Osteoarthritis also called degenerative joint disease, mostly affects cartilage – the hard but slippery tissue that covers the ends of bones where they meet to form a joint.

Healthy cartilage allows bones to glide over one another and absorbs energy from the shock of physical movement. But in osteoarthritis, the surface layer of cartilage breaks and wears away. This allows bones under the cartilage to rub together, causing pain, swelling and loss of motion in the joint.

Over time, the joint may lose its normal shape. Small deposits of bone – called osteophytes or bone spurs – may grow on the edges. Bits of bone or cartilage can break off and float inside the joint space, causing more pain and damage.

People with osteoarthritis usually have joint pain and stiffness. The most commonly affected joints are those at the ends of the fingers (closest to the nail), thumbs, neck, lower back, knees and hips.

The warning signs of osteoarthritis :

Stiffness in a joint after getting out of bed or sitting for a long time
Swelling in one or more joints
A crunching feeling or the sound of bone rubbing on bone

Treatment for Osteoarthritis
Most successful treatments involve a combination of remedies tailored to the patient’s needs, lifestyle and health, including ways to manage pain and improve function.
ExercisePhysical movement is one of the best osteoarthritis treatments. It can improve mood and outlook, decrease pain, increase flexibility, strengthen the heart and improve blood flow, maintain weight, and promote general physical fitness. Your doctor and/or physical therapist can recommend specific types of exercise depending on your particular situation.

Strengthening workouts. These exercises strengthen muscles that support joints affected by arthritis. They can be performed with weights or with exercise bands, inexpensive devices that add resistance.
Aerobic activities, such as brisk walking or low-impact aerobics, that get your heart pumping and can keep your lungs and circulatory system in shape.
Range-of-motion activities. These keep your joints limber.
Balance and agility exercises. These help you maintain daily living skills.

Weight controlOsteoarthritis patients who are overweight or obese should try to lose weight through a healthy diet and regular exercise. This can reduce stress on weight-bearing joints, limit further injury and increase mobility.

Rest and relief from stress on jointsPatients must learn to recognize the body’s signals, and know when to stop or slow down. This will prevent the pain caused by overexertion. Getting proper sleep is important for managing osteoarthritis pain. If you have trouble sleeping, you may find that relaxation techniques, stress reduction and biofeedback can help, as can timing medications to provide maximum pain relief through the night.

Nondrug pain relief and alternative therapiesHeat and cold. Heat can be applied in a number of different ways – with warm towels, hot packs or a warm bath or shower – to increase blood flow and ease pain and stiffness.

In some cases, cold packs (bags of ice or frozen vegetables wrapped in a towel), which reduce inflammation, can relieve pain or numb the sore area.

Transcutaneous electrical nerve stimulation (TENS) uses a small electronic device to direct mild electric pulses to nerve endings that lie beneath the skin in the painful area. It may relieve some arthritis pain by blocking messages to the brain and modifying pain perception.

Massage. As an osteoarthritis treatment, a massage therapist will lightly stroke and/or knead the painful muscles. This may increase blood flow and bring warmth to a stressed area. However, arthritis-stressed joints are sensitive, so the therapist must be familiar with the problems of the disease.

Acupuncture. Some people have found pain relief using this practice, in which fine needles are inserted by a licensed acupuncture therapist at specific points on the skin. Scientists think the needles stimulate the release of natural, pain-relieving chemicals produced by the nervous system.

Nutritional supplements. Natural remedies such as glucosamine and chondroitin sulfate have been reported to improve the symptoms of people with osteoarthritis, as have certain vitamins (such as vitamin D). But the research is unclear.

Treatment/ medications for pain-
Corticosteroids. These are powerful anti-inflammatory hormones that may be injected into the affected joints to temporarily relieve osteoarthritis pain. This is a short-term measure, generally not recommended for more than 2-4 treatments per year.

Hyaluronic acid substitutes. Sometimes called viscosupplements, these are designed to replace a normal component of joint lubrication. They’re injected into the joint, and are only approved for osteoarthritis of the knee.

Topical medications. Doctors may prescribe pain-relieving creams, rubs and sprays, which are applied directly to the skin over painful joints.

SurgeryFor many people, surgery helps relieve the pain and disability of osteoarthritis. It may achieve one or more of the following:

Removal of loose pieces of bone and cartilage from the joint if they are causing symptoms of buckling or locking (arthroscopy)
Repositioning of bones (osteotomy)
Resurfacing (smoothing out) bones
Surgeons may replace affected joints with artificial joints called prostheses. These can be made from metal alloys, high-density plastic or ceramic material. Some prostheses are joined to bone surfaces with special cements. Others have porous surfaces and rely on the growth of bone into that surface (a process called biologic fixation) to hold them in place.

Joint replacement advances in recent years have included the ability, in some cases, to replace only the damaged part of the knee joint, leaving undamaged parts of the joint intact, and the ability to perform hip replacement through much smaller incisions than previously possible.

The decision to use surgery depends on several factors, including the patient's age, occupation, level of disability, pain intensity, and the degree to which arthritis interferes with his or her lifestyle.

After surgery and rehabilitation, the patient usually feels less pain and swelling and can move more easily. Artificial joints can last 10-15 years or longer.