Osteoarthritis

What Is Osteoarthritis?

Osteoarthritis occurs when bones in a joint rub together. Aging, wear on joints, inflammation and bone changes can cause protective cartilage tissue between joints to break down. You may have mild to severe pain when you move the affected joint.

More than 32 million Americans have osteoarthritis, making it the most commonly diagnosed type of arthritis. Osteo is the medical term for bones. Arthritis is the term for diseases that cause painful joint swelling (inflammation) and stiffness.

What are the types of osteoarthritis?

Osteoarthritis most commonly affects your knees. But you can have osteoarthritis in any joint in your body. Types include:
•    Hand and wrist osteoarthritis
•    Hip osteoarthritis 
•    Knee osteoarthritis
•    Neck osteoarthritis 
•    Spine osteoarthritis

What does osteoarthritis feel like?

Osteoarthritis affects everyone differently. The severity of cartilage loss doesn’t always predict how you feel. Some people with minimal joint changes may find it extremely painful to move the joint, while others with severe joint damage may have little, if any, pain.

Osteoarthritis symptoms can range from mild to disabling. Symptoms typically come on gradually and get worse over time as more cartilage wears away. Signs of osteoarthritis include:

• Bumps (bony growths) that form over the affected joint (usually in your hands)
• Difficulty bending or straightening a joint 
• Grinding or crackling sound (crepitus) when moving a joint
• Joint instability, such as a knee giving out
• Pain that worsens with strenuous activity
• Stiffness, swelling and pain that’s worse in the morning or after rest

When should you see a medical professional?

You should see your primary care physician if you have pain that affects your ability to complete daily tasks, sleep or enjoy life.

Your doctor may refer you to a joint specialist, such as:

• Orthopedic doctor 
• Primary care sports medicine doctor
• Physical medicine and rehabilitation specialist (physiatrist)
• Rheumatologist

Why do you get osteoarthritis?

Aging, wear on your joints and other factors can cause cartilage to break down.

Cartilage is a smooth, shock-absorbing tissue at the ends of bones in your joints. It helps bones glide against each other when you move. When this cartilage wears away, the bones press against each other. Extra bone tissue or bone spurs (osteophytes) can form, causing more painful friction in the joint.

There are different causes of osteoarthritis:

• Primary osteoarthritis occurs when cartilage wears down over time due to repetitive use.
• Secondary osteoarthritis occurs when a preexisting condition, such as a joint injury, broken bone or infection, causes cartilage to break down sooner than expected.

Are you at risk for osteoarthritis?

Anyone can develop osteoarthritis. The condition is more common in women older than 50.

Risk factors for osteoarthritis include:

• Excess weight or obesity
• Family history of osteoarthritis
• Joint injuries or fractures
• Metabolic diseases, such as diabetes
• Repetitive stress on your joints from sports, hobbies or jobs

How do doctors diagnose osteoarthritis?

Your doctor will perform a physical exam to check for tenderness, swelling and instability in joints.

You may also get one or more of these tests:

• Blood test: A blood test can help your doctor rule out other causes of joint pain, such as rheumatoid arthritis and gout.
• X-rays: An X-ray can show bone spurs, bone damage and signs of cartilage loss.
• Imaging tests: Your doctor may order an MRI or ultrasound to check for damage to soft tissues in the joint. A CT scan can show bone abnormalities.
• Joint fluid test: Less commonly, your doctor may take a fluid sample from a joint to test for signs of infection and conditions like gout.

How do doctors treat osteoarthritis?

Osteoarthritis treatments can help ease joint pain and swelling so that you can stay active longer.

Your doctor will partner with you to create a personalized treatment plan that relieves symptoms and protects your quality of life. In most cases, our doctors start with nonsurgical treatments. Osteoarthritis treatments include:

Nonsurgical treatments for osteoarthritis

Certain actions can ease symptoms and minimize the loss of joint cartilage. You can:

• Achieve and maintain a healthy weight.
• Alternate applying heat and ice to the affected joint.
• Participate in physical therapy to improve your range of motion in the joint.
• Try integrative medicine therapies, such as acupuncture or massage therapy.
• Use assistive devices, such as a cane or walker.

