Osteoarthritis: Commonly Affected Joints

	Edgar G. Dawson, M.D.
	Christopher I. Shaffrey, MD Harrison Distinguished Professor Neurological and Orthopaedic Surgery University of Virginia Charlottesville, VA, USA

Which joints are affected by Osteoarthritis?
Osteoarthritis can occur in any joint but most often occurs in the spine, hips, knees or hands.

• Spine. Stiffness and pain in the neck or in the lower back can result from osteoarthritis of the spine. Weakness or numbness of the arms or legs can also result. Some people feel better when they sleep on a firm mattress or sit using back support pillows. Others find help from heat treatment or an exercise program to strengthen the back and abdominal muscles. In severe cases, surgery to reduce pain and help restore function may be necessary.

• Hips. Osteoarthritis in the hip can cause pain, stiffness and severe disability. People may feel the pain in their hips, groin, inner thigh or knees. Osteoarthritis in the hip may limit moving and bending. This can make daily activities such as dressing and foot care difficult. Walking aids (such as canes and walkers), medication, and exercise can help relieve pain and improve motion. If the pain is severe and not helped by other methods, hip replacement surgery may be necessary.

• Knees. The knees are the body's primary weight-bearing joints. For this reason, they are among the joints most commonly affected by osteoarthritis. They may be stiff, swollen, and painful, making it hard to walk, climb, get in and out of chairs and use bathtubs. If not treated, osteoarthritis in the knees can lead to disability. Medications, losing weight, exercise, and walking aids can reduce pain and disability. In severe cases, knee replacement surgery may be necessary.

• Hands. In osteoarthritis of the hands, small, bony knobs appear on the end joints of the fingers. They are called Heberden's nodes. Similar knobs, called Bouchard's nodes, can appear on the middle joints of the fingers. Fingers can become enlarged and gnarled, and may ache or be stiff and numb. The base of the thumb joint is also commonly affected by osteoarthritis. Medications, splints or heat treatment can usually help osteoarthritis in the hands.

• History: Your doctor will begin by asking you to describe any symptoms you are having and how they have changed over time. Tell your doctor about any pain, stiffness, or decreased joint function you are experiencing and how it is affecting your daily life. Also talk to your doctor about how you have been treating these symptoms. Be sure to also tell your doctor about any other medical problems you have and if you are taking any medications.

• Physical Examination: After talking with you about your symptoms, your doctor will examine you by checking your reflexes and muscle strength. Your doctor may also ask you to walk and bend to observe your flexibility.

• Tests: Since there is no single test for osteoarthritis, your doctor may need to do a variety of tests including x-rays of your joints to see if there has been any cartilage loss, bone damage or bone spurs. Other tests may include blood tests and a test called “joint aspiration” where fluid is drawn from the joint to be examined.

It is usually not difficult to tell if a patient has osteoarthritis. It is more difficult to tell if the disease is causing the symptoms. Osteoarthritis is so common, especially in older people, that other conditions may play a role in the symptoms. Your doctor will try to find out what is causing the symptoms and rule out any other health problems you may have.

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