Osteoarthritis: DiagnosisTreatmentand Steps to Take

Diagnosis of Osteoarthritis  

There is no single test for osteoarthritis. Diagnosing the condition may include the following:

• Providing to a doctor a medical history that includes your symptomsany other medical problems you and your close family members haveand any medications you are taking.
• Having a physical exam to check your general healthreflexesand problem joints.
• Having images taken of your joint using:
  • X-rayswhich can show loss of joint spacebone damagebone remodelingand bone spurs. Early joint damage does not usually appear on x-rays.
  • Magnetic resonance imaging (MRI)which can show damage to soft tissues in and around the joint. GenerallyMRI helps health care providers evaluate a joint that is locking or giving out.
• Having blood tests to rule out other causes for symptoms.
• Taking joint fluid samples to look for other causes of joint painsuch as infection or gout.

Treatment of Osteoarthritis

The goals of your treatment for osteoarthritis include:

• Reducing pain and other symptoms.
• Improving joint function.
• Stopping the disease from progressing.
• Maintaining a health-related quality of life to help prevent disability.

Treating osteoarthritis usually begins with:

• Learning about osteoarthritis. Your doctor may recommend classes that you can attend or online programs you can join.
• Exercisingwhich can reduce joint pain and stiffness and increase flexibilitymuscle strengthand endurance. Remember to start any exercise program slowly and take the time to adjust to the new level of activity. You should speak to your doctor or physical therapist about a safewell-rounded exercise programwhich may include:
  • Range-of-motion and stretching activities to keep your joints limber.
  • Strengthening exercises performed with weights or exercise bands to strengthen muscles that support joints affected by arthritis.
  • Exercises in the water to help lower the stress on the joints while exercising.
  • Balance and agility exercises to help you maintain daily living skills.
  • Low-impact activities that give you a moderate level of activity without putting stress on the joints. These may include walkingcyclingswimmingtai chiwater aerobicsor a low-impact aerobics class.
• Managing your weight can help reduce the stress on joints. In additionif you are overweight or obeselosing weight can help to reduce painprevent more injuryand increase mobility in the joints. This can be especially helpful for weight-bearing joints such as your knees or hips.
• Using braces or orthotics that your doctor prescribes and that are fitted by a health care professional may be helpful to stabilize a joint affected by osteoarthritis.

Some people may need medications to help manage the symptoms of osteoarthritisincluding:

• Oral pain relievers.
• Oral anti-inflammatory medications to treat pain and inflammation.
• Topical creamsrubsor sprays that you apply to the skin over sore joints to relieve pain.
• Corticosteroidsstrong inflammation-fighting drugs that are usually injected into the joint to temporarily relieve pain. Because they are potent drugsyour doctor will determine how many injections you should receive and how often to achieve the desired benefit.
• Hyaluronic acid substitutes (viscosupplements)which are injected into the knee to replace a normal component of the joint involved in lubrication and nutrition are sometimes recommended for knee osteoarthritis.
• Selective serotonin and norepinephrine reuptake inhibitors that you take orally to help control chronic (long-term) pain.

If other treatments are not helping and if the joint damage is extensivesome people may have surgery. When considering surgerymany factors may determine if it is the right optionincluding your agepain intensitythe degree to which arthritis interferes with your lifelevel of disabilityand occupation. Surgeries may include one or more of the following:

• Osteotomy: Surgical removal of a piece of bone.
• Partial or total joint replacement surgery: Removal of part of all of the damaged joint and replacing it with a new joint made of plasticmetalor ceramic.

Other therapies such as massage can increase blood flow and bring warmth to the area. Some research shows that acupuncture may help relieve osteoarthritis pain. Doctors believe that the needles stimulate the release of naturalpain-relieving chemicals produced by the nervous system. Before using other therapiestalk to your doctor about the best options for your treatment.

Who Treats Osteoarthritis?

Treating osteoarthritis requires a team effort involving you and several types of health care professionals. These may include:

• Rheumatologistswho specialize in arthritis and other diseases of the bonesjointsand muscles.
• Primary care doctorssuch as a family physician or internal medicine specialistwho coordinates care between the different health providers and treats other problems as they arise.
• Orthopaedic surgeonswho specialize in treatment and surgery for bone and joint diseases.
• Physical therapistswho help improve joint function.
• Occupational therapistswho teach ways to protect jointsminimize painperform activities of daily livingand conserve energy.
• Dietitianswho teach about nutrition and maintaining a healthy weight.
• Nurse educatorswho help you understand your condition and help start treatment plans.
• Physiatrists (physicalmedicineand rehabilitation specialists)who supervise exercise programs.
• Psychologists or social workerswho help with psychosocial challenges caused by medical conditions.
• Chiropractorswho focus treatment on the relationship between the body's structuremainly the spineand its functioning.