Osteoarthritis
Osteoarthritis is a joint disease that mostly affects cartilage. Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage allows bones to glide over each other. It also helps absorb shock of movement. In osteoarthritis, the top layer of cartilage breaks down and wears away. This allows bones under the cartilage to rub together. The rubbing causes pain, swelling, and loss of motion of the joint. Over time, the joint may lose its normal shape. Also, bone spurs may grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space, which causes more pain and damage.
People with osteoarthritis often have joint pain and reduced motion. Unlike some other forms of arthritis, osteoarthritis affects only joints and not internal organs. Rheumatoid arthritis – the second most common form of arthritis – affects other parts of the body besides the joints. Osteoarthritis is the most common type of arthritis.
Osteoarthritis occurs most often in older people. Younger people sometimes get osteoarthritis primarily from joint injuries. Osteoarthritis can occur in any joint. It occurs most often in the hands, knees, hips, and spine.
The most commonly reported symptoms of osteoarthritis include pain and stiffness in affected joints, as well as limited mobility.
However, there is truly a wide range of osteoarthritis symptoms among patients, and the severity of symptoms does not necessarily correlate with the degree of joint damage. For example, a patient with a significantly degenerated joint may have fewer symptoms than a patient with only mild joint degeneration. For many, the symptoms come and go, often with long periods between flare ups.
Typical Signs and Symptoms of Osteoarthritis
For many, osteoarthritis pain may become markedly worse over time or with specific activities. Characteristic signs and symptoms of osteoarthritis include:
- Stiffness. A common marker of osteoarthritis is stiffness in the joint that is most pronounced first thing in the morning, or after a prolonged period of inactivity (such as sitting in a car or airplane). The stiffness usually resolves within 30 minutes of light activity, as the joints “warm up” through gentle movement.
- Pain. Another common symptom is pain in the joint that worsens during or after too much movement. The pain may be experienced as dull and aching, or sharp and piercing. In the most severe cases of osteoarthritis, patients may also feel pain when the joints are at rest or only moving slightly.
- Soreness. The joint may feel tender to touch or with slight pressure.
- Inflexibility. Patients may experience loss of full range of motion in the affected joint.
- Swelling. The joint may swell due to excess fluid buildup. This type of swelling is clinically referred to as effusion. If the swelling is severe, the joint may also feel warm to touch.
- Grating or creaking. There might be a sensation of grating or slight grinding when moving the joint, as the surfaces of the articulating points of the joint no longer move smoothly against each other.
- Is the grating or grinding sensation harmful? See What Is Crepitus?
- Bone spurs. Sometimes, bone bumps – which are points of the bone that grow outward as a result of the joint friction and dysfunction – can be felt under the skin. Bone spurs may also be referred to as osteophytes.
- Deformity. In some types of osteoarthritis, physical deformity may be noticeable. For example, enlarged finger joints may result from the friction causes bony enlargements of the finger joints, or advanced degeneration of knee cartilage can lead to an outward, or bowlegged, curvature of the knee.
While osteoarthritis pain is usually felt in the affected joint, for some patients the pain may be referred to other areas of the body. For example, hip osteoarthritis may lead to knee pain, or spinal osteoarthritis may affect nerves that cause pain, numbness or other symptoms in the part of the body that the nerve leads to.
When the hips or knees are affected, walking can be a significant source of pain, and accommodating pain may induce a limp. Pain can be felt in areas outside the damaged joints, including the buttocks, groin, or thigh and may vary in severity from a dull ache to a sharp pain. The hip is one of largest, most flexible joints in the body. Lifestyle can be greatly affected by hip arthritis symptoms such as limited range of motion, swelling, and pain in the hip, groin, leg and back. The symptoms may come and go, developing gradually, over months or years. The hip is a weight-bearing joint especially prone to wear and tear. It is the third most susceptible site to develop osteoarthritis, after the hand and knee. According to the Centers for Disease Control and Prevention (CDC), the lifetime risk of developing symptomatic hip osteoarthritis is 18.5% for men and 28.6% for women.
Personally, my worst osteoarthritis pain is in my hip, neck and shoulders. So here are some activities that help sometimes.
Mitigation tips & Physical therapy for hip osteoarthritis
Low-impact physical therapy can also keep you flexible and allow your hips to move more smoothly. Good exercises for physical therapy include:
- yoga
- tai chi
- stationary biking
- swimming
If you’re unsure about proper posture and alignment, you may want to consult a physical therapist. They can guide you through exercises and minimize the chance of injury.
Stretching
Stretching on a regular basis can help relieve stiff, achy, or painful joints. All stretches should be done gently. Be sure to stop if you feel pain. Use caution when exercising. If you don’t feel pain after the first few days of exercise, gradually increase the time you spend on this activity.
