man holding his fingers with his hand

Osteoarthritis: Symptoms, Causes, Diagnosis, And Treatment

Proper management of osteoarthritis involves a combination of lifestyle changes, medications, and therapies that are specifically tailored to joints such as knees, hands, and hips. Regular check-ups and diagnostic tests are essential for early detection and monitoring of the progression of the disease, allowing for timely adjustments to treatment plans to maintain quality of life.

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Osteoarthritis symptoms can significantly impact daily life. The primary symptoms include joint pain, stiffness, and swelling. Joint pain often worsens with activity and improves with rest. Stiffness, especially after periods of inactivity or in the morning, can make it difficult to move the affected joints. Swelling may occur because of inflammation in the joint area, leading to tenderness and discomfort. These symptoms are common and can affect various joints, making movement and daily tasks a considerable challenge.

As osteoarthritis progresses, these symptoms can often evolve from mild to severe. Initially, you may experience occasional joint pain and stiffness. Over time, the pain can become more persistent and can affect you even during rest. The stiffness might last longer, and swelling can become more pronounced.

Advanced stages may lead to significant joint damage, which can cause deformities and reduce the range of motion.

man holding his fingers with his hand

This progression can severely affect your ability to perform everyday activities, making it necessary for medical intervention in order to manage the symptoms and minimize the pain.

The symptoms of osteoarthritis can also vary depending on the affected joints. In the knees, you might experience pain while walking, climbing stairs, or standing up. Swelling and decreased mobility are common, leading to a sensation of the knee giving way. In the hips, pain might be felt in the groin, outer thigh, or buttocks, especially during weight-bearing activities like walking or standing.

Hip osteoarthritis can significantly impact mobility and flexibility. In the hands, osteoarthritis typically affects the finger joints and the base of the thumb, which can result in pain, swelling, stiffness, and a decreased ability to grip or pinch objects. These localized symptoms can make specific movements difficult and may require targeted treatment to alleviate the discomfort.

Osteoarthritis causes can be divided into two main types: primary and secondary. Primary osteoarthritis is age-related and occurs as a result of the natural wear and tear of joint cartilage over time. As you age, the cartilage that cushions the ends of your bones gradually deteriorates, leading to pain and stiffness. Primary osteoarthritis is the most common type and usually affects older adults.

Secondary osteoarthritis develops because of an underlying condition or injury. Factors like joint injuries from accidents or repetitive stress can damage the cartilage, leading to secondary osteoarthritis. Other conditions like rheumatoid arthritis, gout, or congenital joint disorders can contribute to the development of this type.

Several risk factors increase osteoarthritis risk, with genetic factors playing a significant role.

  • Individuals with a family history of osteoarthritis are more likely to develop the condition.
  • Joint injuries, whether from sports, accidents, or repetitive movements, can also lead to osteoarthritis even years after the initial damage.
  • Overuse of joints through repetitive motions, often seen in certain occupations or sports, can also contribute to the condition.
  • Other risk factors include age, with older adults being more susceptible, and gender, as women are more likely to develop osteoarthritis than men.2

Managing these risk factors through a healthy lifestyle and early intervention can help minimize the development and slow down the progression of osteoarthritis.

Identifying Osteoarthritis

Osteoarthritis diagnosis begins with a clinical examination by your physician. During the exam, your doctor can gauge your medical history, including any symptoms you are experiencing, such as joint pain, stiffness, and swelling, and can also inquire about any previous joint injuries or conditions. The doctor will then perform a physical examination to check for signs of joint tenderness, swelling, redness, and to check your range of motion. This thorough evaluation will help determine if your symptoms match with those that are typical of osteoarthritis.

Imaging tests are very important in the osteoarthritis diagnosis process. X-rays are commonly used to reveal joint damage and the extent of cartilage loss. They can show bone spurs and joint space narrowing, which are common indicators of osteoarthritis.

MRI scans provide a more detailed view of the soft tissues, such as ligaments, tendons, and cartilage, helping to assess the severity of the condition. CT scans can also be useful in visualizing the bone structure and detecting subtle changes in the joint that might not be visible on an X-ray.

Lab tests are another important component of diagnosing osteoarthritis. While no specific blood test can diagnose osteoarthritis, blood tests can help rule out other types of arthritis, such as rheumatoid arthritis or gout.

Joint fluid analysis involves taking a small sample of fluid from the affected joint using a needle. This sample is examined for signs of inflammation, infection, or crystals, which can indicate other forms of arthritis. By ruling out these conditions, doctors are able to diagnose osteoarthritis more confidently.

Treatment Options for Osteoarthritis

Properly managing osteoarthritis involves a combination of non-pharmacological and pharmacological treatments.

