Osteoarthritis, or OA, is a disabling disease of the joint that occurs most often in the knees, hips, hands, and spine. In fact, one-third of U.S. adults older than 65 haveosteoarthritis, according to the Centers for Disease Control and Prevention (CDC), and OA in the knee is a major cause of disability.
Joint pain is the primary symptom of OA. It is caused when the cartilage (lining of the joint or the cushion) in the affected area wears away, leaving the ends of the bones exposed so they rub against each other. But that isn’t the only thing that can cause, or worsen, OA pain. Here are six others to watch out for.
1. Lyme Disease
Lyme disease, an inflammatory disease caused by a tick bite, could potentially exacerbate osteoarthritis pain. “Lyme disease can cause a sharp increase in pain and a lot of swelling in the joints,” says Joseph Ciotola MD, an orthopedic surgeon at the Orthopedic Specialty Hospital at Mercy Medical Center in Baltimore. “It can also make you feel extra-tired.” In the United States, Lyme disease tends to be concentrated most heavily in the Northeast and the upper Midwest, according to the CDC. Some symptoms include aching, swelling, or redness in one or more joints (especially the knees), fever, headache, and lethargy. If you think your OA pain is becoming worse because of Lyme disease, talk to your doctor, who can test for the disease and rule out that possibility, or recommend proper treatment.
2. Lack of Sleep and Increased Pain Sensitivity
Physicians are increasingly recognizing the link between poor sleep and the way individuals respond to pain. “Certain people react very differently to pain because of central sensitization,” says M. Elaine Husni, MD, MPH, director of the Arthritis & Musculoskeletal Treatment Center at the Cleveland Clinic. “They experience pain as 10 times worse [than someone who doesn’t have central sensitization].”
Pain itself changes the way the central nervous system works, causing a person to become hypersensitive to pain. This is called central sensitization. People who have central sensitization can feel more pain with less provocation.
“The clue that someone has central sensitization is that the pain goes outside of the knee [or arthritic joint],” Dr. Husni says. “The person has pain all over. This is also associated with poor sleep and mood disorders because of the overwhelming pain.” Husni says it’s important for physicians to assess all the ways OA pain is affecting their clients so they can recommend appropriate treatment.
3. Weak Muscles
“Having weak muscles around your joint can exacerbate OA,” says Dr. Ciotola, “so low-impact exercise that builds muscle is important.” Ciotola recommends a recumbent bicycle, because it can build up your quadriceps (the big muscles in the front of your thighs) without putting stress on the knee. An interval regime — alternating fast and slow periods of exercise — gives you the benefits of a cardiovascular workout and increases blood flow to muscles, making them stronger.
“Circuit training is also good,” says Ciotola of the type of workout that has you switching between strengthening exercises and aerobics, “because you are building muscle and burning calories at the same time.”
4. Feelings of Helplessness
How an individual responds to pain depends in part on the person’s psychological state. Two psychological factors can make OA pain worse, according to a scientific review published in Rheumatic Disease Clinics: lack of self-efficacy and catastrophizing.
RELATED: How to Keep Arthritis Pain From Affecting Your Mood
Self-efficacy is an individual’s confidence in the ability to accomplish tasks; in other words, a sense of control. People with a greater sense of control manage pain better. In contrast, people who tend to focus on, and ruminate about, their pain (catastrophizing) experience higher levels of pain, emotional distress, and physical disability. Therefore, learning coping skills increases feelings of self-efficacy and can improve pain management.
5. Pain From Compensation
Multiple joint symptoms are common among people with osteoarthritis. For example, foot pain often occurs in people who have OA in their knee. In fact, one-quarter of people who have symptomatic knee OA report pain in one foot, and 55 percent report pain in both feet, according to a July 2015 study in Arthritis Care and Research.
“The body works as a system,” says Husni. “It makes sense that if you have a problem with your knee, it affects other joints.”
Jeffrey Goldstein, MD, clinical professor of orthopedic surgery at NYU Langone Medical Center and director of the spine service at NYU Langone’s Hospital for Joint Diseases, says it’s not just the knee and foot. This pain from compensation can affect other areas of the body as well. It’s a ripple effect. “If you have a bad lower back, it puts more stress on the hips, for example. You have to address the primary problem, the cause of compensation — the bad back, for instance, and the result of compensation — hip pain.”
Chronic dehydration can be a problem for people with osteoarthritis, says Dr. Goldstein, especially in hot summer months. Joint cartilage is mostly water, so you need to stay hydrated for joints and muscles to work properly.
How You Can Ease Osteoarthritis Pain
“Lots of studies show that exercising three times a week keeps your muscles at the top of their game and keeps the ligaments around the joints flexible,” says Husni. “Excess weight can accelerate OA, so maintain a good body weight.”
Ways to keep the extra weight away are also helpful for your OA. A good exercise program includes strengthening to build muscles, stretching, cardiovascular exercise, and range of motion exercises to help maintain and improve joint flexibility. And an anti-inflammatory diet, such as the Mediterranean diet, can help. It emphasizes fresh fruits and vegetables and lean protein sources. Ciotola says to limit sugar intake, and include foods such as fish (or fish oil supplements), turmeric spice, almonds, and spinach.
Lastly, make sure you are properly diagnosed if you have joint paint. “Not every pain is OA,” says Husni. “Joint pain could be bursitis or tendonitis or another type of arthritis.”