Osteoarthritis Guidebook | Information for an Active Life

OSTEOARTHRITIS

GUIDEBOOK Information for an Active Life

A University of Colorado and Colorado State University COMMUNITY OUTREACH INITIATIVE

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Introduction

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What is osteoarthritis (OA)?

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Causes and Risk Factors

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Diagnoses & Treatments

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Understanding Treatments

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OA and your heart

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Glossary

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Types of Arthritis

DISCLAIMER Information and statistics presented in this guidebook are compiled from the Centers for Disease Control and the Arthritis Foundation websites.

This guidebook is intended for informational and educational purposes only. It does not substitute professional medical advice or consultation with healthcare professionals. It should not be used in place of an actual doctor’s visit.

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What is Osteoarthritis?

Osteoarthritis (OA) is the most common type of arthritis, affecting over 32.5 million adults in the U.S. It is a degenerative disease that impacts various parts of a joint including bones, cartilage, and ligaments.

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Not just “wear and tear” from aging Although linked with aging and referred to as a "wear and tear" condition, osteoarthritis can affect anyone and involves more than just the aging process.

While it often appears in those over the age of 50, OA can develop in younger people, too, especially those who have had a prior joint injury, such as a torn ACL or meniscus.

OA can cause cartilage breakdown, bone changes, and inflammation, leading to pain, stiffness, and reduced mobility.

Causes and Risk Factors age | higher risk as you age, typically after 50 biology | those assigned female at birth are more prone to developing OA environmental factors | occupation, activity levels, and other lifestyle choices genetics | a family history of OA increases your risk joint injury | injuries can accelerate OA development musculoskeletal abnormalities | mis-alignment of bones and joints can speed up OA obesity | extra weight increases joint stress and inflammation overuse | repetitive use of joints in jobs or sports weak muscles | inadequate muscle support can lead to poor joint alignment

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All articulating joints and several areas of the body can be affected by osteoarthritis fingers | joints may grow bony spurs, becoming swollen and tender

neck and shoulders | stiffness, especially in the morning; grinding or crunching noises low back | decreased motion, muscle spasms, stiffness

elbows | feeling of grating or locking, cracking of the joint

hips | pain might be felt in the groin or buttocks and occasionally the knee or thigh

knees | you might feel a grating sensation, stiffness, swelling, or instability

feet | pain often occurs in the big toe, with possible swelling in ankles or toes

Diagnosis Diagnosis involves reviewing your medical history, a physical exam, and possibly imaging tests like X-rays or MRIs. Fluid may be drawn from the joint to rule out other conditions.

While there's no cure (yet) for OA, treatments can help manage symptoms.

Treatments Medications | pain relievers like acetaminophen and NSAIDs like ibuprofen help manage pain. Other options include creams, gels, or injections like corticosteroids or platelet-rich plasma Exercise | regular movement helps maintain joint function and reduce pain Weight loss | reducing weight can decrease joint stress Physical and occupational therapy | these can provide specific exercises and assistive devices to help manage symptoms Surgery | in severe cases, joint replacement might be necessary to improve function and reduce pain

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The pain and decreased mobility from OA can lead to less physical activity, which increases the risk of obesity, diabetes, heart disease, and falls. People with OA have a higher chance of falling and fracturing bones.

Maintaining a healthy weight, managing blood sugar levels, staying active, and protecting your joints can help manage OA and improve your overall well-being.

Understanding Treatments for OA Medications No current medication can halt osteoarthritis, but many can reduce pain.

Acetaminophen (Tylenol) | often effective for mild to moderate pain Nonsteroidal anti-inflammatory drugs (NSAIDs) | Drugs like ibuprofen (Motrin or Advil) and naproxen (Aleve) reduce pain and, in higher doses, inflammation Duloxetine (Cymbalta) | originally an antidepressant, it's also used for chronic pain Tramadol (Ultram) | a prescription pain reliever for severe OA pain, but it has addiction risks

For targeted relief, topical treatments like creams or patches can be applied directly to the joints.

Ingredients like capsaicin, salicylates, and menthol can help relieve pain through the skin.

For deeper joint pain, corticosteroid or hyaluronic acid injections might be recommended.

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Additional Pain Relief Methods Heat and cold treatments | heat can improve blood flow and relax stiffness, while cold can reduce pain and swelling Relaxation techniques | methods like deep breathing and guided imagery can relax your body and reduce pain Acupuncture and massage | these can help relieve OA pain and improve joint function Support devices | braces, splints, and special footwear can reduce joint stress

Weight Loss If you're carrying extra weight, losing some can greatly ease the pressure on your joints—every pound lost reduces four pounds of pressure on weight-bearing joints. Studies show significant weight loss can improve pain levels and overall quality of life for those with OA.