Non-Pharmacological Treatments

Numerous non-pharmacological osteoarthritis treatments focus on positive lifestyle modifications to help reduce symptoms and improve joint function. Effective weight management is crucial because excess weight puts considerable strain on weight-bearing joints, particularly the hips and knees. Losing even a small amount of weight can significantly reduce pain and improve mobility. 

Low-impact activities like swimming, walking, and cycling are exercises that help maintain joint flexibility and reduce stiffness. Stretching exercises can also improve the range of motion and decrease stiffness as well.

Pharmacological Treatments

Over-the-counter medications like NSAIDs (nonsteroidal anti-inflammatory drugs) are regularly used to relieve pain and reduce inflammation among individuals with osteoarthritis.3 Examples of this type of medication include ibuprofen and naproxen. 

For more severe pain, your doctor might prescribe stronger prescription-strength NSAIDs or a combination of medications. Corticosteroids, either taken orally or injected directly into the affected joint, can provide significant relief from inflammation and pain. However, these are often used for short-term relief due to the potential side effects that can occur with long-term use.

Additional pharmacological options include topical treatments like creams and gels that can be applied directly to the painful joint. These can be useful for localized pain relief without the systemic, full-body side effects of oral medications. Hyaluronic acid injections, which lubricate the joints, can also be considered for knee osteoarthritis.4 Combining these treatments for osteoarthritis options can help better manage the symptoms.

Working closely with your healthcare provider is valuable in order to develop a comprehensive treatment plan that is tailored to your specific needs and condition. Early and consistent management can significantly improve the quality of life for those living with osteoarthritis.

Medications for Osteoarthritis

Managing pain is an important aspect of osteoarthritis treatment, and several medications are available to help relieve symptoms.

Pain Relievers

Over-the-counter pain relievers are often the first line of defense against osteoarthritis pain. Acetaminophen is commonly used because it can help reduce pain without causing stomach issues. However, it provides only a limited level of pain relief, and it does not reduce inflammation.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are also widely used. They help alleviate pain and reduce inflammation, making them more effective for treating osteoarthritis symptoms. These medications are generally safe when used as directed, but long-term use can lead to side effects such as gastrointestinal problems and increased risk of heart disease.5

Prescription Medications

In scenarios featuring excessive pain, doctors may prescribe stronger osteoarthritis medications. Opioids, such as oxycodone and hydrocodone, can be used for short-term relief of intense pain.6 However, due to the risk of addiction and other side effects, they are usually not recommended for long-term use. 

Tramadol is another prescription option that can be used for moderate to severe pain.7 It is considered less addictive than traditional opioids and can be used for longer periods under close medical supervision.

Topical Treatments

Creams, gels, and patches are topical osteoarthritis remedies that can provide localized pain relief. These products often contain NSAIDs or capsaicin and can be applied directly to the painful joint. They are especially useful for those who prefer not to take oral medications or have specific joint pain. Topical therapies are usually considered safe and effective when used properly and have fewer systemic side effects.

Surgical Options for Osteoarthritis

Osteoarthritis surgery is considered when non-invasive methods prove insufficient for pain relief and when the discomfort and disability significantly impact daily life. Severe pain that disrupts sleep, persistent swelling, and a significant loss of joint function are the main criteria for considering surgery.

There are several types of osteoarthritis surgery, with the more prominent options including:

  • Arthroscopy involves using a small camera to remove or repair damaged cartilage and is minimally invasive.8
  • Joint resurfacing replaces only the damaged parts of the joint, preserving more of the natural bone.
  • Total joint replacement, or arthroplasty, is a more extensive procedure where the entire joint is replaced with a prosthesis. This option is common for knees and hips and can be very effective in relieving pain and restoring function.

Osteoarthritis in Different Joints

Although osteoarthritis can occur in any joint, it commonly affects knees, hands, and hips.

Osteoarthritis in the Knee

Knee osteoarthritis symptoms include pain, swelling, and decreased mobility. The pain often worsens with activity and improves with rest, but it can be persistent in certain advanced cases. Osteoarthritis knee swelling results from inflammation in the joint, leading to stiffness and reduced range of motion.

Treatment options for knee osteoarthritis include knee braces, which provide support and reduce pain, and physical therapy to strengthen the muscles surrounding the knee. Knee injections, such as corticosteroids or hyaluronic acid, can also help reduce inflammation and pain.

Effective osteoarthritis knee exercises include low-impact activities like swimming, cycling, and walking. Strengthening exercises such as leg lifts and hamstring curls are also helpful for maintaining joint function and reducing symptoms.

Osteoarthritis of the Hands

Osteoarthritis can impact the hands, typically affecting the finger joints and the base of the thumb. Symptoms include pain, swelling, and stiffness, which can make gripping and pinching objects difficult. Over time, joint deformities may develop, which can further limit hand function.

Methods for managing hand osteoarthritis include using splints to support the affected joints and reduce pain. Occupational therapy can help improve hand function through exercises and the use of adaptive tools. Pain management strategies, such as NSAIDs and topical treatments, can also provide some relief from symptoms and improve hand mobility.

