Osteoarthritis (Degenerative Arthritis): An Overview

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Degenerative arthritis is a type of arthritis in which there is a gradual breakdown of cartilage (the protective covering at the end of two bones where they meet a joint) and other tissues surrounding the joints. Degenerative arthritis is commonly referred to as osteoarthritis (OA) or wear-and-tear arthritis and is sometimes called degenerative disease.

The term "arthritis" describes more than 100 conditions that affect the joints. Each type of arthritis causes its own specific symptoms, but most cause joint pain and stiffness.

Degenerative arthritis is the most common form of arthritis, affecting around 32.5 million American adults. It is also a leading cause of disability worldwide. Disability in OA is primarily due to the pain in weight-bearing joints.

Keep reading to learn more about the signs and symptoms of degenerative arthritis, its causes, how it is diagnosed and treated, and prevention strategies. 

Man with degenerative arthritis works with physical therapist

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Degenerative Arthritis Symptoms

The symptoms of degenerative arthritis will vary depending on what joints are affected. Symptoms of the condition will worsen over time.

The only instance in which OA symptoms appear suddenly and become worse quickly is when a joint is injured. That type of OA is sometimes called post-traumatic arthritis. It occurs after a bone fracture or dislocation, and damage causes OA to happen quickly in that affected joint.

Degenerative arthritis causes symptoms in affected joints. These include:

  • Pain (sometimes throbbing)
  • Dull aches
  • Swelling
  • Stiffness
  • Crepitus (clicking or popping when bending the affected joint)
  • Reduced flexibility
  • A reduced joint of motion (limited movement of a joint)

Joint stiffness in degenerative arthritis is generally present in the morning and after rest periods. Stiffness often improves with activity.

The most commonly affected joints in degenerative arthritis are:

  • The hands at the ends of the fingers and the bases and ends of the thumbs
  • Knees
  • Hips
  • Neck
  • Low back

Degenerative arthritis affects people differently. Some people experience mild symptoms that do not affect their day-day-activities. Others might have significant pain and disability. For most people, joint damage from OA slowly occurs over many years. For some, it may occur rapidly.

When to See a Healthcare Provider

Mild joint pain from degenerative disease can be successfully treated at home. However, you should make an appointment with your healthcare provider if you are also experiencing swelling, redness, warmth, and tenderness in a joint.

You want to get immediate medical treatment for joint pain caused by an injury, especially if there is a joint deformity, intense pain, sudden swelling, or you are unable to use the joint.

Causes

Researchers don't know exactly what triggers degenerative arthritis or why the breakdown of tissues starts. But once the condition starts to develop, it can damage various parts of the joints including:

As joint damage progresses, joint pain and swelling, as well as reduced range of motion, occur. If pain is severe, it may cause a person to be less active, leading to muscle weakness over time. Weak muscles cannot support joints very well and affected joints will eventually become deformed.

In addition to damage, bone spurs start to grow on the edges of the deformed joint. Bone and cartilage might also break off and end up inside the joint space. Both events lead to more joint and tissue damage.

Risk Factors

Anyone can get OA, but it is more common as people age. Females are more likely to have OA, especially after age 50 and after menopause. In addition, OA is linked to different risks for the condition, including the following:

  • Genetics: People who are born with joint abnormalities are more likely to develop degenerative arthritis at a young age. Some people might also have genetic defects in joint cartilage that cause them to develop early-onset OA—OA that occurs between the ages of 18 and 44.
  • Weight: Being overweight increases your risk for degenerative arthritis. An extra 10 pounds of body weight increases force on the knees by 30–60 pounds with each step.
  • Injuries: An injury can lead to OA in the injured joint. For example, a runner who experiences knee injuries might be at a higher risk for OA of the knee. Or, someone who has had a back injury might develop OA in their spine.
  • Overuse: Repeated use of the same joints, such as on the job or in sports, can sometimes lead to degenerative arthritis.

What Makes Degenerative Arthritis Different From Other Types of Arthritis

Degenerative arthritis differs from other types of arthritis because of what causes it. For most people, OA is caused by mechanical wear and tear of the body over time and is common with aging.

Other types of arthritis, especially inflammatory autoimmune arthritis, like rheumatoid arthritis and psoriatic arthritis, occur because the immune system malfunctions and starts attacking healthy tissues.

Inflammatory arthritis conditions can occur at any age and affect children, teens, and young adults. They also cause systemic (whole-body) symptoms, like fatigue, fever, and malaise (a general unwell feeling), and affect multiple joints.

In comparison, OA affects one or a few joints on one side of the body and does not cause systemic symptoms.

Diagnosis

A diagnosis of degenerative arthritis is made with a medical history, physical examination, and imaging studies. There are no blood tests to confirm it, but your healthcare provider might perform bloodwork to rule out other conditions that might lead to secondary OA and types of autoimmune arthritis.

Secondary OA occurs because of another disease or condition, such as a congenital (present at birth) joint disorder or autoimmune arthritis.