Exercise and Physical Therapy Regular exercise is crucial. It keeps you moving, eases pain, helps with weight loss, and lowers the risk of other health issues. Consider gentle activities like walking, cycling, swimming, yoga, and water aerobics.

If joint pain limits your movement, a physical therapist can tailor an exercise plan that suits your needs.

Healthy Lifestyle Tips Quit smoking | smoking can worsen joint pain and interfere with surgery recovery Use assistive devices | tools that help with daily tasks can make life easier Emotional support | managing pain and mobility issues can be tough, so consider seeking support for emotional well-being Discuss your needs | whether at home or work, communicate your limitations and needs to those around you Diet and supplements | eating well and considering supplements like glucosamine might help, though their effectiveness varies

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Surgery

If other treatments don’t provide relief, surgery like joint replacement might be considered to alleviate pain and restore function.

Work with your doctor to find the best combination of treatments for your specific situation.

Having osteoarthritis (OA) might raise your chances of getting heart disease.

Here’s what you need to know and how you can look after your heart.

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Osteoarthritis and Heart Health Even though osteoarthritis is mostly known for causing joint damage, pain, and swelling, it can also affect other parts of your body, including your heart. Research indicates that people with OA are nearly three times more likely to suffer from heart disease or heart failure compared to those without OA. This risk is particularly high if the arthritis affects the knees or hips.

While osteoarthritis isn’t typically seen as an inflammatory disease, newer studies suggest it does involve some inflammation, which can contribute to heart disease.

Aging plays a role in both conditions, leading to harder and stiffer arteries that can cause high blood pressure and heart damage, and to joints wearing out over time.

Staying active is key for keeping your heart and joints healthy Studies have found that OA patients who don’t exercise are more likely to develop heart disease and die from it. If joint pain is stopping you from being active, consider joint replacement surgery to help regain your mobility and reduce your risk of heart disease.

Being overweight can also increase your risk of both OA and heart disease. Extra weight strains your joints and heart, potentially leading to damage. Fat cells can also produce chemicals that inflame your joints, heart, and blood vessels.

Metabolic syndrome—a mix of conditions like high blood pressure, high blood sugar, excess belly fat, and abnormal cholesterol levels—is common in people with OA, with about 60% of OA patients having these issues compared to 23% of the general population. This syndrome can increase your heart disease risk and potentially worsen joint damage.

Although you can’t reverse aging, you can manage other risk factors Talk to your doctor about your ideal weight and try to achieve it through diet and exercise.

Engage in low-impact exercises such as swimming, bicycling, or walking, which are easier on your joints.

Regularly check your blood sugar, blood pressure, and cholesterol with your doctor. Manage any outof-range levels through diet, exercise, and possibly medications.

Use the lowest possible dose of NSAIDs like ibuprofen or naproxen for the shortest time needed to manage your pain, and consider non-drug pain relief methods like ice, heat, and massage.

If pain is keeping you from exercising, discuss with your doctor whether joint replacement surgery might be an option for you. Weigh the potential benefits and risks before deciding.

GLOSSARY

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A

Analgesics | medications that relieve pain without causing loss of consciousness

Arthritis* | a condition that causes pain, swelling, and stiffness in your joints, making it hard to move and do everyday activities. There are more than 100 types of arthritis

Arthroplasty | surgical rebuilding or replacement of a joint

Articular Cartilage | the smooth, white tissue that covers the ends of bones where they come together to form joints, allowing bones to glide over each other with minimal friction

*many of the different types of arthritis are listed at the end of this glossary

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Bone Spurs | bony projections also known as osteophytes that develop along the edges of bones in joints affected by osteoarthritis Bursa | a sac filled with lubricating fluid, located between tissues — such as bone, muscle, tendons and skin — to decrease rubbing, friction and irritation

b

C

23 Cartilage | a firm, rubbery material that covers the ends of bones in normal joints and serves as a cushion between bones, allowing smooth joint movement Corticosteroids | drugs that work to decrease inflammation and pain.

Often called "steroids," drugs in this category are prednisone or prednisolone

Cortisone | a potent antiinflammatory corticosteroid that may be given as an injection (shot) to decrease swelling and relieve pain

Degenerative | the gradual deterioration of tissue or organs over time, often associated with aging

d

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Glucosamine and Chondroitin | nutritional supplements often taken together to help manage the symptoms of osteoarthritis

H

g

Hydrotherapy | a program of exercises performed in a large pool. Hydrotherapy may be easier on painful joints because the water takes some of the weight off the painful areas while enabling resistance training. Hydrotherapy also is called aqua therapy or water therapy

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Immune system | the body’s specific defense system against diseases Inflammation | a process by which the body's white blood cells and chemicals protect the body against infection and foreign substances such as bacteria and viruses

Parts of the body can become red, swollen, hot, and painful. It can happen when you're injured or have an infection.

