor or pharmacist before using pain-relieving medication on a continuing basis.
5. Joint Injections
   For some patients, a doctor may consider injecting certain medications into the affected joint to provide temporary symptom relief. Whether this treatment is appropriate depends on the joint involved, the patient's symptoms, and individual clinical circumstances.
6. Surgery
   If osteoarthritis becomes severe, significantly affects mobility or daily life, and other treatments are unable to adequately control symptoms, surgery may be considered.
   Joint replacement surgery is one treatment option that may be considered for some patients with severe joint damage. The potential benefits and risks, as well as the patient's age, overall health, and individual needs, should all be considered when making this decision.

How to Care for Yourself When You Have Osteoarthritis

Consistent self-care can help manage symptoms and maintain joint mobility. Practical measures that may be incorporated into daily life include:

• Staying physically active and exercising regularly at an appropriate level
• Strengthening the muscles surrounding the affected joint
• Maintaining an appropriate body weight
• Avoiding sudden increases in exercise intensity or physical activity
• Modifying repetitive activities if they trigger joint pain
• Taking breaks when pain develops after activity, while avoiding unnecessary prolonged inactivity
• Using heat or cold therapy when appropriate to help relieve symptoms
• Choosing suitable footwear that provides stability while walking
• Using walking aids or joint supports if recommended by a healthcare professional

Patients should not regularly use medications, dietary supplements, or products claiming to rebuild cartilage or cure osteoarthritis without consulting a doctor or pharmacist. Evidence regarding the effectiveness of these products varies, and some may not be appropriate for people with certain medical conditions or those taking particular medications.

Who Should See a Doctor?

A doctor or healthcare professional should be consulted if any of the following applies:

• Joint pain or stiffness persists for a prolonged period
• Pain begins to interfere with walking, work, or everyday activities
• Joint movement becomes noticeably restricted
• Joint swelling repeatedly occurs
• Symptoms do not improve after lifestyle adjustments or basic self-care
• Pain medication is required frequently or for prolonged periods
• There is a history of joint injury or surgery
• The patient has underlying medical conditions or takes several medications and needs treatment for joint pain

Seeking medical advice when symptoms begin to affect daily activities can help determine the cause of the problem and identify an appropriate management plan for each individual.

Summary

Osteoarthritis is a joint disease caused by changes in various tissues within the joint. It can lead to pain, stiffness, and reduced mobility. Several factors are associated with its development, including age, body weight, previous joint injury, repetitive joint use, joint structure, and genetics.

Management of osteoarthritis focuses on maintaining mobility, reducing pain, and helping patients continue their daily activities. Appropriate exercise, weight management, physical therapy, and medications or other treatments may be used depending on each patient's individual circumstances.

If joint pain or stiffness persists and begins to interfere with daily life, medical advice should be sought for proper assessment and management. Severe sudden pain, a swollen red and warm joint, fever, or inability to bear weight requires prompt medical attention.

Prepared by: ผศ. นพ. ภราดร ว่องวิกย์การ

References

1. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) - Osteoarthritis
2. NHS - Osteoarthritis
3. Medline Plus - Osteoarthritis