by R.L. Fielding
Osteoarthritis is a chronic condition in which
tissue known as cartilage breaks down. When this tissue
deteriorates, it leaves the bones to rub against each other,
causing pain and stiffness. If you have osteoarthritis,
you’ve probably heard something like this definition from your
doctor. The disease may also be
referred to as osteoarthritis, degenerative
joint disease or degenerative
Normal Joint Osteoarthritis In general terms, osteoarthritis
is considered to be a chronic condition. It is important to
make the distinction between chronic and acute conditions.
Illnesses such as a cold or the flu are acute conditions,
because they have a clear beginning and end as well as a
specific cause, such as a virus. These illnesses can be
diagnosed with special tests, and many of the most common ones
can be treated with drugs or medical procedures. Chronic
conditions like osteoarthritis, on the other hand, often last
for several years or even a lifetime. All of the causes of
osteoarthritis aren’t yet known, so there may be no single,
In fact, treatment for osteoarthritis may require a
variety of medications and other measures, and these may change
over time. Because this disease is long-lasting and can affect
your day-to-day life for years, it is crucial that you take an
active role in managing it. You can make a difference in how
you feel by monitoring your symptoms, following your treatment
plan, and dealing with the daily challenges the condition
Osteoarthritis is a painful
condition, but there are options
for you to consider that will
probably reduce the suffering.
What Causes Osteoarthritis?
Like other chronic conditions, osteoarthritis has no single,
specific cause. Instead, there are several factors involved in
the disease, including heredity and lifestyle. It may take a
combination of these factors to eventually result in
Heredity - Scientists believe that in osteoarthritis, as in
many other diseases and conditions, heredity may play a role in
the disease. Researchers are studying several genes that may be
connected to osteoarthritis. The outcomes of these studies may
help predict who is most likely to get the disease.
Obesity - You probably already know that being overweight puts
you at risk for heart disease and certain types of cancer, but
it can also have a profound effect on your joints. The reason
is that your major joints, such as knees and hips, already bear
the brunt of your body’s weight as you move through normal
daily activities. Being overweight puts even more pressure on
Injury and overuse of joints - Sometimes repetitious movements
or serious injuries to joints can lead to osteoarthritis years
later. Some full-time athletes, for example, may injure the
same joints over and over again, causing damage to the joints,
tendons and ligaments that speeds up cartilage breakdown.
What are the Different Types of Arthritis?
There are more than 100 different types of arthritis and
related diseases. It is important to know which type of
arthritis you have so you can treat it properly. If you don’t
know which type you have, call your doctor or ask during your
Osteoarthritis - The most common type of arthritis is
osteoarthritis, or OA. OA affects about 21 million Americans.
OA is sometimes called degenerative arthritis because it is
caused by the breakdown of cartilage and bones, causing pain
and stiffness. OA usually affects the fingers and
weight-bearing joints, including the knees, hips, back and
neck. It affects both men and women and usually occurs after
Rheumatoid Arthritis - In rheumatoid arthritis, or RA, an
abnormality in the body’s immune system causes inflammation of
the joints. Inflammation begins in the joint lining, or the
synovium, and over time leads to damage of both cartilage and
bone. Rheumatoid arthritis often affects the same joints on
both sides of the body. RA affects about 2.1 million Americans
and is more common in women than in men.
Fibromyalgia - Fibromyalgia is a disease that causes widespread
pain and distinct tender points, which are places on the body
that are highly sensitive to touch and produce pain. People
with fibromyalgia usually have fatigue, disturbed sleep and
stiffness. Fibromyalgia is a common condition that usually
affects women and it does not cause muscle or joint damage.
Lupus - Lupus is a disease that affects the skin and joints. In
some people, lupus also affects the internal organs such as the
kidneys, lungs or heart. Lupus affects women about eight to 10
times more often than men. Symptoms often first appear in women
between ages 18 and 45. Some of the more common symptoms
include a rash over the cheeks and across the bridge of the
nose; scaly, disc-shaped sores on the face, neck and/or chest;
abnormal sun sensitivity; kidney problems; and forms of
Bursitis and Tendinitis - Bursitis and tendinitis are
caused by irritation from injuring or overusing a joint.
Bursitis affects a small sac called the bursa that helps to
cushion the muscles and tendons surrounding the joint.
Tendinitis affects the tendons that attach muscle to bone.
