Diagnosis

During the physical exam, your doctor will check your affected joint for tenderness, swelling,
redness and flexibility.

Imaging tests

To get pictures of the affected joint, your doctor might recommend:

 X-rays. Cartilage doesn't show up on X-ray images, but cartilage loss is revealed by a

narrowing of the space between the bones in your joint. An X-ray can also show bone
spurs around a joint. X-rays of the affected joints are the main way osteoarthritis is
identified. The common X-ray findings of osteoarthritis include loss of joint cartilage,
narrowing of the joint space between adjacent bones, and bone spur formation. Simple X-ray
testing can be very helpful to exclude other causes of pain in a particular joint as well as
assist the decision-making as to when surgical intervention should be considered.

 Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic

field to produce detailed images of bone and soft tissues, including cartilage. An MRI isn't
commonly needed to diagnose osteoarthritis but can help provide more information in
complex cases.

 Ultrasound can be useful for evaluating the soft tissue structures that surround the affected
joint, such as tendons. Ultrasound can also be used to identify changes to the delicate
membrane that encapsulates the joint (synovial lining) or an abnormal increase in joint fluid
(synovial fluid).

Lab tests

Analyzing your blood or joint fluid can help confirm the diagnosis.

 Blood tests. Although there's no blood test for osteoarthritis, certain tests can help rule
out other causes of joint pain, such as rheumatoid arthritis.

 Joint fluid analysis. Your doctor might use a needle to draw fluid from an affected joint.
The fluid is then tested for inflammation and to determine whether your pain is caused by
gout or an infection rather than osteoarthritis.
Treatment

Osteoarthritis can't be reversed, but treatments can reduce pain and help you move better.

Medications

Medications that can help relieve osteoarthritis symptoms, primarily pain, include:

 Acetaminophen. Acetaminophen (Tylenol, others) has been shown to help some people

with osteoarthritis who have mild to moderate pain. Taking more than the recommended
dose of acetaminophen can cause liver damage.

 Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as

ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), taken at the
recommended doses, typically relieve osteoarthritis pain. Stronger NSAIDs are available
by prescription.

NSAIDs can cause stomach upset, cardiovascular problems, bleeding problems, and liver
and kidney damage. NSAIDs as gels, applied to the skin over the affected joint, have fewer
side effects and may relieve pain just as well.

 Duloxetine (Cymbalta). Normally used as an antidepressant, this medication is also

approved to treat chronic pain, including osteoarthritis pain.

 Counterirritants. These OTC products have ingredients like capsaicin, menthol and

lidocaine. They irritate nerve endings, so the painful area feels cold, warm or itchy to
take focus away from the actual pain. 
 Corticosteroids –These prescription anti-inflammatory medicines work in a similar way
to a hormone called cortisol. The medicine is taken by mouth or injected into the joint at
a doctor’s office.
 Platelet-rich plasma (PRP). Available from a doctor by injection, this product has
proteins that help ease pain and inflammation.
Nondrug Therapies

Exercise

Movement is an essential part of an OA treatment plan. Getting 150 minutes of moderate-to-

vigorous exercise per week should be the goal according to the U.S. Department of Health and
Human Services. A good exercise program to fight OA pain and stiffness has four parts:

 Strengthening exercises build muscles around painful joints and helps to ease the stress
on them. 
 Range-of-motion exercise or stretching helps to reduce stiffness and keep joints
moving.
 Aerobic or cardio exercises help improve stamina and energy levels and reduce excess
weight.
 Balance exercises help strengthen small muscles around the knees and ankles and help
prevent falls.

Talk to a doctor or physical therapist before starting a new exercise program.

Weight Loss

Weighing more than what’s healthy puts extra stress on the hips, knees, feet and back. Losing
weight helps to reduce pain and stop or slow down joint damage. Every pound of weight lost
removes four pounds of pressure on lower-body joints.

Physical Therapies and Assistive Devices

Physical therapists, occupational therapists and chiropractors can provide:

 Specific exercises to help stabilize your joints and ease pain.

 Information about natural treatments and products that can ease pain.
 Instruction to make movement easier and to protect joints. 
 Braces, shoe inserts or other assistive devices.

Therapy

 Physical therapy. A physical therapist can show you exercises to strengthen the muscles
around your joint, increase your flexibility and reduce pain. Regular gentle exercise that
you do on your own, such as swimming or walking, can be equally effective.

 Occupational therapy. An occupational therapist can help you discover ways to do

everyday tasks without putting extra stress on your already painful joint. For instance, a
toothbrush with a large grip could make brushing your teeth easier if you have
 osteoarthritis in your hands. A bench in your shower could help relieve the pain of
standing if you have knee osteoarthritis.

 Transcutaneous electrical nerve stimulation (TENS). This uses a low-voltage electrical

current to relieve pain. It provides short-term relief for some people with knee and hip
osteoarthritis.
Surgical and other procedures

If conservative treatments don't help, you might want to consider procedures such as:

 Cortisone injections. Injections of a corticosteroid into your joint might relieve pain for a
few weeks. Your doctor numbs the area around your joint, then places a needle into the
space within your joint and injects medication. The number of cortisone injections you can
receive each year is generally limited to three or four, because the medication can worsen
joint damage over time.

 Lubrication injections. Injections of hyaluronic acid might relieve pain by providing

some cushioning in your knee, though some research suggests that these injections offer
no more relief than a placebo. Hyaluronic acid is similar to a component normally found in
your joint fluid.

