Osteoarthritis – Stages, Symptoms, Causes, Diagnosis, and Treatment

What is Osteoarthritis (OA)?

Osteoarthritis (OA) is a chronic degenerative condition of the joints that predominantly affects the knee joints, spine and hip joints, and the joints present in your hands. Your bones have a cushion of protective cartilage surrounding them. Due to age and other factors, this protective layer wears off, which is called Osteoarthritis.

More about Osteoarthritis

Osteoarthritis of the knee impacts the functionality of the knee joints. It further leads to pain and discomfort in the knee area. This health condition can also cause disability with its progression.

A study by the CDC (Centers for Disease Control and Prevention) shows that OA of the knee affects millions of people worldwide. The figures are gradually increasing with 1 out of 2 people having the likelihood of developing OA in their lifetime.

OA of the knee can significantly affect your health, productivity at work, and finances.

What are the Stages of Osteoarthritis?

There are different OA stages of the knee, starting from 0 to 4, depending on the severity of the condition.

Stage 0 (Normal). It denotes that your knees do not show any signs and symptoms of OA. It is a normal knee condition, and you do not need any treatment for the same.

Stage 1 (Minor). In this stage, you are most likely to develop minor bone issues, bone spurs, and wear and tear towards the end of the knee joint. However, this stage is not much of a concern, and you might not experience any pain or discomfort. Although you are less likely to need any specialized treatment, your doctor may recommend making some lifestyle changes and taking supplements like chondroitin and glucosamine.

Stage 2 (Mild). In this stage, you are most likely to develop more bone spurs leading to mild joint pain. In most cases, people with Stage 2 OA experience stiffness around the knee joints, especially when sitting for a long time, after a workout session, or getting up in the morning. When a doctor gets to diagnose your condition at this stage, it becomes easy for them to manage the disease well and stop the progression.

Stage 3 (Moderate). In this stage, the cartilage surface tends to erode, causing narrowing the gaps between the bones and more bone spurs. As the disease progresses, the joints happen to swell, leading to pain and discomfort while moving, running, walking, and kneeling, among others. Moreover, you might experience a popping noise while walking, besides joint stiffness. Your doctor is likely to prescribe pain-relief treatments and OTC (over-the-counter) NSAIDs to counter the pain. In case these do not work, he or she might recommend taking opioid pain-relief medications.

Stage 4 (Severe). In this stage, the level of damage to your knee joints is high, causing more friction, joint stiffness, and pain. As Stage 4 is the advanced stage of the disease, it is most likely to make even the day-to-day activities difficult. Although other treatments may provide some relief, your doctor is more likely to recommend surgical treatment.

What are the Symptoms of Osteoarthritis?

The signs and symptoms of osteoarthritis usually develop gradually and worsen with time. It includes the following:

• Pain in the affected area that might intensify after or during a particular movement or activity.
• You might experience stiffness in joints, especially after waking up in the morning or standing after prolonged sitting.
• You might feel tenderness in your joints, mainly when light pressure to the joints is applied.
• You might feel the loss of flexibility in your joints.
• You are most likely to experience a grating sensation while walking or using your knees otherwise.
• Your joints are more likely to swell, causing pain and uneasiness.

When Should You See the Doctor?

If you experience any of the symptoms mentioned above, you should consult your doctor, preferably an orthopaedician . Avoiding the symptoms might aggravate the condition. In the worst-case scenario, it can also lead to permanent disability.

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What are the Causes of Osteoarthritis?

One of the leading causes of osteoarthritis is the deterioration of the cartilage that cushions your bone ends. So, what is cartilage? It is a firm yet lubricating tissue that helps in the frictionless movement of joints. When this tissue breaks down, your bones tend to rub on to one another. Therefore, osteoarthritis is also known as wear and tear ailment.

However, apart from wearing off the cartilage, this health condition impacts your joints as a whole. Many factors increase your risk of developing osteoarthritis. It includes the following:

• Aging: The chances of developing osteoarthritis increase with age.
• Gender: Women are considered more prone to developing this health condition.
• Obesity: If your weight is more than the healthy levels (being overweight or obese), it puts pressure on the weight-enduring joints, including your knees and hips. It might be a contributing factor to osteoarthritis. Moreover, your fat tissues happen to produce certain chemicals that can lead to painful joint inflammation.
• Genes: If osteoarthritis runs in your family, your likelihood of developing it increases.
• Joint or Sports Injuries: Any injury to the knees (sports or accidental) can also put you at higher risk of developing osteoarthritis.
• Metabolic Ailments: Certain metabolic health conditions, such as diabetes and hemochromatosis (excessive iron in your body), also increase your risk of developing this bone condition.
• Deformities of the Bone: Some congenital disabilities, like defective cartilage or deformed joints, can also increase the risks of osteoarthritis.

How Do Doctors Diagnose Osteoarthritis?

• Your doctor does a physical examination and examines the affected area to find the signs of swelling, soreness, redness, and restricted movement.
• He or she is also likely to prescribe imaging tests, including X-ray and MRI (Magnetic Resonance Imaging), to get a clear picture of your joints.
• The doctor is more likely to examine your blood and joint fluid parameters to confirm the diagnosis. It includes blood tests and joint fluid analysis.

What are the Treatment Options for Osteoarthritis?

Although osteoarthritis is an irreversible health condition, treatments can help you manage the pain and other symptoms well. The treatment options include the following:

Medications

• Acetaminophen. This medication is most likely to be effective on mild to moderate discomfort and pain.
• Nonsteroidal anti-inflammatory drugs or opioids. Your doctor may also prescribe NSAIDs/opioids to counter osteoarthritis pain.
• Duloxetine. Although it is primarily an antidepressant, it has shown to be l useful in treating osteoarthritis-related pain.

Therapies

• Physiotherapy. A trained physiotherapy professional can help you with workouts to strengthen the surrounding knee joint muscles, get relief from pain, and increase flexibility levels.
• Occupational therapy. A therapist can help you learn things to ease your everyday tasks while not exerting stress on your joints. For example, he or she may suggest using a stool in your bathroom while taking a shower; doing so will help you avoid standing for a long time while bathing.

Surgical Procedures

In case medications and therapies do not help, your doctor may recommend the following treatment options:

• Cortisone injections. Corticosteroid injections are administered into space within your knee joints to relieve joint pain.
• Lubrication injections. Your doctor is likely to inject hyaluronic acid to lubricate your joints and reduce pain.
• Realignment of bones (knee osteotomy). If one of the sides of your knee is more damaged than the other, your doctor may suggest knee osteotomy.
• Joint replacement (arthroplasty). As the name suggests, it is a surgical procedure in which your doctor will replace the damaged parts of your knee with artificial joints.

Prevention

Strengthening your muscles and maintaining a healthy weight have shown to be effective at preventing the progression of osteoarthritis.

• Strengthen the muscle. Regular exercises like walking, water exercises, and other sports help to prevent knee locking and stiffness. 
• Keep a check on your weight. Maintaining weight is recommended for all ages. Ideal weight reduces the stress and pressure placed on the knee and reduces the chances of arthritis. 

Conclusion

As osteoarthritis is a progressive disease, there is no permanent cure for it. However, with the right treatment and lifestyle changes, you can manage it to a great extent and lead a normal life.