SUMMARY
Osteoarthritis (OA) is the most common types of arthritis. It is a mechnical arthritis meaning it involves pain from friction due to lost integrity or degeneration of a joint as opposed to a lot of inflammation. It typically becomes symptomatic as we get older. Certain types of OA are more common in women (Heberden nodes in women) while others are more common in men, but overall it is pretty evenly balanced between the sexes. The cause of OA is not known. Since it is an almost universal occurence and frequently affects weight bearing joints it is thought to be a result of wear and tear. OA at a younger age or in an unusual joint distribution is thought to be due to a congenital abnormality like a dysfunctional hip from birth. It could be hereditary, a sign of a rare disease or could be due to an injury like an old fracture or severe sprain.

DIAGNOSIS
Blood tests do not help diagnose OA but sometimes are useful to exclude other types of arthritis. A doctor makes the diagnosis based on a combination of history and physical along with x-rays. X-rays can show narrowing of joint spaces, overgrowth of bone like spurs, increased density or whiteness along bone margins or cysts just beneath the surface of the joint. But, interestingly, some patients with severe x-ray abnormalities have minimal pain.

WHAT TREATMENTS?
Although patients often inquire about diet and non-drug treatments for OA but there is no lifestyle change that predictably subdues OA. Some physical therapy or exercises can help like bicycling, doing strengthening exercises or using a heel pad for knee arthritis. Unfortunately, currently there are not medications that can cure or even slow down the damage of OA. Anti-inflammatory pills also known as NSAID can help with the pain and stiffness. Steroids should not be used except sometimes steroid injections into the affected joint can help temporarily. Glucosamine sulfate 1500 mg. a day has been shown to decrease pain and might prove to slow progression of knee OA. Topical rubs like compounded NSAID gels and Capsaicin help some. A liquid called Hyaluronic acid can be injected into the knee for OA of the knee. Lastly, surgery such as joint replacement can be a dramatically helpful intervention.

OUTLOOK
Although the course of OA varies from person to person, for the most part, OA or degenerative joint disease does degenerate or worsen though usually slowly. Some patients will have mild cosmetic changes or nagging discomforts while others will have to markedly alter their lifestyle to compensate for the pain and disability that OA can cause. Like with other types of arthritis, the day when we can start to turn back the tide of OA will come.