Wear and Tear Arthritis

Osteoarthritis is not just a consequence of aging

Osteoarthritis is a painful condition in which wear and tear leads to inflammation and degeneration of your joints, such as the knees, hip, and shoulder—hence it's nickname, wear and tear arthritis. Specifically, it's the cartilage inside the joints that is worn away. This can occur due to aging, but also use. Osteoarthritis can cause considerable pain and disability, but many treatments are available.

1:35

7 Risk Factors for Developing Osteoarthritis

Wear and Repair

Cartilage undergoes a normal cycle of breakdown and repair. As the joint surface wears away, your body attempts to replace it using an inflammatory response.

The fundamental problem of osteoarthritis is thought to be the imbalance between natural degradation and this fresh cartilage production. As the joint swells, new bone is created to increase the surface area of the joint. And when your body cannot compensate for the cartilage that is lost, osteoarthritis is the result.

This is part normal wear and tear and part disease process. Because the cartilage is not replaced effectively, the joint lining wears thin.

A Deeper Loss

While osteoarthritis was once thought to be confined to the cartilage surface, it is now known that osteoarthritis goes deeper, affecting the entire joint. All of the cartilage can be lost and you can develop damage to bone, the formation of bone spurs, and inflammation of the soft tissues.

Knee pain in older man
seb_ra / Getty Images

Is It Inevitable?

Osteoarthritis tends to affect older people, but researchers don't yet fully understand why some people develop arthritic changes in their 40s and 50s while others live long lives with few joint problems.

People once thought that osteoarthritis was simply due to the demands they placed on their joints throughout life, attributing their joint deterioration to the activities of their youth. Research has taught us, though, that it's not that simple. Many avid runners and competitive athletes have no problems with arthritic joints, while others have severe arthritis.

Doctors now understand that osteoarthritis is not an inevitable part of aging. It seems as though a combination of different factors leads to the development of osteoarthritis in individuals.

In different people, different factors may be more important, but it is unusual to have just one underlying problem that causes osteoarthritis.

Treatment

Treatments for osteoarthritis are directed at controlling the inflammatory response and maximizing your body's ability to compensate for joint wear and tear.

Drugs

Medications serve the dual purpose of helping to reduce inflammation and pain. Your doctor may consider:

  • Anti-inflammatory medications: Non-steroidal anti-inflammatory medications, also called NSAIDs, are oral medications that help control the cycle of inflammation and reduce pain. Common NSAIDs (both over-the-counter and prescription) include Motrin/Advil (ibuprofen), Naprosyn/Aleve (naproxen sodium), and Celebrex (celecoxib).
  • Cortisone injections: Cortisone is a natural anti-inflammatory produced by your adrenal glands. Injecting a synthetic form of the hormone into an affected joint delivers a very high dose of anti-inflammatory medication right where it's needed. While not a pain killer itself, cortisone can reduce discomfort by way of reducing inflammation.

Therapies

Physical therapy strengthens the muscles around the joint, relieving some of the burden on the cartilage and bone.

Synvisc (hylan G-F 20), also called hyaluronic acid, may also be considered. It contains substances that are secreted by cartilage cells and help give your joint fluid a slippery quality.

By injecting this substance into the knee, some people believe you are replacing this vital component of joint fluid.

Synvisc is approved for osteoarthritis by the U.S. Food and Drug Administration (FDA), but it's considered a treatment or therapy as opposed to a drug.

Long-term studies have yet to show any clear benefit of Synvisc, however many patients believe in its effects. What has been shown is that patients who are treated with Synvisc are more likely to go longer before needing a knee replacement.

