Osteoarthritis Osteoarthritis (OA) is the most common form of arthritis and sooner or later, most of us will be affected in one or another of our joints. OA is caused by damage to articular cartilage. Articular cartilage is a tough, smooth protective layer covering the surfaces of bones where they meet at a joint. It is kind of like a linoleum layer over the “sub-floor” of bone. It allows smooth friction-free motion, aided by the presence of a lubricating fluid called synovial fluid. Excess wear can create holes in the cartilage thus exposing the underlying bone. The resulting bone-on-bone friction causes inflammation, which in turn leads to pain, stiffness and often swelling. Once the cartilage is damaged, the body is not able to heal it or stimulate growth of new normal cartilage. A lot of research being done on finding ways to solve this problem, but so far success has been limited. The future likely lies in stem cell research. The symptoms of OA can be relieved in many ways. To help maintain function it is important to keep the joint active. Improving the strength and flexibility in muscles around a sore joint also helps. To learn how to do this properly, I advise seeing a physiotherapist. Many medications are available to relieve symptoms. Tylenol is an effective and safe pain reliever. There is a whole family of oral anti-inflammatory medications (e.g. Advil, Motrin, Celebrex), which work well but may have more side effects. There are also some new topical versions, which are applied to the skin. Natural substances such as glucosamine have also been shown to be beneficial. For joints that remain painful and swollen, cortisone injections can be very effective. Cortisone is a potent anti-inflammatory that can be put right into the sore joint. Contrary to all the negatives people hear about cortisone, it is a very safe and relatively painless option. A second form of injection therapy involves improving the lubrication in the joint by injecting a substance called hyaluronic acid. This requires a series of 3 shots given a week apart. Braces and supports can be another useful adjunct for some arthritic joints. These braces, some of which are custom made, help relieve pain by taking stress off the worn areas in the joint. Finally for really troublesome symptoms that don’t respond to the above, joint replacement may be the ultimate solution. This involves removing the worn out, painful bone and resurfacing it with plastic and/or metal. Although hip and knee replacements have been available for many years, this technique is now being used for shoulders, ankles, finger and toe joints.