Medical History

Your healthcare provider will first want to know when symptoms started, past treatment, past joint surgery or injuries, family history of OA, and other details about your health. You will be asked questions about specific symptoms you are experiencing.

Questions your healthcare provider might ask are:

  • Where does it hurt?
  • How much pain are you experiencing in affected joint locations?
  • How long have you had these symptoms?
  • Are your joints stiff in the morning?
  • Do certain activities make the pain worse? If so, which activities?
  • Has your gait (how you walk) changed?
  • Do you have any additional symptoms, especially non-joint ones (fatigue, fever, malaise, etc.)?

You will want to be prepared in advance of your appointment. Write down the information you want to remember for your visit and bring your notes with you to rely on during the appointment.

Physical Exam

During the physical exam, your healthcare provider will assess your joints by touch to look for signs of OA. That examination will assess:

  • Pain levels
  • Joint range of motion
  • Muscle strength in affected areas
  • The presence of swelling and tenderness in an affected joint
  • Your gait, if you have knee or hip pain and other symptoms
  • For evidence of joint deformity or bony spurs

Imaging

If your physical exam and medical history suggest degenerative arthritis, your healthcare provider will request imaging to confirm the diagnosis and learn about the severity of joint degeneration. Imaging includes:

  • X-rays: X-rays can show joint and bone changes and damage.
  • Ultrasound: Ultrasound imaging can better visualize synovial tissue (joint lining), tendons, ligaments, and bone.
  • Magnetic resonance imaging (MRI): MRIs are more detailed than X-rays and can better show damage to joints, bones, muscles, ligaments, and cartilage.
  • Arthroscopy: An arthroscopy might be done to look for degenerative changes in a joint, detect a bone disease or tumor, better understand bone pain and inflammation, or treat a joint condition. The test uses a thin tube with a light and camera attached to look internally at a joint.

Lab Work

There is no single blood test that confirms a diagnosis of degenerative arthritis. But some types of blood tests can rule out other causes of your pain, such as inflammatory arthritis.

If you have severe pain or swelling in a joint, your healthcare provider might perform a joint fluid analysis test. This test uses a needle to pull fluid from an affected joint. The fluid is then tested for signs of inflammation or infection.

Treatment

Damage from degenerative arthritis cannot be reversed. But treatments can reduce pain and help you to move better.

Lifestyle Changes

Lifestyle changes will not cure degenerative arthritis. But these changes will ease your pain, improve your mobility, and slow down future damage.

Manage Weight

Being overweight can stress your joints. Eating a healthy diet and being active regularly can help you reach and maintain a healthy weight. A nutritionist or dietitian can help you to meet weight loss goals.

Exercise

Joint pain might make it harder to exercise, but inactivity can increase your pain and make joints stiff, making it even harder to be active.

The Centers for Disease Control and Prevention (CDC) recommends at least 150 minutes or more per week of moderate-intensity aerobic exercise or 75 minutes per week for vigorous-intensity aerobic exercise for people with arthritis.

Moderate intensity exercise means exercising enough to break a sweat and increase your heart rate. Vigorous-intensity activities cause you to breathe hard and fast, and your heart rate goes up significantly.

Reduce Stress

Stress can make arthritis pain worse. Since you cannot make OA go away, you will need to focus on self-care.

Ways to prioritize your self-care include:

  • Relaxation: You can find relaxation each day through simple things, like a walk, a warm bath, meditation, or yoga.
  • Talk it out: Talk to a trusted friend or family member, religious leader, or mental health professional. Talking to someone helps you put stressful issues into perspective and offers you another point of view on your situation.
  • Learn to say no: You do not have to take on every task you are asked to do. You are allowed to say no, delegate, or give yourself time to slow down and rest.

Medicines

There are many different medicinal options to help manage symptoms and pain from degenerative arthritis. Treatments include pills, topicals, and injections. They include:

  • Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs): Analgesics like Tylenol (acetaminophen) and NSAIDs like Advil (ibuprofen) can help relieve pain. NSAIDs can also bring down inflammation. You can find these pain relief drugs over the counter, but your healthcare provider can prescribe stronger pain relievers if necessary.
  • Topical pain relief: These creams, lotions, and ointments contain ingredients like capsaicin or menthol. When applied to painful joints, topical treatments can stop the pain.
  • Corticosteroids: These are sometimes given as an injection to people with degenerative arthritis. The injection is given directly into a joint to offer pain and symptom relief for weeks or months at a time.
  • Hyaluronic acid: Hyaluronic acid naturally occurs in the joints and acts as a lubricant. It can break down in people with degenerative arthritis, so your healthcare provider might recommend injections of the fluid. The injection is usually given at the site of the affected joint. Your healthcare provider might remove access fluid before giving you the hyaluronic acid injection.

