What is this condition?

Osteoarthritis, the most common form of arthritis, is an ongoing process that breaks down cartilage around a bone, then causes new bone to grow around and under the affected joint. It usually occurs in the hips and knees. Osteoarthritis is widespread and affects both sexes after age 40. It can be disabling and usually gets worse as the person ages, ranging from minor dysfunction of the fingers to severe hip or knee problems.

What causes it?

Osteoarthritis, a normal part of aging, results from many metabolic, genetic, chemical, and mechanical factors. One form of osteoarthritis results from a specific event, such as a fall, an inherited deformity, or obesity that leads to degenerative changes.

What are its symptoms?

The most common symptom of osteoarthritis is deep, aching joint pain, which occurs particularly after exercise or other joint stress. The pain goes away when the person rests. Other symptoms include stiffness in the morning (again, relieved by rest), aching during changes in weather, "grating" of the joint during motion, and tight muscles that hamper movements. These symptoms are worse if the person has poor posture or job stress or is obese. When it affects the hands, osteoarthritis changes the shape of the joints and can eventually make them red, swollen, tender, and numb.

How is it diagnosed?

The doctor can assess obvious changes in the person's joints and use X-rays to see such signs as joint deformity, bony deposits, and joint fusion. There is no lab test specific for osteoarthritis, but tests can rule out other inflammatory joint problems.

How is it treated?

The doctor will prescribe medications to relieve pain and minimize stiffness. Medications include aspirin (or other nonnarcotic pain relievers), Butazolidin, lndocin, Nalfon, Advil or Motrin, or Darvon and, in some cases, injections of corticosteroids. Such injections, given every 4 to 6 months, may delay the development of new deposits in the person's hands. The person will also be taught specific exercises to promote flexibility.

Other treatments

The doctor may put the person in a brace or traction, suggest a cane or crutches for walking, and encourage other supportive measures such as massage, steam baths, paraffin (wax) dips for the hands, and exercise. Surgery is reserved for people who have severe disability or uncontrollable pain.

What can a person with osteoarthritis do?

Pace yourself. Plan rest periods during the day and be protective about getting a good night's sleep. Because osteoarthritis is not a disease of your whole body, concentrate on therapy that improves your flexibility and comfort.

Specific treatments

• Hand: Hot soaks and paraffin dips can relieve pain.

• Lower and middle back: Use a firm mattress (or bed board) to decrease morning pain.

• Neck: Check the tightness of your cervical collar; watch for redness after prolonged use.

• Hip: Use moist heat pads to relieve pain (usually with prescribed antispasmodic drugs) and do stretching and strengthening exercises. You may need to inspect your braces or a walker for proper fit.

• Knee: Regularly exercise to maintain flexibility, muscle tone, and strength. Consider a brace or an elastic wrap for support.

More good moves

• Take your medication exactly as prescribed, and report side effects immediately.

• Avoid overexertion, and learn to stand and walk without stressing joints. Be especially careful when stooping or picking up objects.

• Wear well-fitting supportive shoes; don't allow the heels to become too worn down.

• Install safety devices at home, such as hand rails in the bathroom .

• Maintain your proper weight to lessen stress on joints.