Harvard Men's Health Watch

Osteoarthritis: Symptoms and treatment

Arthritis is one of the leading causes of pain and disability in America, and osteoarthritis (OA) is far and away the most common type. OA begins in the cartilage, the smooth, slippery tissue that covers the ends of the bones as they come together in joints. Healthy cartilage allows the joints to move smoothly and painlessly, but in OA the cartilage undergoes chemical and structural changes, then gradually wears away.

Scientists don't fully understand what causes OA, but they have identified factors that increase risk. Advancing age is the most important. Others include a family history of OA, obesity, biomechanical abnormalities that increase stress on joints, serious injuries, and certain repetitive activities such as frequent knee bending and lifting. Poor nutrition may also play a role.

Doctors can confirm a diagnosis of OA by taking x-rays that show the typical joint space narrowing due to loss of cartilage, accompanied eventually by the increased density of the bones near the joint (sclerosis) and bone spurs (osteophytes). In some cases, blood or joint fluid tests may be needed to rule out conditions that mimic OA. Advanced imaging techniques are sometimes important; for example, an MRI can be helpful when OA strikes the spine. But most people can diagnose their own OA based on typical symptoms, and many can treat themselves with diet, exercise, and many nonprescription medications. If these measures don't do the trick, doctors can provide treatments that are usually quite effective.

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