Inflammation can happen on the inside of your body where you cannot see it.

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J

Joint | the area where two or more bones meet, allowing movement of the skeleton

Joint Deformity | abnormal positioning or shape of a joint, often caused by damage from osteoarthritis

Joint Fusion | a surgical procedure that fuses the bones in a joint, typically to relieve pain and improve stability

Joint Replacement Surgery | a surgical procedure in which natural joints are replaced with synthetic ones to restore function in the affected area

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M

Meniscus | The meniscus is a specific type of cartilage found in the knee. It is C-shaped and acts like a cushion between the thigh bone and shin bone, helping to stabilize the knee and absorb shock during movement.

The meniscus is made of cartilage, but not all cartilage is a meniscus

n

Non-weight-bearing joint | a joint that does not bear the weight of the body, such as the shoulder or elbow

NSAIDs (Nonsteroidal AntiInflammatory Drugs) | a class of medications that reduce pain, inflammation, and fever such as Advil or Motrin or Ibuprofen

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o

Osteoarthritis (OA) | a condition where the cartilage and bone in a joint wear down over time. This can cause pain, stiffness, and difficulty moving the joint

p

Physical Therapy | a program of exercise and other treatments to help keep your muscles strong and your joints from becoming stiff. A physical therapist can show you how to use special equipment to help you move better and how to use devices such as crutches, walkers and canes

Range of Motion | the extent of movement a joint can achieve, usually measured in degrees Rehabilitation | the process of helping someone recover from an injury, illness, or surgery. It often involves exercises, therapy, and other treatments to improve strength, mobility, and function. Rehabilitation does not usually involve being hospitalized

S

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Stiffness | a reduced ability to move a joint freely, often accompanied by pain or discomfort Synovial joint | a type of joint in your body that allows movement, like in your knees, elbows, and shoulders.

These joints are surrounded by a capsule and contain synovial fluid, which helps lubricate and cushion the joint for smooth movement

W Weight-Bearing Joint | a joint that supports the weight of the body, such as the hip, knee, or spine

Types of Arthritis Achilles tendinitis Achondroplasia Acromegalic arthropathy Arthritis is an Adhesive capsulitis umbrella term for Adult-onset still’s disease more than 100 Ankylosing spondylitis conditions Anserine bursitis Avascular necrosis Behcet’s syndrome Seronegative arthritis Blount’s disease Brucellar spondylitis Bursitis Caplan’s syndrome Carpal tunnel syndrome Chondrocalcinosis Chondromalacia patellae Chronic synovitis Churg-Strauss syndrome Viral arthritis Cogan’s syndrome Crest syndrome Cryoglobulinemia Diabetic finger sclerosis Diffuse idiopathic skeletal hyperostosis (DISH)

Discitis Discoid lupus erythematosus Drug-induced lupus Duchenne’s muscular dystrophy Dupuytren’s contracture Ehlers-Danlos syndrome Enteropathic arthritis Epicondylitis Erosive inflammatory Exercise-induced compartment syndrome Felty’s syndrome Femoral epiphysis Fibromyalgia Fifth’s disease Flat feet Foreign body synovitis Freibert’s disease Fungal arthritis Arthritis is Gaucher’s disease among the Gout leading causes Granulomatous arteritis of disability in Hemarthrosis adults in the US Hemochromatosis Hip dysplasia Henoch-Schoenlein purpura

Hurler syndrome Immune complex disease Juvenile idiopathic arthritis Kawasaki disease Legg-calve-perthes disease Lyme disease Marfan’s syndrome Mucopolysaccharidosis Myofascial pain syndrome Neonatal lupus Ochronosis Osgood-shlatter’s disease Osteoarthritis Osteomalacia Osteonecrosis Osteoporosis Overlap syndrome Pachydermoperiosteosis Plantar fasciitis Polymyalgia rheumatica Popliteal cysts Pott’s disease Prosthetic joint infection Reiter’s syndrome Retrocalcaneal bursitis

Osteoarthritis (OA) can affect people of any age. About 7% of people aged 18 to 44 have OA

Reynaud’s phenomenon Rheumatic fever Rheumatoid arthritis Rheumatoid vasculitis Sarcoidosis Saturnine gout Scleroderma Septic arthritis Shigella arthritis Sickle cell arthropathy Sjogren’s syndrome Spinal stenosis Spondylolysis Staphylococcus arthritis Stickler syndrome Subacute cutaneous lupus Sweet’s syndrome Tarsal tunnel syndrome Tennis elbow Tuberculosis arthritis Urticarial vasculitis Viral arthritis Wegner’s granulomatosis Whipple’s disease Wilson’s disease

Osteoarthritis affects women and people of color more than others.

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LetsCureOA@CUAnschutz.edu