Publication date Sep 13, 2007
Osteoarthritis can make your joints stiff and painful. This can make it hard to do everyday things, such as getting out of a chair or tying a shoelace. Although it can’t be cured, there are treatments that can help relieve the symptoms of osteoarthritis and help you move more easily.
Osteoarthritis is a disease that affects joints. It's most common in the joints in your knees, hips, hands and spine.
Osteoarthritis happens when the cartilage at the ends of bones becomes damaged. Cartilage is a hard, slippery material that coats the end of a bone where it meets another bone. It allows bones to move smoothly without rubbing together.
When cartilage is damaged the bone in your joints tries to repair the damage (bone can grow and mend itself). But instead of making things better, in osteoarthritis the bone grows abnormally and makes things worse. For example, the bone can grow into a knobbly shape and make the joint painful and unstable.
No one really understands why bone does this. And it's not clear if the cartilage damage happens before the bone grows abnormally.
Osteoarthritis is not due simply to aging or wear and tear of the cartilage at the end of the bones. But you’re more likely to get it as you get older. Being overweight, being a woman and having osteoarthritis in your family also increase your risk of getting the condition.
The symptoms of osteoarthritis usually come on gradually, sometimes over many years. The most common ones are:
Your doctor will ask you about your symptoms and look at your joints. He or she may also order some tests, such as an X-ray and blood test, to check whether your symptoms are due to osteoarthritis or another condition.
There is no cure for osteoarthritis, but there are treatments that can help control the pain and discomfort it causes, as well as helping you move more freely. There’s good research to show that the ones we list below can help.
Exercising moderately but regularly reduces your pain, and helps you stay active and move more easily. There’s good research to show exercising helps people with osteoarthritis of the knee. There’s less clear evidence that it helps people with osteoarthritis of the hip. A physiotherapist can tell you about exercises that should help your joints. But swimming, walking and cycling are also good forms of exercise.
Creams or gels containing capsaicin are likely to reduce pain in the short term and the effect can build up. After 1 week of rubbing in a little bit of capsaicin three or four times a day, up to two-thirds of people who used it for osteoarthritis in their hands said it had eased their pain. Brand names for capsaicin cream include Axsain and Zacin. It can cause a mild burning feeling.
Having a brace or tape to support your knee can reduce your pain and help you move around better within three weeks of wearing it. You'll need to talk to your doctor and get help from a physiotherapist before taping your leg.
Acupuncture can help reduce symptoms of osteoarthritis of the knee. But there isn’t any good research to say whether it helps osteoarthritis in the hip. Acupuncture is unlikely to cause any serious problems.
A dietary supplement called chondroitin is likely to help people with knee osteoarthritis. But the improvement might not be very big. You can buy this supplement from a pharmacy. There hasn’t been any good research to see if chondroitin helps osteoarthritis in the hip.
Some people with osteoarthritis take another supplement called glucosamine, which you can also buy from a pharmacy. But there isn’t enough research to say for certain it can help.
There are also several different types of shoe wedges and insoles you can try, which aim to reduce pressure on painful joints. Your doctor or physiotherapist can tell you more about these, but there isn’t very much research on them.
Paracetamol can help reduce the pain and tenderness of osteoarthritis. It may help you do everyday things, like getting out of a chair or going for a walk. It doesn’t work as well as drugs called NSAIDs (see below), but some people prefer taking it because it causes fewer side effects. You shouldn’t take more than the recommended dose because paracetamol can damage the liver.
Nonsteroidal anti-inflammatory drugs (NSAIDs) work well to control pain and swelling due to osteoarthritis. This should help you move your joints more easily. Most people take NSAIDs as tablets. You can buy some NSAIDs, such as ibuprofen, over the counter at a pharmacy. Other NSAIDs can be prescribed by your doctor. These include celecoxib (Celebrex) diclofenac (Diclomax, Motifene, Voltarol), naproxen (Naprosyn, Synflex) and piroxicam (Feldene). Taking NSAIDs regularly can irritate your stomach and cause indigestion and stomach ulcers. In rare cases this can lead to bleeding in the stomach. Your doctor will give you the lowest dose of NSAID to keep down the risk of this happening. He or she may also prescribe another drug to protect your stomach from the harmful effects of NSAIDs. Some NSAIDs increase very slightly the risk of having a heart attack or stroke. For this reason your doctor will ask you if you have any heart problems before prescribing an NSAID.
NSAID creams and gels that you can rub into your joints can help to reduce pain, especially in joints in the hand and knee. You should be able to move these joints more easily. You can buy some creams and gels at a pharmacy (Feldene P, Ibuderm), but for others you’ll need a prescription (Powergel, Traxam, Voltarol Emugel). You’re less likely to get the stomach problem with creams and gels than you are with NSAIDs tablets (see above). But you may get itchiness or a rash where you apply the cream.
Injections of steroids or a drug based on hyaluronic acid into the knee joint can reduce pain. The effects of steroids last up to four weeks. Hyaluronic acid seems to have most effect between 5 and 13 weeks after injection.
Surgery to replace a knee or hip usually works well. There’s a very good chance that the pain and stiffness in your joint will go away completely after a replacement operation. But these are serious operations and they may not be suitable for everybody. You’ll need a few weeks to recover from an operation to replace a knee or hip joint. It can help to exercise. A physiotherapist will be able to advise you about what to do.
Another type of operation called an osteotomy, during which a small piece of bone is removed from the knee, can help reduce pain and improve movement. Research shows it works as well as a knee replacement operation in some people.
The following things can help to reduce pain and stiffness in osteoarthritis:
Simple aerobic exercise: You could try walking or swimming.
Walking sticks: Some people say that they couldn't walk down the street without a walking stick. So using a walking stick can help you feel more independent.
Osteoarthritis is a disease that usually, but not always, progresses very slowly, often over many years. The pain and stiffness may even get better with time. But it's hard to predict what will happen to you as an individual.
Research shows that you may be able to avoid developing severe symptoms by keeping your weight at a healthy level and staying mobile.
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice.
If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.