 Realigning bones. If osteoarthritis has damaged one side of your knee more than the
other, an osteotomy might be helpful. In a knee osteotomy, a surgeon cuts across the
bone either above or below the knee, and then removes or adds a wedge of bone. This
shifts your body weight away from the worn-out part of your knee.

 Joint replacement. In joint replacement surgery, your surgeon removes your damaged
joint surfaces and replaces them with plastic and metal parts. Surgical risks include
infections and blood clots. Artificial joints can wear out or come loose Lifestyle and home
remedies

 Arthroscopic surgery. This is a common outpatient procedure for knees and shoulders.

Doctors can repair the surfaces of damaged joints, removing loose cartilage, repairing
cartilage tears, and smoothing bone surfaces. Diseased joint components are replaced in
arthroplasty.

 Joint fusion. Also called arthrodesis, this surgery involves fusing two bones on each end of a
joint, getting rid of the joint itself. It’s used when joints are severely damaged and cause
severe pain. It’s also done when joint replacement is not effective, as with the ankle. Though
 a fused joint is not flexible, it is more stable, can bear weight better, and will no longer cause
pain due to osteoarthritis.

Learn all you can about your condition and how to manage it, especially about how lifestyle
changes can affect your symptoms. Exercising and losing weight if you're overweight are
important ways to lessen the joint pain and stiffness of osteoarthritis.

 Exercise. Low-impact exercise can increase your endurance and strengthen the muscles
around your joint, making your joint more stable. Try walking, bicycling or water aerobics.
If you feel new joint pain, stop.

New pain that lasts for hours after you exercise probably means you've overdone it, not
that you've caused damage or that you should stop exercising. Try again a day or two later
at a lower level of intensity.

 Lose weight. Carrying extra weight increases the stress on your weight-bearing joints,
such as your knees and your hips. Even minor weight loss can relieve some pressure and
reduce your pain. Talk to a dietitian about healthy ways to lose weight.

Other things to try include:

 Movement therapies. Tai chi and yoga involve gentle exercises and stretches combined
with deep breathing. Many people use these therapies to reduce stress in their lives, and
research suggests that tai chi and yoga might reduce osteoarthritis pain and improve
movement.

Make sure the yoga you choose is a gentle form and that your instructor knows which of
your joints are affected. Avoid moves that cause pain in your joints.

 Heat and cold. Both heat and cold can relieve pain and swelling in your joint. Heat,
especially moist heat, can help muscles relax and ease pain. Cold can relieve muscle aches
after exercise and decrease muscle spasms.

 Capsaicin. Topical capsaicin, a chili pepper extract, applied to your skin over an arthritic
joint might help. You might have to apply it three to four times a day for several weeks
before you see a benefit. Some people can't tolerate the irritation. Wash your hands well
after applying capsaicin cream.

 Braces or shoe inserts. Shoe inserts or other devices might help reduce pain when you
stand or walk. These devices can support your joint to help take pressure off it.
  Assistive devices. Assistive devices can help relieve stress on your joints. A cane or
walker take weight off your knee or hip as you walk. Hold the cane in the hand opposite
the leg that hurts.

Tools for gripping and grabbing may make it easier to work in the kitchen if you have
osteoarthritis in your fingers. Check catalogs or medical supply stores or ask your doctor
or occupational therapist about assistive devices.
Alternative medicine

Complementary and alternative medicine treatments that have shown promise for
osteoarthritis include:

 Acupuncture. Some studies indicate that acupuncture can relieve pain and improve
function in people who have knee osteoarthritis. During acupuncture, hair-thin needles
are inserted into your skin at precise spots on your body.

 Glucosamine and chondroitin. Studies have been mixed on these nutritional

supplements. A few have found benefits for people with osteoarthritis, while most
indicate that these supplements work no better than a placebo. Glucosamine and
chondroitin can interact with blood thinners such as warfarin (Jantoven, and cause
bleeding problems.

 Avocado-soybean unsaponifiables. This nutritional supplement — a mixture of avocado

and soybean oils — is widely used in Europe to treat knee and hip osteoarthritis. It acts as
an anti-inflammatory, and some studies have shown that it can slow or even prevent joint
damage.

 Omega-3 fatty acids. Omega-3s, found in fatty fish and fish oil supplements, might help
relieve pain and improve function.
Nursing Management

• Pain management and optimal functional ability are major goals of nursing intervention. The
patient’s understanding of the disease process and symptom pattern is critical to a plan of care.
Because patients with OA usually are older, they may have other health problems. Commonly
they are overweight, and they may have a sedentary lifestyle.

• Weight loss and exercise are important approaches to pain and disability improvement
(Christensen, et al., 2005; Klippel, et al., 2008). Exercises such as walking should be begun in
moderation and increased gradually.
• A referral for physical therapy or to an exercise program for people with similar problems can
be very helpful. Canes or other assistive devices for ambulation should be considered.

• Patients should plan their daily exercise for a time when the pain is least severe or plan to use
an analgesic agent, if appropriate, before exercising. Adequate pain management is important
for the success of an exercise program. • Open discussion regarding the use of complementary
and alternative therapies is important to maintain safe and effective practices for patients
looking for a “cure.

References:

Curtis (2020). Osteoarthritis Diagnosis. Retrived from https://www.arthritis-

health.com/types/osteoarthritis/osteoarthritis-diagnosis

Khatri (2021). What are the Treatments for Osteoarthritis. Retrieved from
https://www.webmd.com/osteoarthritis/guide/options-basics

Osteoarthritis (n.d) Retrived from https://www.arthritis.org/diseases/osteoarthritis