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Osteoarthritis
Yusuf Yazici, M.D., and Akgun Ince, M.D.
Dr. Yazici is Attending Physician, Division of Rheumatology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, and Dr. Ince is Assistant Professor of Internal Medicine, Division of Rheumatology, Saint Louis University School of Medicine, St. Louis, MO.
Osteoarthritis (OA) is the most common form of arthritis. If you live long enough, you'll probably get it. Arthritis is defined as the inflammation of one or more joints in the body, such as a knee, hip or elbow. There are a number of possible causes; sometimes, no clear cause is found. OA is as serious as it is common. Today, it is the second leading cause of long-term disability in the U.S. As the Baby Boom generation ages, OA will become even more widespread and more of a burden on the nation's health care system.
Who Gets OA?
While the percentage of people with OA varies from one group to another, no age group, community or category of people is immune. As you get older, you are more likely to suffer from OA. More than half of all people over 65 have OA symptoms in the knees. By age 75, virtually everyone suffers from OA-related knee problems.
We do not know exactly why the risk of getting OA increases with age. We do know that certain occupations that are hard on the knees or other joints, including those requiring kneeling, squatting and climbing stairs, carry an increased risk of OA. Many more women than men get the disease, especially women who have passed menopause. For some reason, African-Americans are more likely to develop knee OA than whites.
Those who are overweight are also more likely to develop OA, especially in the knees. While some explain this by pointing to the stress that extra weight puts on our weight-bearing joints, there may also be something else at work here. Studies show, for instance, that overweight people are also more likely to get OA in the hand, fingers and other non-weight-bearing joints.
As with knee OA, hip OA is more common in people whose jobs involve heavy lifting and other activities that stress joints. Unless carried to an extreme, amateur sports and recreational activities do not generally increase someone's likelihood of getting OA.
Finally, some people seem to have been born with a genetic predisposition for the disease.
What Are the Symptoms?
Joint pain is the most important symptom of OA, the one that causes people to seek treatment from a doctor. The pain of OA usually comes on gradually over a period of months or years. Typically, the pain gets worse when the affected joints are used and gets better with rest.
Morning stiffness is a common sign of OA and usually lasts less than 30 minutes. Longer-lasting morning stiffness sometimes, but not always, points to another type of arthritis called rheumatoid arthritis, or RA. OA sufferers commonly feel stiff after prolonged periods of rest; this stiffness usually goes away after a few minutes.
OA causes physical changes to the joints, including making them swollen or sore and reducing range of motion. It can also cause the growth of osteophytes, or bone spurs. Over time, these spurs can damage the joint by destroying cartilage and causing other problems.
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