This article shares information
about osteoarthritis and how it
differs from other health
There are also tips about
Other common forms of arthritis and related conditions
• Polymyalgia Rheumatica
• Psoriatic Arthritis
• Ankylosing Spondylitis
• Juvenile Rheumatoid Arthritis
How is Osteoarthritis Different?
In osteoarthritis, the cartilage begins to break down, usually
gradually. As the cartilage wears away, the bones become
exposed and rub against each other, which leads to pain. The
deterioration of cartilage also affects the shape and makeup of
the whole joint, so that it no longer functions smoothly. You
may notice a limp when you walk, or you may have trouble going
up and down stairs. This deterioration puts additional stress
on the joint as it moves.
Other problems can occur inside the joint as cartilage
breakdown affects the joint components. Fragments of bone or
cartilage may float in the joint fluid, causing irritation and
pain. Bony spurs or osteophytes can develop on the ends of the
bones. Fluid inside the joint may not have enough of a
substance called hyaluronan, which may affect the joint’s
ability to absorb shock. And although inflammation is not a
main symptom of osteoarthritis, it can occur in the joint
lining in response to the breakdown of cartilage.
Treatment Plan and New Developments
For some people who suffer from pain associated with arthritis,
their symptoms can be managed with exercise, heat/cold therapy,
joint protection, assistive devices, weight control, or in some
severe cases, surgery. For others, medications are needed to
help manage the symptoms associated with arthritis.
COX-2 inhibitors are the newest members of the NSAID class of
medications. Available by prescription only, they became widely
used in recent years to reduce joint pain and swelling. COX-2
inhibitors work by selectively blocking, or inhibiting, one of
the two enzymes associated with inflammation. Some experts have
hypothesized that this selective inhibition may be the reason
for the negative cardiovascular effects currently associated
with COX-2 inhibitors.
Non-selective NSAIDs were developed earlier than COX-2
inhibitors and have been widely used to relieve arthritis pain
and inflammation for many years. Unlike COX-2 inhibitors,
non-selective NSAIDs inhibit both major enzymes involved in the
inflammatory process, COX-1 and COX-2. The non-selective NSAID
category includes a number of different medications that are
available in both prescription and over-the-counter (OTC)
However, recent controversy about the safety of pain
medications for arthritis has left patients and health care
professionals alike uncertain about which medications are safe
to use. In fact, a recent survey by the Boston-based Rippe
Lifestyle Institute indicated that many people with arthritis
are suffering unnecessarily because they have stopped or
reduced their use of pain relievers due to confusion about
which drugs are considered safe.
To clarify the confusion around recent news about arthritis
medications, here are some facts:
On April 7, 2005, the FDA announced the following:
• Bextra, a COX-2 inhibitor manufactured by Pfizer, was being
voluntarily withdrawn from the market.
• All prescription NSAIDs must revise their labeling to include
a “black box” warning that highlights the potential increased
risk for cardiovascular (CV) events as well as the potentially
life threatening gastrointestinal (GI) bleeding associated with
these drugs. Celebrex, the only COX-2 inhibitor remaining on
the US market, was included in this directive.
• All OTC NSAIDs (except aspirin) will be required to revise
their labeling to include more specific information about the
potential for GI and CV side effects, a stronger reminder to
follow label instructions, as well as a warning about potential
To further evaluate the potential for increased CV risk, the
FDA also announced that all NSAIDs must conduct and submit to
the Agency a comprehensive review and analysis of pertinent
safety data from clinical trials.
The FDA emphasized that when label directions are followed, OTC
pain relievers such as Aleve (naproxen sodium) provide a safe
and effective way to treat mild to moderate pain of minor
arthritis. If patients have questions, they should consult
their health care professional about which treatment option is
For more information about osteoarthritis, and living with it,
visit the ALEVE website at http://www.aleve.com. ALEVE is an
over-the-counter (OTC) pain reliever that provides relief for a
variety of pain conditions, including minor pains associated
About the Author: The above information from What is
Osteoarthritis?, What Causes Osteoarthritis?, What are the
Different Types of Arthritis?, and How is Osteoarthritis
Different? has been excerpted from The Arthritis Foundation’s
Guide to Good Living with Osteoarthritis, copyright ©2000,
Arthritis Foundation. For more information about this book and
other resources about osteoarthritis, call (800) 283-7800.