Osteoarthritis affects the cartilage (a type of tough, flexible tissue) covering the end of your bones. This cartilage gets rougher and thinner. The bone underneath thickens and your joint can become inflamed (swollen, hot and painful). The tissues around your joint such as the ligaments and joint capsule may thicken and become tighter too. There may be a build-up of fluid inside your joint. These changes can make it difficult for you to use your joint as easily as you previously could.
Osteoarthritis can affect people in different ways, and can affect one joint differently to another. For many, osteoarthritis gradually progresses over many years. However, experts believe that it doesn’t necessarily keep on getting worse as you get older.
The main symptoms of osteoarthritis are pain and stiffness in the affected joint, though this pain can sometimes spread to surrounding areas. The pain usually gets worse when you use your joint, but if your arthritis is severe, it may be there all the time. Any stiffness of your joint is usually worse in the morning, or after resting.
You may notice other symptoms developing over time. The main ones are listed below.
- Reduction in your ‘range of movement’ in the joint. This means not being able to move your joint into the positions you did before, or move them as far.
- A crunching and grinding feeling and noise in your joints when you move them.
- Change in the shape of your joint, with hard bony growths and/or soft swelling caused by extra fluid.
- Your joint may give way when you put weight on it. This can happen because your muscles have weakened or because your joint is less stable.
There may be times when your symptoms get worse, for example, when the weather is damp or when you have been more active than usual. Often you won’t know what the reason is – you’ll just have some times when things are easier than others.
If you have any of these symptoms, see your GP.
Your GP will ask about your symptoms and how they’re affecting your life. They may also ask you about your medical and family history, what work you do (or used to do), and whether you’ve had any past injuries from sport or work.
There’s no single test for osteoarthritis and an examination is often all that’s needed to diagnose the condition. Your GP may look to see if you have any bony growths and swelling and any creaking in your joint. They’ll look for any shrinking (‘wasting’) of the muscles around your joint. They might also check how well your joint moves and how stable it is.
Your GP may suggest you have an X-ray of your affected joint. An X-ray can help to show if the normal space in your joint is reduced because you have lost protective cartilage. It can also show if you have any extra bone growth around your joint or any roughening or thickening of the surface of your joint. X-rays aren’t very useful in diagnosing osteoarthritis in its early stages and carry very small health risks.
There’s no cure for osteoarthritis, but there are a number of treatments that can help you to manage it and control your symptoms. There are lots of ways you can help yourself.
Your GP will discuss with you the various options for managing your arthritis. What they recommend will depend on your personal circumstances. These may include how severe your symptoms are, which joints are affected and your occupation and leisure activities.
There are many things you can do to reduce the pain and stiffness in your joints, and to make day-to-day life easier. Self-help measures can help to reduce the stress on your joints and reduce the severity of your condition. Some of the main ones are listed below.
- Try to maintain a healthy weight for your height. Excess weight can put more stress on your joints and make osteoarthritis worse, so losing it can help. Use our BMI (body mass index) calculator to see if you’re a healthy weight.
- Exercise regularly and keep moving – this is important. Exercise can help to keep your joints working well and reduce your pain. It will also help to build up your muscle strength.
- Pace yourself. For example, spread out any chores that need doing, rather than trying to do them all at once.
- Wear shoes with a soft, thick, cushioned sole or use an insole. This will help to reduce any jarring.
- Massage the muscles around your joint to help ease pain.
- Use a heat pad or an ice pack to help relieve pain. Don’t put either of these directly on to your skin as they may damage it or even give you a burn. Wrap them in a towel or dishcloth first.
- Think about making changes to your car, home or workplace to ease any stress on your joints. You may be able to get help from an occupational therapist. This is a health professional who can give practical assistance to help you manage with everyday tasks and increase your independence.
- Use braces or supports to keep your joint stable and provide support. Ask your physiotherapist about these.
There may be other things you can do to help ease your osteoarthritis symptoms. Ask your physiotherapist or practice nurse for suggestions. You’ll also be able to get hints and tips from charities and support groups. See our ’Other helpful websites’ section below for more information.
