How to Spot Osteoarthritis (and What to Do About It)
There’s nothing easy about osteoarthritis (OA)—a degenerative disease that affects the smooth cartilage lining of your joints. Symptoms can come on gradually, worsening over time until the joint no longer functions properly. Catching OA early can prevent significant tissue damage—but it’s tricky to spot. “Some people don’t feel symptoms of osteoarthritis until it has progressed quite a bit,” says Dominic King, D.O., and orthopedic and sports medicine physician at the Cleveland Clinic in Ohio. These are five red flags to keep an eye out for.
Not all osteo aches are created equal. “There are a variety of ways a person experiences the pain,” says King. Some people feel a sharp or stabbing pain during activity while other people get a dull and achy sensation when they’ve been resting and then start moving again. Some lucky folks get a combination of both. Says King, “The pain is typically coming from inflammation of the synovium (the capsule around the knee), the meniscus (shock absorber inside the knee), or the bone under the cartilage.”
As with pain, not all joints develop stiffness the same way. For instance, your shoulder may only develop stiffness in certain directions, such as reaching behind your back. “Joint stiffness is not easily explained,” says John Fitzgerald, M.D., a clinical professor of medicine in the division of rheumatology at the University of California, Los Angeles. A possible cause: Joint fluid temporarily thickens when you’ve been sitting a while, adding resistance when you try to stand. “This stiffness typically resolves with motion,” says King.
Swelling of the joint can be mild to moderate, and is more likely to occur after activity. Swelling is triggered by inflammatory cells (white blood cells) that migrate into and around the joint, resulting in a fluid buildup. Certain joints may experience more swelling than others. “The knee joint commonly gets swollen,” says King. It’s less likely in the hip or shoulder (and harder to see). “The wrist and ankle are in-between in terms of their level of swelling,” adds King.
Reduced Range of Motion
Early on with OA, you may have difficulty moving a joint through its entire range. A reduced range of motion can come on gradually—your knee, for example, normally fully extends when you get up and fully flexes when you squat, but over time you may realize it no longer truly straightens when you stand. If the range of motion of your knee or hip is restricted, things like climbing stairs are suddenly harder. Swelling and stiffness contribute to that loss of range.
Your joint is like a hinge, swinging your bones back and forth silently. An early sign of osteoarthritis can be a sound or feeling of popping, clicking, or snapping in your joints—referred to as crepitus. (The word “crepitus” means creaking in Latin.) “If it’s painless, it’s not likely to be an issue,” says King. “But, if it’s painful, that can be a sign of osteoarthritis.” The pops and snaps may be due to an irregular cartilage surface in the joint rubbing against another irregular cartilage surface because of the joint degeneration.
How Weight Loss Helps
If you have osteoarthritis of weight-bearing joints—i.e., your hips, knees, ankles, and feet—and you’re overweight, it’s time to shed some pounds, says Dr. Fitzgerald. Weight loss reduces joint forces, lessening the pain of movement. “Weight loss can come from aerobic exercises, such as brisk walking, and biking, but almost always is most effective when dietary intake is reduced,” adds Kim Huffman, M.D., Ph.D., associate professor in the division of rheumatology at Duke University Medical Center in Durham, NC.
Why Exercise Matters
It’s natural to want to cut down on activities when you have joint pain, stiffness, or swelling. But actually, you should do the opposite. “A joint is not just the bones and cartilage but also muscles, tendons, and ligaments," says Dr. Fitzgerald. “We can’t fix arthritis, but we can improve the strength and stability of the joint by exercising.” Along with aerobic activity like walking and swimming, slow stretches and strength training can help joints with mobility. Check with a physical therapist to make sure you’re doing the movements right!
Should You Try Physical Therapy?
“In the early stages of osteoarthritis, aside from weight loss (if you’re obese), the most critical component of treatment is physical therapy,” believes Dr. Huffman. A physical therapist can teach you specific exercises that will protect your joints while boosting muscle strength around them. In addition, a physical therapist can use cold or heat therapy to ease pain, swelling, and stiffness. Many physical therapists use hands-on (manual) therapy techniques to improve a joint’s range of motion, as well as increase strength and flexibility.
Seek Help for Early Signs
If you experience any of these early symptoms of osteoarthritis, don’t ignore them—it could make matters worse. Instead, schedule an appointment with your healthcare provider who may refer you to an orthopedist, rheumatologist, or physical therapist. Learning that you have osteoarthritis is a bummer—but it’s better to find out now so you can make lifestyle changes and explore treatments, including physical therapy, that may prevent or reduce the risk of joint dysfunction and damage in the future.