Usually, OA has a gradual onset. Early in the disease, joints may ache after physical work or exercise. Osteoarthritis can occur in any joint. Most often it occurs in the hands, hips, knees, or spine. The symptoms of OA include:

• Steady or intermittent pain in a joint.
• Stiffness after getting out of bed.
• Joint swelling or tenderness in one or more joints.
• A crunching feeling or sound of bone rubbing on bone.
• Hotness, redness and tenderness are not usually associated with OA, but are more often symptoms of rheumatoid arthritis.

Not everyone with osteoarthritis feels pain. In fact, only a third of people with OA show evidence in their X-rays report pain or other symptoms.

OA is one of the most frequent causes of physical disability among adults. More than 20 million people in the United States have the disease, according to data from the National Institute of Arthritis and Muscloskeletal and Skin Diseases. Some younger people get osteoarthritis from a joint injury, but osteoarthritis most often occurs in older people. In fact, by age 65, more than half of the population has damage to at least one joint that would show up on an X-ray. Because the number of older Americans is increasing, so is the number of people with osteoarthritis. Both men and women have the disease. Before age 45, more men have the disease, while after age 45 OA becomes more common in women.

OA is usually caused by wear and tear in the cartilage, which is often an effect of advanced age. In younger people, OA is generally caused by trauma or injury to the joint.

No single test can diagnose osteoarthritis. Most doctors make a diagnosis based on clinical history, physical examination, symptom evaluation or an X-ray. It is usually not difficult to tell if a patient has osteoarthritis. What is harder to determine is whether the disease is causing the patient’s symptoms.

Most successful treatment programs involve a combination of treatments tailored to the patient’s needs, lifestyle, and overall health. Osteoarthritis treatment has four general goals:

• Control pain through drugs and other measures.


• Improve joint care through rest and exercise.


• Maintain an acceptable body weight.


• Achieve a healthy lifestyle.

Doctors also use medicines to eliminate or reduce pain and to improve joint function. Doctors consider a number of factors when choosing medicines for their patients with osteoarthritis. Two important factors are the nature of the pain and potential drug side effects. Patients must use medicines carefully and tell doctors about any changes that occur. The following types of medicines are commonly used in treating osteoarthritis:

• Nonsteroidal anti-inflammatory drugs (NSAID’s). Many NSAID’s are used to treat osteoarthritis.
• COX-2 inhibitors. These medicines reduce inflammation like traditional NSAID’s, but cause fewer gastrointestinal side effects.
• Acetaminophen-containing drugs. This type of drug does not irritate the stomach, and is less likely than NSAID’s to cause long-term side effects. However, this class of medications, while very effective, may have very damaging side effects in people with liver disease, heavy alcohol drinkers and those on blood-thinning medicines should use acetaminophen with caution.
• Surgery is an option as well.