Lifestyle

Choices you make every day can also have a big impact in managing osteoarthritis:

  • Weight loss: Weight loss decreases the burden the joint must carry, especially when it comes to the hips, knees, and feet.
  • Activity modification: Limiting certain activities that increase your pain and inflammation may be necessary. You may be able to substitute other activities, though. For example, aquatic exercise is gentler on the joints than, say, jogging or a typical weight circuit at the gym.
  • Diet: Specific diets have been studied, but little has been proven. In small studies, antioxidants have been shown to decrease the progression of osteoarthritis, but this has not been proven in larger studies, and they have not been shown to change the overall incidence of osteoarthritis. Vitamin D has also been shown to decrease the progression of osteoarthritis. These data suggest that diet may be important in preventing the progression of the disease, but other factors may play a bigger role in prevention.

Replacement, Resurfacing, and Regeneration

Cartilage can be replaced, resurfaced, and regenerated via various techniques, and those procedures help some people delay or avoid total joint replacement surgeries. Much of this work is in its early stages, though, so doctors are continuing to look for better methods.

Glucosamine and Chondroitin

The supplements glucosamine and chondroitin became popular for joint pain years ago. The two substances are "building blocks" of cartilage, so it made logical sense. Early studies appeared to yield promising results.

However, as researchers looked into them further, mixed results and large amounts of poor-quality evidence led glucosamine and chondroitin to fall out of favor with many in the medical community. The two just don't appear to do much in the way of alleviating osteoarthritis symptoms or joint pain in general.

Some researchers have called for higher-dose studies of glucosamine, saying that's what's needed to prove its benefits. Others say a form of glucosamine called prescription patented crystalline glucosamine sulfate is superior to other forms.

An important consideration with any treatment is whether the potential benefits outweigh the risks. With studies showing little or no benefit and possible risks, such as negative interactions with medications such as the blood-thinner Coumadin (warfarin), the medical community has largely stopped recommending these supplements.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sandell LJ, Aigner T. Articular cartilage and changes in arthritis. An introduction: cell biology of osteoarthritis. Arthritis Res. 2001;3(2):107-13. doi:10.1186/ar148

  2. Loeser RF. The role of aging in the development of osteoarthritis. Trans Am Clin Climatol Assoc. 2017;128:44-54.

  3. Pelletier JP, Martel-pelletier J, Rannou F, Cooper C. Efficacy and safety of oral NSAIDs and analgesics in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Semin Arthritis Rheum. 2016;45(4 Suppl):S22-7. doi:10.1016/j.semarthrit.2015.11.009

  4. Bowman S, Awad ME, Hamrick MW, Hunter M, Fulzele S. Recent advances in hyaluronic acid based therapy for osteoarthritis. Clin Transl Med. 2018;7(1):6. doi:10.1186/s40169-017-0180-3

  5. Henrotin Y, Marty M, Mobasheri A. What is the current status of chondroitin sulfate and glucosamine for the treatment of knee osteoarthritis? [published correction appears in Maturitas. 2014 Dec;79(4):487]. Maturitas. 2014;78(3):184–187. doi:10.1016/j.maturitas.2014.04.015

  6. Harrison-Muñoz S, Rojas-Briones V, Irarrázaval S. Is glucosamine effective for osteoarthritis?. ¿Es efectiva la glucosamina para el tratamiento de la artrosis?Medwave. 2017;17(Suppl1):e6867. Published 2017 Mar 15. doi:10.5867/medwave.2017.6867

  7. McCarty MF, O'Keefe JH, DiNicolantonio JJ. Glucosamine for the treatment of osteoarthritis: The time has come for higher-dose trialsJ Diet Suppl. 2019;16(2):179–192. doi:10.1080/19390211.2018.1448920

  8. Bruyère O, Altman RD, Reginster JY. Efficacy and safety of glucosamine sulfate in the management of osteoarthritis: Evidence from real-life setting trials and surveysSemin Arthritis Rheum. 2016;45(4 Suppl):S12–S17. doi:10.1016/j.semarthrit.2015.11.011

  9. National Institutes of Health: National Center for Complementary and Integrative Health. Glucosamine and chondroitin for osteoarthritis. Updated November 2014.