Here are a few possible stretches:
Forward fold
Start with your feet shoulder-width apart or sit in a chair. Slowly lean forward, keeping your upper body relaxed. You should feel the stretch in your hips and lower back.
Knee pull
Lie on your back. Pull your bent knee up toward your chest until you feel a stretch. If your body allows it, use your other leg to deepen the stretch.
Extended leg balance
This is the same exercise as the knee pull, but it’s done from a standing position. Place one hand along the wall for support.
Cobra
Start by lying face down on the floor. Your palms should be on the floor at shoulder or chest height. Push against your palms to lift your chest off the floor. Feel the stretch in your lower back and hips. Hold this position for 10 seconds. Release. Repeat two or three times.
Osteoarthritis of the neck
Neck osteoarthritis can cause stiffness and pain in the neck. Symptoms of neck OA can include the following:
- pain when holding the neck in the same position for long periods of time
- headaches
- grinding sensation or popping noise when turning the neck
- numbness or weakness in hands, fingers, and arms
- balance impairments
- feeling weakness in the hands and legs
- difficulty walking
- muscle spasms in the shoulders and neck
Help for Neck Pain
We put a lot of impact on our joints over the years. Eventually they start to show the signs of wear and tear. With age, arthritis can cause the joints in our knees, hands, wrists, and feet to become stiff and sore.
Arthritis also affects the vertebrae in our neck, which get worn down from years of supporting our head. After age 60, more than 85 percent of people have arthritis in their neck, according to the American Academy of Orthopaedic Surgeons (AAOS).
If your neck is sore, see a doctor to find out exactly what’s causing your pain. You can visit your family doctor or see a specialist like an orthopedist, rheumatologist, or osteopathic doctor. Your doctor can also advise you on therapies to help relieve the pain such as postural changes, physical therapy, yoga, or Pilates. And your doctor may recommend pain relieving medication or steroid injections.
You can also try basic exercises at home. Though you might be tempted to keep your neck still when it hurts, staying immobile will only increase the stiffness. It will also cause you to lose even more movement. Stretching and strengthening exercises will help keep your neck limber and reduce your arthritis pain.
Here are a few exercises you can try for relieving neck arthritis. Remember to move gently and smoothly through each exercise. Never make any sudden movements or jerk your neck. Twisting and turning your neck is done in the neck rotation exercise. Also, stop if any exercise increases your neck pain.
Neck drop and raise
This stretch works both the front and back of your neck to increase flexibility and movement.
Stand up straight, or sit in a chair. Slowly drop your head forward until your chin touches your chest.
Hold this position for 5 to 10 seconds. Then return to your starting position.
Next, lean your head slightly back and hold this position for 5 to 10 seconds.
Repeat the stretch in each direction five times.
Head tilt
This opposing motion works the sides of your neck.
Stand up straight or sit in a chair. Slowly tilt your head toward your right shoulder while keeping your left shoulder down.
Hold this position for 5 to 10 seconds, then return your head to center.
Repeat on the left side by tilting your head toward your left shoulder and holding your right shoulder down.
Hold this position for 5 to 10 seconds.
Repeat the whole sequence five times.
Neck rotation
Here is another good exercise for the sides of your neck.
Sit in a chair, or stand up with good posture. Slowly turn your head to the right, keeping your chin straight.
Hold this position for 5 to 10 seconds, then return to center.
Slowly turn your head to the left and hold for 5 to 10 seconds. Then return to center.
Repeat five times on each side.
Neck retraction
You should feel this stretch in the back of your neck.
Sit in a chair with your shoulders back and your head straight. Pull your chin straight in, like you are making a double chin.
Hold this position for 5 to 10 seconds while feeling the stretch in your neck.
Return to your original position. Then repeat five times.
Shoulder rolls
While you focus on your neck, don’t neglect your shoulders. Exercising your shoulders will also strengthen the muscles that support your neck.
Shoulder rolls are a basic, easy exercise to keep your shoulder and neck joints fluid.
Sit in a chair or stand with your feet shoulder-width apart. Roll your shoulders up, back, and down in one smooth motion.
Repeat this movement five times. Then reverse the motion, rolling your shoulders up, forward, and down five times.
At first, you may only be able to do one or two repetitions of each exercise. As you get used to the movements, you should be able to increase the number of reps.
In my experience with osteoarthritis, it is often somewhat painful to perform these exercises. I stop when the pain becomes too uncomfortable and usually find that after relaxing for a few minutes following the exercises, I hurt less that before. It feels like putting up with some extra pain for a little while reduces the chronic pain for a while longer. It’s like the contrast of the relaxation period after exercising feels better because the extra exercise pain has stopped.
See more pain relief tips here.