Osteoarthritis is a disease of the joints. Unlike many other forms of arthritis, such as rheumatoid arthritis and systemic lupus, osteoarthritis does not affect other organs of the body.
The most common symptom of osteoarthritis is pain in the affected joints after repetitive use. Joint pain is usually worse later in the day. There can be swelling, warmth, and creaking of the affected joints. Pain and stiffness of the joints can also occur after long periods of inactivity, for example, sitting in a theater. In severe osteoarthritis, complete loss of cartilage causes friction between bones, causing pain at rest or pain with limited motion.
The pain of arthritis makes it tough for many people to get a good night’s sleep. Worse yet, tossing and turning at night can actually increase the perception of pain.
“There’s a reciprocal relationship between pain and poor sleep. The poorer people sleep, the more pain they tend to be in,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. “If people with arthritis can improve the quality of their sleep, they can usually reduce their day-to-day pain.”
Symptoms of osteoarthritis vary greatly from patient to patient. Some patients can be debilitated by their symptoms. On the other hand, others may have remarkably few symptoms in spite of dramatic degeneration of the joints seen on X-rays. Symptoms also can be intermittent. It is not unusual for patients with osteoarthritis of the hands and knees to have years of pain-free intervals between symptoms.
Osteoarthritis of the knees is often associated with obesity or a history of repeated injury and/or joint surgery. Progressive cartilage degeneration of the knee joints can lead to deformity and outward curvature of the knees referred to as "bow legged." Patients with osteoarthritis of the weight bearing joints (like the knees) can develop a limp. The limping can worsen as more cartilage degenerates. In some patients, the pain, limping, and joint dysfunction may not respond to medications or other conservative measures. Therefore, severe osteoarthritis of the knees is one of the most common reasons for total knee replacement surgical procedures in the U.S.
Osteoarthritis of the spine causes pain in the neck or low back. Bony spurs that form along the arthritic spine can irritate spinal nerves, causing severe pain, numbness, and tingling of the affected parts of the body.
Osteoarthritis causes the formation of hard bony enlargements of the small joints of the fingers. Classic bony enlargement of the small joint at the end of the fingers is called a Heberden's node, named after a British doctor. The bony deformity is a result of the bone spurs from the osteoarthritis in that joint. Another common bony knob (node) occurs at the middle joint of the fingers in many patients with osteoarthritis and is called a Bouchard's node, named after a French doctor who studied arthritis patients in the late 1800s. The Heberden's and Bouchard's nodes may not be painful, but they are often associated with limitation of motion of the joint. The characteristic appearances of these finger nodes can be helpful in diagnosing osteoarthritis. Osteoarthritis of the joint at the base of the big toes leads to the formation of a bunion. Osteoarthritis of the fingers and the toes may have a genetic basis, and can be found in many female members of some families.