Osteoarthritis

Symptoms and Diagnosis

Pain and Stiffness in Joints

Different types of arthritis have different symptoms. In general, people with most forms of arthritis have pain and stiffness in their joints.

Osteoarthritis usually develops slowly and can occur in any joint, but often occurs in weight-bearing joints. Early in the disease, joints may ache after physical work or exercise. Most often, osteoarthritis occurs in the hands, hips, knees, neck, or low back.

Common Signs

Common signs of osteoarthritis include

  • joint pain, swelling, and tenderness
  • stiffness after getting out of bed
  • a crunching feeling or sound of bone rubbing on bone.

Not everyone with osteoarthritis feels pain, however. In fact, only a third of people with x-ray evidence of osteoarthritis report pain or other symptoms.

Diagnosis

To make a diagnosis of osteoarthritis, most doctors use a combination of methods and tests including a medical history, a physical examination, x-rays, and laboratory tests.

  • A medical history is the patient's description of symptoms and when and how they began. The description covers pain, stiffness, and joint function, and how these have changed over time.
  • A physical examination includes the doctor's examination of the joints, skin, reflexes, and muscle strength. The doctor observes the patient's ability to walk, bend, and carry out activities of daily living.
  • X-rays are limited in their capacity to reveal how much joint damage may have occurred in osteoarthritis. X-rays usually don't show osteoarthritis damage until there has been a significant loss of cartilage.

Questions Your Doctor May Ask

It is important for people with joint pain to give the doctor a complete medical history. Answering these questions will help your doctor make an accurate diagnosis:

  • Is the pain in one or more joints?
  • When does the pain occur and how long does it last?
  • When did you first notice the pain?
  • Does activity make the pain better or worse?
  • Have you had any illnesses or accidents that may account for the pain?
  • Is there a family history of any arthritis or rheumatic diseases?
  • What medicines are you taking?

A patient's attitudes, daily activities, and levels of anxiety or depression have a lot to do with how severe the symptoms of osteoarthritis may be.

Who Can Provide Care

Treating arthritis often requires a multidisciplinary or team approach. Many types of health professionals care for people with arthritis. You may choose a few or more of the following professionals to be part of your health care team.

  • Primary care physicians -- doctors who treat patients before they are referred to other specialists in the health care system. Often a primary care physician will be the main doctor to treat your arthritis. Primary care physicians also handle other medical problems and coordinate the care you receive from other physicians and health care providers.
  • Rheumatologists -- doctors who specialize in treating arthritis and related conditions that affect joints, muscles, and bones.
  • Orthopaedists -- surgeons who specialize in the treatment of, and surgery for, bone and joint diseases.
  • Physical therapists -- health professionals who work with patients to improve joint function.
  • Occupational therapists -- health professionals who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
  • Dietitians -- health professionals who teach ways to use a good diet to improve health and maintain a healthy weight.
  • Nurse educators -- nurses who specialize in helping patients understand their overall condition and implement their treatment plans.
  • Physiatrists (rehabilitation specialists) -- medical doctors who help patients make the most of their physical potential.
  • Licensed acupuncture therapists -- health professionals who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.
  • Psychologists -- health professionals who seek to help patients cope with difficulties in the home and workplace resulting from their medical conditions.
  • Social workers -- professionals who assist patients with social challenges caused by disability, unemployment, financial hardships, home health care, and other needs resulting from their medical conditions.
  • Chiropractors -- health professionals who focus treatment on the relationship between the body's structure -- mainly the spine -- and its functioning.
  • Massage therapists -- health professionals who press, rub, and otherwise manipulate the muscles and other soft tissues of the body. They most often use their hands and fingers, but may use their forearms, elbows, or feet.