Activities
of daily living, such as climbing stairs or opening jars, often
become more difficult as the joints become more affected by the
disorder.
Osteoarthritis typically occurs in one or two
joints at first, most frequently targeting weight-bearing joints
that include:
- Hip
- Knee
- Spine
- Hands
- Small hand joints may also be involved.
Pain And Limitation Of Motion
The pain of osteoarthritis often manifests as
a deep ache within or near the affected joint, coupled with a limitation
of motion. In OA, most people typically experience joint pain that
worsens during the course of the day, whereas others report the
greatest pain in the morning (which is related to the symptom of
stiffness after activity)
Osteoarthritic pain primarily is caused by joint
damage.
- Joint pain results when bony overgrowths rub together or when
small stress fractures are present.
- In addition, secondary injuries may occur if pain limits a
joint's normal range of motion.
- The body may respond by protectively "favoring"
one joint over another. For example, if the painful joint is
a knee or an ankle, the "favored" joint may be overused,
causing painful muscle strain.
Other painful sensations, such as rubbing or grating
within the joint, may be felt when a person performs specific activities
such as:
- Bending
- Kneeling
- Stair climbing
As cartilage wears away on the
ends of the bones and cushioning is lost, the intensity of pain
may increase. Pain may become quite severe if the cartilage has
completely deteriorated and the joint becomes unstable.
Sometimes osteoarthritis can cause referred pain
- that is, pain that is not experienced directly in the damaged
joint, but is felt in other regions instead. For example:
- An arthritic hip joint may cause painful sensations in the
buttocks, groin, thigh, or knee.
- Arthritis of the spine can cause pain that radiates to the
neck, arms, or legs.
Osteoarthritic pain, like other pain, may worsen
after stressful life events, such as the loss of a loved one or
separation from a spouse.
Stiffness After Inactivity
After periods of inactivity (for example, sleeping
or prolonged sitting), a person may experience considerable stiffness
in the osteoarthritic joint. Stiffness usually lasts for about 30
minutes or less and is improved by mild activity that 'warms up'
the joint.
Bony Enlargement And Swelling
Progressive breakdown of cartilage may lead to
the formation of enlarged bony growths or "spurs"
on the bone ends. Such growths increase the appearance of swelling
and knobbiness as they continue the cycle of irritation and swelling.
Once the synovial membrane (smooth
tissue that surrounds the joint) becomes irritated by the erosion
of cartilage, it may produce an excessive amount
of fluid that can collect within the joint and lead to continual
or occasional swelling.
Osteoarthritis usually doesn't cause any prominent
inflammation (a protective response in which tissue may become red,
warm, and tender) in response to injury. This distinguishes it from
rheumatoid arthritis, which is associated with
considerable joint inflammation. Occasionally people with osteoarthritis
experience mild inflammation, although the exact cause of this response
remains unknown.
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