Physical Therapy

Physical therapy can help increase your mobility and balance and improve joint function and flexibility. Exercise can help you maintain a healthy weight and reduce stress on your joints. Just be careful not to overuse joints and make OA symptoms worse.

The safest exercises for people with degenerative arthritis are low-impact exercises like walking, biking, and swimming. Your healthcare provider or physical therapist may have additional recommendations or ideas to help you keep moving.

Surgery

Your healthcare provider might suggest surgery when lifestyle changes, physical therapy, and medicines do not help manage degenerative arthritis pain and there is severe joint damage.

Different surgical options are available. Your healthcare provider will recommend one based on the affected joint and how much pain you are experiencing.

Surgical options for people with damage from degenerative arthritis might include:

  • Joint replacement: With this procedure, the damaged joint is replaced with an implant that copies the motion of a natural joint.
  • Arthroscopy: This surgical procedure can fix tears in the soft tissues, repair damaged cartilage and ligaments, and remove free-floating cartilage pieces.
  • Joint resurfacing: This procedure replaces the damaged part of a knee or hip joint rather than the entire joint.
  • Osteotomy: With this procedure, the surgeon will cut and remove bones or add a wedge near a damaged joint. The goal is to shift weight from an area damaged by OA or that is misaligned.
  • Arthrodesis: Also called joint fusion surgery, this procedure uses pins, plates, rods, and other hardware to connect two or more bones. Over time, the bones will grow together and lock the joint in its correct place. This procedure is usually done on an ankle, wrist, thumb, finger, or the spine.

Complications of Degenerative Arthritis

While rare, degenerative arthritis can lead to serious complications. Complications of OA include:

  • Osteonecrosis: Bone death
  • Chondrolysis: A complete breakdown of cartilage causing bone tissue to enter the joint
  • Stress fractures: Hairline cracks in the bone after injury or stress to a joint
  • Infection or bleeding in joints
  • Deterioration of ligaments, tendons, and other surrounding joint tissues
  • Pinched nerve if OA affects the spine

Your healthcare provider can help create a treatment plan for degenerative arthritis, which can reduce the potential for these complications.

Prevention

Degenerative arthritis is more common with age, and while it may not be able to slow time, you can still take steps to prevent OA or its progression.

Steps to take to prevent OA or its progression are:

  • Maintaining a healthy weight: If you are at a healthy weight, maintaining that weight can help you to prevent stress on your joints that leads to degenerative changes. If you are overweight, losing weight can help to reduce stress on joints that lead to joint damage.
  • Exercise: Being active is the best way to prevent joint problems. It can also keep joints from getting stiff and it keeps muscles strong. Talk to your healthcare provider about safe exercises you can do.
  • Prevent joint injury: Joint injuries increase the risk for degenerative arthritis. When you exercise, you should start slowly and work up to your goal. You should also be careful with daily activities, especially those that put stress on joints. Be mindful of your posture when lifting, sitting, or standing, especially when you carry heavy items.
  • Pay attention to pain: If you experience joint pain after an activity, you may have done too much. Rest affected joints, and use ice to relieve pain and swelling.

Summary

Degenerative arthritis, commonly referred to as osteoarthritis or wear-and-tear arthritis, affects millions of Americans. Over time and as people age, the protective cartilage at the ends of bones wears down. While degenerative arthritis can affect any joint, it mainly affects the knees, hips, spine, and hands.

OA can be managed, but joint damage can't be reversed. Staying active and maintaining a healthy weight can help to prevent the disease or reduce its progression.

There are many treatment options for OA pain and other symptoms. Surgery is generally the last option considered for managing pain and repairing damage to a joint. It can help reduce pain and improve mobility and quality of life.

A Word From Verywell

Degenerative arthritis will get worse with time, especially if left untreated. It can also lead to disability. But most people can enjoy a full and healthy life despite their condition.

Work with your healthcare provider if OA is affecting your quality of life. There are plenty of treatment options available, including surgery to replace damaged and painful joints. Treating OA is the best way to improve symptoms, your ability to get around, and your life quality.

Frequently Asked Questions

  • How serious is degenerative arthritis?

    Most people can manage degenerative arthritis with lifestyle therapies and medications. But it can be a severe condition for some, and you might need surgery to repair joint damage.

  • Can degenerative arthritis cripple you?

    Degenerative arthritis can become a crippling condition if left untreated. It can cause debilitating pain and disability.

  • What are the four stages of osteoarthritis?

    Osteoarthritis is often progressive, which means symptoms will get worse with time. OA stages are used to create a treatment plan:

    • Stage 0: The asymptomatic (no symptoms) stage
    • Stage 1: Early OA presenting with mild joint pain
    • Stage 2: Mild/minimal, presenting with difficulty bending joints and joint stiffness
    • Stage 3: Moderate stage, causes pain with movement, stiffness in the morning and with activity, and visible swelling in joints
    • Stage 4: Severe, causing high pain levels with movement, intense stiffness, severe swelling and inflammation, and difficulty with performance of daily activities
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