What Is Degenerative Arthritis?

The Most Common Type of Arthritis

Arthritis of the knee. Coloured X-ray of the knee of an obese 48 year old patient showing degenerative arthritis caused by the extreme stress on the knee from being overweight.
Science Photo Library - ZEPHYR/Brand X Pictures/Getty Images

Degenerative arthritis and degenerative joint disease are medical terms that are used interchangeably with osteoarthritis. Degenerative arthritis, or osteoarthritis, is the most common type of arthritis. In the United States, about 30 million people have osteoarthritis, according to the Centers for Disease Control and Prevention (CDC). While it is most common type of arthritis among adults over 65 years old, anyone at any age can develop the disease.

The risk of developing the disease does increase with age. Prevalence of osteoarthritis increases significantly after age 50 in men and after age 40 in women. Also, it is not uncommon for degenerative arthritis to develop years after an injury (i.e., post-traumatic osteoarthritis).

The joints typically affected by degenerative arthritis include the knees, hips, big toes, fingers, and spine. The protective cartilage that covers the bones in an affected joint deteriorate or degenerate. When that occurs, the body starts to form new bone (e.g., osteophytes) in a reparative effort. The loss of cartilage and the development of osteophytes contribute to pain, which is the primary characteristic associated with degenerative arthritis.

Cause of Degenerative Arthritis

Degenerative arthritis, or osteoarthritis, actually develops when the reparative effort by the body is unable to keep up with the pace of degeneration.

What initiates the degeneration and subsequent reparative effort is not precisely understood. There are multiple factors involved, making it a bit more complicated than the over-simplified explanation which is typically offered—that being, wear-and-tear which accompanies aging.

There are biochemical, structural  and metabolic changes that can occur to joint cartilage.

Genetics are also likely involved. In fact, degenerative arthritis is thought to involve the entire joint structure with erosion of articular cartilage, hypertrophy of bone at the margins of the affected joint, changes to the synovial membrane (i.e., joint lining), subchondral bone sclerosis, and involvement of the ligaments and periarticular muscles. It's complicated and there is much more to be discovered at the cellular level.  

NOTE: While degenerative arthritis is commonly linked to aging, patients who develop osteoarthritis at a young age or in unusual joints, such as the shoulder or ankle with no history of injury, should be evaluated for unrecognized inflammatory arthritis, avascular necrosis, or certain genetic conditions, for example, hemochromatosis, a condition characterized by the accumulation of too much iron in the body.

Treatment of Degenerative Arthritis

There is not much available to prevent the progression of osteoarthritis. Treatment is currently aimed at managing symptoms, which includes pain, stiffness, limited range of motion, and crepitus.  Rest, maintaining your ideal weight, using mobility aids, heat, range of motion exercise, acetaminophen or NSAIDs (nonsteroidal anti-inflammatory drugs) are usual modes of treatment that help manage symptoms.

Narcotic pain medications are typically not needed. Intra-articular steroid injections can be used to tame a flare of symptoms. With severe degenerative arthritis, when conservative treatments are inadequate, surgery may be necessary. Surgical options include joint debridement, osteotomy, arthrodesis, and total joint arthroplasty (i.e., joint replacement).

A Word From Verywell

Degenerative arthritis is the type of arthritis most people think of when arthritis is mentioned. Diagnosis is largely based on the results of imaging studies (i.e., x-rays), blood tests, and a physical examination.

Some tests are performed to rule out other types of arthritis. 

In addition to an accurate diagnosis and proper treatment, staying physically active will help you manage degenerative osteoarthritis. To improve your quality of life with osteoarthritis, the CDC states, " Experts recommend that adults engage in 150 minutes per week of moderate physical activity, or 30 minutes a day for 5 days. Moderate, low impact activities recommended include walking, swimming, or biking. Regular physical activity can also reduce the risk of developing other chronic diseases such as heart disease, stroke, and diabetes." The CDC also emphasizes the importance of losing weight if you are overweight.  

Sources:

Osteoarthritis - Degenerative Joint Disease. Merck Manual. Fourteenth edition.

Osteoarthritis Fact Sheet. CDC. Updated February 2, 2017.

Kelley's Textbook of Rheumatology. Ninth edition. Elsevier. Pathogenesis of Osteoarthritis. Chapter 98. Cesare et al.

Continue Reading