As of Thursday, August 22, 2013
DEAR DOCTOR K: My joints hurt. Does that mean I have osteoarthritis?
DEAR READER: Your knee aches from time to time, or maybe your fingers don’t seem as nimble as they used to be. That doesn’t mean you have osteoarthritis — but you might.
There are many different kinds of arthritis. They all damage the cartilage, the flexible tissue lining joints. Every joint is a spot where two (or more) bones meet. The cartilage in a joint keeps bone from rubbing against bone.
Osteoarthritis is the most common type of arthritis. I am one of its victims: It ruined my right hip and required a total hip replacement. Medical research is starting to understand what leads to the slow degeneration of cartilage seen in osteoarthritis, but we still don’t have a complete picture.
In my right hip, for example, the cartilage had been getting progressively thinner for years. I didn’t know it, because it wasn’t causing symptoms. But when bone started to rub against bone, I had symptoms — mainly pain.
As in my case, the symptoms of osteoarthritis usually develop over many years. The first sign is often joint pain after strenuous activity or overusing a joint. Joints may be stiff in the morning, but loosen up after a few minutes of movement. As the condition gets worse, the pain becomes more continuous. The joint may be mildly tender much of the time, and movement may cause a crackling or grating sensation. Some people have continual joint pain that is bad enough to interfere with sleep.
People with osteoarthritis often have it in more than one joint. It is most common in the knee, hip, lower back, neck and certain finger joints.
If you suspect you have osteoarthritis, see your doctor. There’s no definitive test for it. Your doctor will make the diagnosis based on your description of symptoms, a physical examination and perhaps some additional tests.
Prepare for your appointment by making a list of your symptoms and the circumstances under which they occur. Do you notice them during or after a particular activity? Are they worse first thing in the morning? Your symptoms — what they are, when they first began and how they’ve changed over time — provide important clues for your doctor.
During the physical exam, your doctor will watch how you move and will look at your joints for specific abnormalities. The bony enlargement of a joint without swelling is a classic sign of osteoarthritis. The doctor will also move your joints through their range of motion to detect any pain, resistance, unusual sounds or instability. Your doctor may also order an imaging test, such as an X-ray.
If you do have osteoarthritis, treatment will help you manage your pain and preserve the function of your affected joints. Most people with osteoarthritis just require pain medicines. But when a joint is badly damaged, joint replacement surgery can fix the problem.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.