Pain and stiffness in the joints are the most common symptoms. The pain is often worse after exercise and when you put weight or pressure on the joint.
If you have osteoarthritis, your joints probably become stiffer and harder to move over time. You may notice a rubbing, grating, or crackling sound when you move the joint.
The phrase "morning stiffness" refers to the pain and stiffness you may feel when you first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that "warms up" the joint.
During the day, the pain may get worse when you're active and feel better when you are resting. After a while, the pain may be present when you are resting. It may even wake you up at night.
Some people might not have symptoms, even though x-rays show the changes of OA.
Signs and tests
A physical exam can show:
Joint movement may cause a cracking (grating) sound, called crepitation
Joint swelling (bones around the joints may feel larger than normal)
Limited range of motion
Tenderness when the joint is pressed
Normal movement is often painful
No blood tests are helpful in diagnosing OA.
An x-ray of affected joints will show a loss of the joint space. In advanced cases, there will be a wearing down of the ends of the bone and bone spurs.
OA cannot be cured. It will most likely get worse over time. However, your OA symptoms can be controlled.
You can have surgery, but other treatments can improve your pain and make your life much better. Although these treatments cannot make the arthritis go away, they can often delay surgery.
Over-the-counter pain relievers, which you can buy without a prescription, can help with OA symptoms. Most doctors recommend acetaminophen (Tylenol) first, because it has fewer side effects than other drugs. If your pain continues, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs). Types of NSAIDs include aspirin, ibuprofen, and naproxen.
Other medications or supplements that you may use include:
Corticosteroids injected right into the joint to reduce swelling and pain
Over-the-counter remedies such as glucosamine and chondroitin sulfate
Capsaicin (Zostrix) skin cream to relieve pain
Artificial joint fluid (Synvisc, Hyalgan) can be injected into the knee to relieve pain for 3 - 6 months
Staying active and getting exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.
Other lifestyle recommendations include:
Applying heat and cold
Eating a healthy, balanced diet
Losing weight if you are overweight
Protecting the joints
As the pain from your OA becomes worse, keeping up with everyday activities may become more difficult or painful.
Sometimes making changes around the home will take some stress off your joints, and relieve some of the pain.
If your work is causing stress in certain joints, you may need to adjust your work area or change work tasks.
Physical therapy can help improve muscle strength and the motion of stiff joints, as well as your sense of balance. Therapists have many techniques for treating OA. If therapy does not make you feel better after 6 - 8 weeks, then it likely will not work at all.
Massage therapy may also help provide short-term pain relief. Make sure you work with an experienced massage therapist who understands how to work with sensitive joint areas.
Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. You should use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.
Acupuncture is a treatment based on Chinese medicine. How it works is not entirely clear. Some studies have found that acupuncture may provide short-term pain relief for people with OA.
S-adenosylmethionine (SAMe, pronounced "Sammy") is a man-made form of a natural byproduct of the amino acid methionine. It has been marketed as a remedy for arthritis, but scientific evidence to support these claims is lacking.
Severe cases of OA might need surgery to replace or repair damaged joints. Surgical options include:
Arthroscopic surgery to trim torn and damaged cartilage
Changing the alignment of a bone to relieve stress on the bone or joint (osteotomy)
Surgical fusion of bones, usually in the spine (arthrodesis)
Every person with OA is different. Pain and stiffness may prevent one person from performing simple daily activities, while others are able to maintain an active lifestyle that includes sports and other activities.
Your movement may become very limited over time. Doing everyday activities, such as personal hygiene, household chores, or cooking may become a challenge. Treatment usually improves function.
Reactions to drugs used for treatment
Decreased ability to perform everyday activities, such as personal hygiene, household chores, or cooking
Decreased ability to walk
Calling your health care provider
Call your health care provider if you have symptoms of OA that get worse.
Try not to overuse a painful joint at work or during activities.
Gregory PJ, Sperry M, Wilson AF. Dietary supplements for osteoarthritis. Am Fam Physician. 2008;77:177-184.
Hunter DJ. In the clinic: Osteoarthritis. Ann Intern Med. 2007;147(3):ITC8-1-ITC8-16.
Hunter DJ, Lo GH. The management of osteoarthritis: an overview and call to appropriate conservative treatment. Med Clin North Am. 2009;93:127-43, xi.
Richmond J, Hunter D, Irrgang J, et al. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad Orthop Surg. 2009;17:591-6000.
Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377:2115-2126.
Ariel D. Teitel, MD, MBA, Clinical Associate Professor of Medicine, NYU Langone Medical Center. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.