It affects over half of all seniors. Degenerative arthritis, or osteoarthritis, is the most common disease that affects the weight-bearing joints. It follows a progressive course, but one that usually advances slowly over many years, unlike other types of arthritis that cause a more rapid disability. Although greater than 50% of people over the age of sixty-five have osteoarthritis on x-ray not all of them are symptomatic. What are the symptoms of degenerative arthritis?
Symptoms of Degenerative Arthritis
The first symptom of osteoarthritis is usually pain, although it may be quite mild and occur only after physical activity. This type of early pain resolves with rest and is usually responsive to aspirin or a non-steroidal anti-inflammatory medication. At this point, a person may not be aware they have early degenerative arthritis but may believe they just “overdid it". The discomfort is due primarily to breakdown of cartilage and formation of bone spurs. These bone spurs, or osteophytes, break off and enter the joint space, which leads to stiffness.
Gradually, these episodes of pain after activity become more frequent, and stiffness upon awakening in the morning appears. The stiffness gradually resolves as the osteoarthritis sufferer moves around and usually lasts less than thirty minutes. At this stage, the symptoms are still easily controlled with analgesics.
As the disease progresses, which may occur slowly over several years, pain begins to occur at rest in the absence of activity, and the morning stiffness becomes more pronounced. At this stage, the pain may be less responsive to analgesics, and the arthritis sufferer knows something is wrong.
At this point, the pain may be due to stretching of the joint capsule, fluid in the joint space, small tears in the cartilage or chronic inflammation. Doctors once believed that degenerative arthritis didn’t involve significant inflammation, but they now know that inflammatory chemicals are released into the joint spaces with degenerative arthritis, which accounts for some of the pain.
Signs of Degenerative Arthritis
For some people, the symptoms worsen with changes in weather especially changes in barometric pressure. They may also experience a symptom called crepitus, a course grating sound that occurs when an affected joint is moved. The joints can become unstable over time, which is particularly problematic when it involves weight-bearing joints.
The joints in the hands and fingers are frequently involved, and swollen nodules form over the joints in the fingers called Heberden’s and Bouchard’s nodes. These nodes make it more difficult to move the fingers and may restrict a degenerative arthritis sufferer’s ability to do manual tasks such as knitting or sewing.
In more advanced cases, the symptoms of degenerative arthritis lead to more serious complications such as contractures and compression of nerves of the spinal cord, which can have serious consequences.
The Bottom Line
Degenerative arthritis is a common, but highly variable disease. It may be asymptomatic and in people who do have symptoms progression can occur very slowly over years to decades, or it may advance more rapidly leading to significant disabilities. Fortunately, there are treatments that can bring some relief to the stiff, achy joints of degenerative arthritis.
Professional Guide to Diseases. Ninth edition. Lippincott, Williams, and Wilkinson. 2009.