Painkillers may help to ease your pain and stiffness, but they can’t cure osteoarthritis. Paracetamol generally helps for mild pain, although experts now think that it doesn’t work as well as they previously thought for everyone. You can also try non-steroidal anti-inflammatory (NSAID) creams and gels, such as ibuprofen and diclofenac. You can rub these directly on to your joint. Your GP may also prescribe a cream containing a painkilling substance called capsaicin, which is made from the pepper plant. Always read the patient information leaflet that comes with your medicine and if you have any questions ask your pharmacist for advice.
If these medicines don’t work, your GP may suggest you take NSAIDs as tablets rather than as a cream or gel. They may also suggest a stronger type of painkiller called an opioid. Using NSAIDs for long periods is usually safe, but it has been linked with heart, kidney and stomach problems. Ask your doctor about how these risks might apply to you.
If you have a particularly painful, swollen joint, your GP may suggest you have a steroid injection directly into your joint. This can only be done a few times each year, but can help to reduce inflammation and ease pain.
You may decide to try a type of pain relief called transcutaneous electrical nerve stimulation (TENS). This is an electronic device that sends pulses through your skin to your nerve endings. It interferes with the messages being sent to your brain and may help to relieve your pain. Some people with osteoarthritis may find it useful, although it is controversial whether TENS works for many patients or for long periods of time
You can buy a TENS machine from your pharmacy. You could ask your physiotherapist if you can borrow one to try out before you decide to buy one.
If you have severe pain from osteoarthritis or it has a significant impact on your life, your doctor may suggest you have an operation. This will usually be for hip or knee osteoarthritis, and only after you’ve tried other non-surgical treatments. This could be keyhole surgery or an operation to replace part, or the whole, of your affected joint with an artificial one. Your doctor will discuss with you what’s best in your particular circumstances.
Complementary therapies sit outside of, and can be used alongside, conventional medicine. Many people with osteoarthritis take supplements or use complementary medicines to ease their symptoms. It can be a way for you to feel more in control of this long-lasting condition. Although complementary therapies are widely used, we don’t have much real evidence about how well they work.
You might feel that fish oils, such as cod liver oil, help to ease pain and stiffness. However, experts can’t yet say that they really work for osteoarthritis.
Glucosamine and chondroitin are two of the most commonly used supplements for osteoarthritis. Experts aren’t yet sure how well they work, if at all. However, from studies so far it seems that chondroitin, with or without glucosamine, might help a little to reduce pain. Glucosamine and chondroitin aren’t generally recommended by doctors as treatments for osteoarthritis.
There’s a little evidence that acupuncture is effective at treating osteoarthritis, but experts disagree about whether it should be recommended as a treatment.
Speak to your pharmacist before you try any complementary therapies or herbal remedies. This is important because some of them might interact with other medicines you’re taking, or have side-effects of their own. You can find out more information about specific complementary therapies for osteoarthritis from Arthritis Research UK – see our resources section below for details.
We don’t fully understand why a person gets osteoarthritis. However, certain factors may increase your risk of developing the condition. You’re more likely to develop osteoarthritis if:
- one of your parents has the condition
- you’re over 50
- you’re female
- you’re overweight or obese
- you have previously injured or had an operation on your joint
- you repeatedly use a particular joint in your job or hobby
- you were born with problems with the structure or stability of your joints, or developed them in childhood
Having joint pain may mean it’s hard for you to get out and about, go to work or enjoy your hobbies and interests. This can make you feel low, which then makes you less likely to feel like going out, doing things and meeting people. This is all quite natural.
But there’s a lot you can do to help yourself. Keep as active as possible. Continue with hobbies and interests you enjoy, perhaps with some adaptations to your techniques or using assistive devices or gadgets. Find a new hobby or interest, or perhaps volunteer to help others. This will lift your spirits, help you meet people and give you a sense of purpose.
If you’re in work, ask if your employer has an occupational health department. They’ll be able to help you make adjustments to your way of working, or to your workspace to make working easier.
Talk to your GP if your condition is having a significant impact on your day-to-day life and what can be done to help you. Remember you’re not alone: many other people have osteoarthritis, and have found ways to cope with their symptoms. See our resources section for details of organisations which can provide information, support and lots of practical tips on living with osteoarthritis.
Many people with osteoarthritis take non-prescribed supplements and foods in the hope they’ll ease their symptoms. And some people do find that their symptoms improve when they change what they eat – but this is different for different people. There’s a wide range of foods and supplements which have been claimed to help treat osteoarthritis. However, there’s very little evidence to show this for most substances (see our section on complementary treatments for osteoarthritis above).
