Osteoarthritis occurs as a result of the breakdown of the cartilage in the joints. In a normal joint, the ends of the bones are covered with cartilage: a durable, elastic tissue that protects the bones and allows the joint to move freely. Cartilage gets the oxygen and nutrients it needs by absorbing them, like a sponge, from the joint fluid (called synovial fluid). As the joint bends, waste products are squeezed out of the cartilage; as the joint relaxes, nutrients and oxygen are absorbed. (Controlled movement, therefore, benefits the joints.)
In osteoarthritis, the cartilage thins out and may even wear away, leaving areas where bones rub directly against each other. As a result, the edges of the bones may thicken and form bony swellings called spurs (medically known as osteophytes). Stiffness and dull pain in the joints, with little or no inflammation, are generally the result. These are the typical symptoms of osteoarthritis.
The weight-bearing joints (hips, knees, and spine) are most frequently involved in osteoarthritis. Other joints often affected are the finger joints closest to the tips of the fingers, which may develop bony knobs. The joint at the base of the thumb and the big-toe joint may also be affected. Osteoarthritis rarely affects the wrists, elbows, shoulders, ankles, or jaw. Although osteoarthritis may affect more than one joint at a time, the disease does not affect other systems or organs of the body.
Osteoarthritis is considered a chronic disease, but it may not necessarily get progressively worse, and many people with the condition are relatively free of symptoms. Few people are severely disabled by the disease.
While a breakdown of the cartilage in the joints is essentially the source of the symptoms of osteoarthritis, it is not always clear why this breakdown occurs. Most often, the thinning of the cartilage is attributed to years of wear and tear and the inability of the body to repair the resulting damage.
Previous injury that causes inflammation in a joint can also make it more likely to be affected by osteoarthritis. Unusual stress on a joint, either through a repetitive activity -- such as typing or playing a sport -- or because of excess body weight, may bring about the changes associated with osteoarthritis, perhaps earlier than is typical.
Some individuals are born with a misalignment of their joints that leaves them prone to osteoarthritis. And in some cases, there appears to be a genetic component.
Diagnosing osteoarthritis can be difficult, partly because the disease's symptoms may be mistaken for those of other conditions, including injuries, muscle or spinal-disc problems, or even other forms of arthritis. X-rays and laboratory tests can help rule out other conditions. But perhaps the most valuable diagnostic tool available to doctors is the physical examination, including a medical history and a detailed discussion of the symptoms.
To help your doctor make a diagnosis, be prepared to tell him or her which part of your body hurts; what the pain feels like, when it began, and how long it lasts; what, if anything, seems to trigger the pain or make it worse; when and if you have stiffness or other symptoms; what activities you may have trouble doing; and what, if anything, helps to relieve your pain.
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