Medication treatments for osteoarthritis

Your doctor may recommend one or more of these therapies to ease joint pain and swelling:

• Injectable corticosteroids 
• Injectable lubricants (hyaluronic acid)
• Nonsteroidal anti-inflammatory drugs (NSAIDS) 
• Pain relievers
• Supplements, such as glucosamine, turmeric and collagen

Genicular artery embolization (GAE) for knee osteoarthritis

We’re among a few centers in the region offering an advanced minimally invasive osteoarthritis treatment called genicular artery embolization (GAE). An interventional radiologist injects beads into an artery to reduce blood flow to the joint lining (synovium) of the affected knee. The immediate pain relief from GAE can last for months or years.

Genicular nerve ablation (GNA) for knee osteoarthritis

Genicular nerve ablation (GNA) is a minimally invasive, outpatient procedure for severe knee osteoarthritis. It may be an option for patients who can’t get, or don’t want, knee replacement surgery. The treatment uses heat to create lesions on sensory genicular nerves, which stops the nerves from sending pain signals from the knee to the brain.

Interventional radiologists, pain management doctors and physical medicine and rehabilitation specialists (physiatrists) are among the UCLA Health experts who perform this procedure. 

Low-dose radiotherapy (LDRT) for osteoarthritis

Low-dose radiotherapy (LDRT) precisely delivers safe amounts of radiation to an arthritic joint. The treatment reduces the amount of inflammation-causing cells in a joint, helping to ease pain. Our highly skilled radiation oncologists provide this treatment, which typically involves six 10-minute LDRT sessions over three weeks. You can have the treatment multiple times, if needed.

Platelet-rich plasma (PRP) therapy for osteoarthritis

PRP is a regenerative therapy that uses platelets taken from your blood to stimulate the body’s natural healing process. Platelets are a type of blood cell that aids clotting. The treatment causes your body to make more growth factors  proteins that repair damaged tissues and joints. You may need one or more PRP sessions.

During PRP therapy, a health care provider:

• Draws a sample of your blood 
• Uses a centrifuge machine to separate platelets from other blood cells
• Uses the centrifuge to concentrate the platelets within the plasma 
• Injects the platelet-rich plasma into your joint

Surgical treatments for osteoarthritis

If symptoms persist and affect your ability to enjoy life, your doctor may refer you to an orthopedic surgeon. Surgical treatments for osteoarthritis include:

• Arthroscopy: Your surgeon uses a small, flexible scope device (arthroscope) to remove bone spurs, loose bone fragments and damaged tissue from a joint. This minimally invasive surgery takes place through small incisions.
• Cartilage grafting: Your surgeon replaces damaged cartilage with healthy cartilage taken from another part of your body or a donor. 
• Joint fusion: A surgeon uses plates, pins, screws and bone from a donor (graft) to permanently connect bones. Joint fusion stops bones in joints from rubbing together.
• Joint replacement (arthroplasty): During joint replacement, a surgeon removes damaged bone and cartilage and replaces them with prosthetic implants. Your surgeon may replace an entire joint (total joint replacement) or only damaged sections (partial joint replacement). 
• Osteotomy: Your surgeon reshapes the ends of bones to change how they meet and take pressure off the joint.

Promising joint regeneration therapies

The Department of Orthopedic Surgery at UCLA Health is part of multi-institutional, federally funded research team working to develop new osteoarthritis therapies. Our physician-scientists are helping to create injectable medications to help the body make new, healthy cartilage tissue and repair damaged joints. These regenerative therapies will be available in clinical trials. 

Can osteoarthritis get better on its own?

Unfortunately, no. Osteoarthritis is a chronic, degenerative disease. Cartilage may continue to break down over time. 

Actions, such as maintaining a healthy weight and minimizing stress on joints, can ease pain and help you stay active. If the condition impacts your ability to sleep, move and enjoy life, your doctor may recommend surgical treatments.

Can you prevent osteoarthritis?

Certain actions can help protect your joints from osteoarthritis.

You can:

• Engage in lower-impact activities that are easier on joints, such as walking, cycling and swimming. 
• Lose weight, if needed. Studies show that women with excess weight who lose 10 pounds can cut their 10-year risk of knee osteoarthritis in half. 
• Minimize activities that put repetitive stress on joints.
• Seek help to quit smoking, which weakens bones and slows healing.
• Strengthen the muscles that support your joints. 
• Use orthotics in your shoes to provide support and absorb shocks to your body.