Osteoarthritis in the Hip

Osteoarthritis hip symptoms often manifest as pain in the groin, outer thigh, or buttocks, especially during weight-bearing activities like walking or standing. This pain can limit mobility and affect daily activities. Options for addressing hip osteoarthritis include physical therapy to strengthen the muscles around the hip and enhance flexibility.

Pain medications, such as NSAIDs, can help manage pain and inflammation. In severe cases, surgical options like total hip replacement may be considered to restore joint function and help reduce pain.

Therapies and Self-Care for Osteoarthritis

Physical therapy is an important component of osteoarthritis therapies. It helps improve joint function by strengthening the muscles bordering the affected joints, increasing flexibility, and reducing pain. A physical therapist can create a specialized exercise program that includes stretches and low-impact activities like swimming or walking, which are important for maintaining mobility and reducing stiffness.

Occupational therapy focuses on assisting with daily activities and recommending adaptive tools. An occupational therapist can teach you how to perform tasks in ways that minimize stress on your joints, suggest modifications to your home or workplace, and provide splints or braces to support affected joints and help you maintain independence and improve your quality of life.

Proper osteoarthritis self-care involves several strategies.9 Heat and cold therapy can help manage pain and inflammation; heat can be applied to relax muscles and cold to reduce swelling. An active lifestyle is beneficial to stay active to prevent joint stiffness, but always remember to provide your body with plenty of rest.

Incorporating a balanced diet rich in anti-inflammatory foods like fruits, vegetables, and omega-3 fatty acids can support joint health, and maintaining a healthy weight reduces stress on weight-bearing joints.

Final Words

Living with the many symptoms associated with osteoarthritis can be challenging and painful. Thankfully, numerous practices can help you successfully manage these difficult symptoms and reestablish equilibrium in your lifestyle. From medications and surgery to non-invasive practices such as physical therapy, these treatments can significantly improve your ability to manage osteoarthritis symptoms and maintain an optimal quality of life.

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References

[2] Tschon M, Contartese D, Pagani S, Borsari V, Fini M. Gender and Sex Are Key Determinants in Osteoarthritis Not Only Confounding Variables. A Systematic Review of Clinical Data. J Clin Med. 2021 Jul 19;10(14):3178. doi: 10.3390/jcm10143178. PMID: 34300344; PMCID: PMC8303951.;

[3] Magni A, Agostoni P, Bonezzi C, Massazza G, Menè P, Savarino V, Fornasari D. Management of Osteoarthritis: Expert Opinion on NSAIDs. Pain Ther. 2021 Dec;10(2):783-808. doi: 10.1007/s40122-021-00260-1. Epub 2021 Apr 19. PMID: 33876393; PMCID: PMC8586433.;

[4] Santilli V, Paoloni M, Mangone M, Alviti F, Bernetti A. Hyaluronic acid in the management of osteoarthritis: injection therapies innovations. Clin Cases Miner Bone Metab. 2016 May-Aug;13(2):131-134. doi: 10.11138/ccmbm/2016.13.2.131. Epub 2016 Oct 5. PMID: 27920810; PMCID: PMC5119711.;

[5] Hijos-Mallada G, Sostres C, Gomollón F. NSAIDs, gastrointestinal toxicity and inflammatory bowel disease. Gastroenterol Hepatol. 2022 Mar;45(3):215-222. English, Spanish. doi: 10.1016/j.gastrohep.2021.06.003. Epub 2021 Jun 19. PMID: 34157367.;

[6] Ivers N, Dhalla IA, Allan GM. Opioids for osteoarthritis pain: benefits and risks. Can Fam Physician. 2012 Dec;58(12):e708. PMID: 23242901; PMCID: PMC3520677.;

[7] Toupin April K, Bisaillon J, Welch V, Maxwell LJ, Jüni P, Rutjes AW, Husni ME, Vincent J, El Hindi T, Wells GA, Tugwell P. Tramadol for osteoarthritis. Cochrane Database Syst Rev. 2019 May 27;5(5):CD005522. doi: 10.1002/14651858.CD005522.pub3. PMID: 31132298; PMCID: PMC6536297.;

[8] Felson DT. Arthroscopy as a treatment for knee osteoarthritis. Best Pract Res Clin Rheumatol. 2010 Feb;24(1):47-50. doi: 10.1016/j.berh.2009.08.002. PMID: 20129199; PMCID: PMC2818323.;

[9] Safari R, Jackson J, Sheffield D. Digital Self-Management Interventions for People With Osteoarthritis: Systematic Review With Meta-Analysis. J Med Internet Res. 2020 Jul 20;22(7):e15365. doi: 10.2196/15365. PMID: 32706657; PMCID: PMC7428148.;