Some people feel that certain fruits and vegetables make their arthritis worse. These might include potatoes, tomatoes, peppers and citrus fruits like oranges. Experts don’t recommend leaving these foods out of your diet – in fact vegetables and fruit are a very important part of a healthy diet.
So there isn’t really a special diet for osteoarthritis. The best thing you can do is to make sure your diet lets you keep an appropriate weight for your height. Use our BMI (body mass index) calculator to see if you’re a healthy weight. If you’re overweight, this will put a strain on your joints, particularly your knees, hips and lower back. This will affect how mobile you are. If you lose even just a little weight, it may significantly help to reduce pain and stiffness in your joints. Exercise will also help with this (see exercise FAQ below).
You can find out more about individual foods and dietary supplements for osteoarthritis from Arthritis Research UK. See our resources section for more details. If you’re thinking about making changes in your diet, or taking vitamin or mineral supplements discuss this with your GP.
There are many things you can do at home to make day-to-day tasks easier for you and reduce the stress on your joints. If you make a few small changes, it may help to protect your joints and ease aches and pains. Some helpful tips are listed below.
- Use labour-saving gadgets and aids specially designed for people with arthritis. These include devices for turning on taps, kitchen utensils with padded handles and automatic can-openers.
- Rearrange your kitchen and other rooms to make sure the things you use most are easy to reach.
- When you’re lifting things, try to reduce the weight of the item and spread the load across more than one joint. For example, lift with two hands instead of one. If you can’t reduce the weight of an item, slide it rather than picking it up; for example, slide heavy pans across the worktop.
- Plan ahead and pace your day. Don’t do large jobs all at once. Instead split them up and do a little at a time. You may find it easier to leave larger tasks for the afternoons when you’re less stiff and sore.
- Adapt your car to make driving easier. A padded steering wheel, extra side mirrors or a steering wheel knob may all help. If your osteoarthritis is more severe, you may wish to consider driving an automatic rather than a manual car.
An occupational therapist can assess you in your home to see whether you may be eligible for financial help to make changes to your home. Your local social services department may also be able to help with equipment or adaptations to your home. Some equipment may be available through the NHS, but you may have to pay some costs yourself.
See our resources section for details of organisations which can provide information, support and lots of practical tips on living with osteoarthritis.
When you have osteoarthritis, moving can hurt. But it’s important to keep your joint moving to stop it stiffening up. Taking some regular exercise won’t make your arthritis worse or damage your joints any further.
Taking exercise doesn’t mean you have to use special equipment or facilities. Simple exercises are often the best. There isn’t one single exercise regime for osteoarthritis. The type of exercise that’s best for you may depend upon your own personal circumstances. The important thing is to find something that you can stick with and enjoy.
Exercises for osteoarthritis should include:
- stretching exercises – to reduce pain and ease movement
- strengthening exercises – to keep and improve muscle strength
- fitness exercises – to keep your heart healthy. Swimming can be particularly good for osteoarthritis
Speak to your physiotherapist for more information about exercising safely. They can help you to create an individual exercise programme that works for you. You’ll also find helpful information about exercises for osteoarthritis from the organisations listed in our resources section. And see our topic on starting exercise to give you some ideas.
Splints make sure that your wrist and hand are held and supported in the correct position. There are two main types of splint for arthritis of the wrist and hand.
- Resting splints. These support your hand, wrist and forearm while you’re resting or sleeping. They are usually worn in bed at night. Resting splints are normally custom made to fit you. Your physiotherapist or occupational therapist can give you advice on how to get a splint made.
- Working splints. This type of splint may help you when you’re using your hands, for example when you’re driving or gardening. They are made of an elastic material, which provides you with more flexible support. Working splints come in a number of different types, for example those that specifically support your thumb or wrist.
Compression gloves, sometimes called isotoner gloves, may also be helpful in reducing pain and swelling. You may find these easier to wear than splints.
If you wish to wear a splint while driving, contact your insurance company first to check whether your cover will be affected.
It’s important that you don’t wear your splint all the time; don't wear it overnight unless your therapist specifically advises you to do this. Check your skin regularly to make sure the splint hasn’t made it red or sore. And do some gentle hand and wrist exercises after removing the splint to stop your joints stiffening up.
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Reviewed by Kristina Routh, Freelance Health Editor, Bupa Health Content Team, June 2016.
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