• Osteoarthritis


Osteoarthritis, also known as “degenerative joint disease,” is considered a non-inflammatory type of arthritis affecting primarily the cartilage

Osteoarthritis is common

  • Osteoarthritis is the most common form of arthritis. It causes more work disability in the United States than any other disease.
  • Arthritis affects 20% of Americans, about half of whom primarily have OA.
  • DJD is found radiographically in almost all 75-year-old patients, most of whom are asymptomatic.



  • Generalized OA: Involves five or more joints, most often
    • DIP joints of the hand (Herberden nodes)
    • PIP joints of the hand (Bouchard nodes)
    • First carpometacarpal joint
    • First MTP joint of the feet
    • Knee
    • Hip
    • Spine
  • Large-joint OA: Might occur as part of generalized OA or alone.
    • Knees
    • OA
  • Erosive OA: Rare

Hereditary (resulting from collagen gene defects)

Secondary: Results from previous cartilage damage.

  • Episodic trauma
  • Congenital anatomic abnormalities (slipped capital femoral epiphyses, congenital hip dysplasias)
  • Neuropathies
  • Endocrine & Metabolic causes (obesity, hemochromatosis, Wilson disease, CPPD disease, Paget disease, acromegaly)

Clinical Findings

Most OA is asymptomatic.

Symptomatic OA is characterized by

  • Local pain of gradual onset exacerbated by using the involved joint. Pain typically worsens as the day progresses and is relieved by rest

Treatment Options

Non-pharmacologic Therapy

  • Patient education and self-management programs including rest during pain, avoidance of trauma, etc.
  • Weight loss
  • Physical and occupational therapy
  • ROM and strengthening exercises
  • Aerobic conditioning especially swimming and walking
  • Assistive devices for ambulation and activities of daily living (canes, walkers, bathtub, toilet wall bars, etc.)
  • Acupuncture

Pharmacologic Therapy

  • Oral non-opioid analgesics (acetaminophen)
  • Topical analgesics (capsaicin cream)
  • NSAIDs (Naproxen, Ibuprofen, Diclofenac, Indomethacin, Piroxicam)
  • CoX2 inhibitors (Celecoxib)
  • Intra-articular injections: Steroid, Platelet Rich Plasma (PRP), Hyaluronate, Ozone
  • Opioid analgesics (e.g., Tramadol)

Surgical Therapy

  • Closed tidal joint lavage
  • Arthroscopic debridement and joint lavage
  • Osteotomy
  • Total joint arthroplasty

Recent Studies Show

  • Some foods can fight osteoarthritis (Details)