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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Introduction


October 29, 2008

Osteoarthritis
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Learn The Basics
Introduction
Introduction
htmOAIntro
Osteoarthritis, also called degenerative joint disease or wear-and-tear arthritis, is a common medical condition affecting approximately 20 million Americans.
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InteliHealth
2008-10-29
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InteliHealth/Harvard Medical Content
2010-10-29

Reviewed by the Faculty of Harvard Medical School

Introduction
 
Osteoarthritis, also called degenerative joint disease or wear-and-tear arthritis, is a common medical condition affecting approximately 20 million Americans. Most people with arthritis have this form of the disease, as opposed to rheumatoid arthritis, infectious arthritis, gout or others.
 
Osteoarthritis is particularly common among older people, but it is not an inevitable part of aging. In other words, it is not "normal" for an elderly person to have joint pain. Anyone who has bothersome joint pain, elderly or not, should be thoroughly evaluated by a health-care provider. There are many causes of joint pain and many types of arthritis; appropriate treatments vary accordingly. It is never a good idea to assume that joint pain is "just due to aging." Osteoarthritis occasionally develops in younger people too, usually in association with a specific risk factor, such as joint injury.

 

Joint Wear And Tear
 
Some people refer to osteoarthritis as wear-and-tear arthritis because it is associated with long-term joint use (over several decades) and trauma (such as automobile accidents and sports injuries). Its onset is typically gradual, and the joint undergoes initial changes long before the first symptoms appear.
    • Joint pain is usually the first symptom, often worsening during movement, improving during rest and causing prominent pain at night after an especially active period.
    • Stiffness may be present after a period of immobility, such as after a night's sleep, but it is brief (lasting only 15 or 20 minutes) and improves with movement.
    • As osteoarthritis becomes more severe, joint motion decreases. The joint may become swollen or the bones enlarged, and movement may be accompanied by a grating sensation called crepitus.
The term "arthritis" means joint inflammation, but inflammation is actually minimal in osteoarthritis compared with other common forms of arthritis, such as rheumatoid arthritis and gout. However, differences between these three most common types of arthritis are not absolute. For example, rheumatoid arthritis can lead to osteoarthritis over a period of several years.
 
Disease
Swelling
Time Of Day*
Pain
Duration
Osteoarthritis
None or mild
PM
With movement
Chronic (long-term)
Rheumatoid arthritis
Yes, prominent
AM
Without movement, may improve with movement
Chronic
Gout
Yes, prominent
AM onset
With and without movement
Acute (sudden, short-term)**
 
*When osteoarthritis is severe, pain at night is common and may wake you from sleep. On the other hand, morning stiffness that lasts for more than an hour is common in rheumatoid arthritis.
 
**Gout is usually acute (short-term), but chronic (long-term) forms of this disease may develop many years after the initial attacks begin.

 

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