Joint by joint: the prime targets of osteoarthritis

Osteoarthritis (OA) can affect any of the body's joints, but it most often occurs in the hands, knees, hips or spine — or in joints that have been injured or stressed. The following is a closer inspection.

• Osteoarthritis of the fingers is usually hereditary. Heberden's nodes, the small bony knobs that form on the ends of finger joints, occur most often in middle-aged and older women.
• The nodes are usually painless and tend to develop so slowly that a woman may not notice them until, for example, she has trouble slipping a ring over the joint.
• Heberden's nodes are twice as likely to develop in women whose mothers also have them.
• Similar enlargements on the middle finger joints are known as Bouchard's nodes.
• Both Heberden's and Bouchard's nodes may first develop in one or a few fingers and later affect others.
• As Heberden himself noted, the problem with these nodes is mainly cosmetic.
• A more painful form of OA affecting the end joints of fingers is called nodal osteoarthritis.
• A single joint suddenly becomes painful, tender and swollen for three or four weeks — and then the problem subsides.
• Nodal OA is also hereditary and mainly affects women 45 and older, who are 10 times more likely to develop it than men in the same age group.
• The joint at the base of the thumb also commonly develops osteoarthritis.
• By contrast, OA rarely affects the knuckles where the fingers attach to the hand.

• The knees bear more weight than any other joint in the body — which makes them very susceptible to OA.
• When that happens, the knees may become swollen and feel stiff when you try to move them.
• You may notice you have trouble walking to the mailbox, climbing stairs and getting in and out of the car.
• According to studies, strengthening the muscles surrounding the knee can often dramatically improve the symptoms of osteoarthritis of the knee.

• Like the knees, the weight-bearing hips are susceptible to OA. People with osteoarthritis of the hip may have trouble bending and the pain and stiffness may cause them to limp when they walk.
• The pain may not only be felt in the hip but may also radiate to other parts of the body, especially the groin or down the inside of the thigh.
• Some cases of osteoarthritis of the hip seem to be hereditary.
• Also, people who are bowlegged or who have other congenital abnormalities that cause the bones of the hip to be misaligned are at increased risk for hip osteoarthritis.
• Losing weight can help — but is not as helpful for relieving hip osteoarthritis as it is for the knee.
• Drugs and exercise can also help relieve pain and improve movement.
• Hip-replacement surgery is very effective when other treatments fall short of relieving the pain or disability.

• Osteoarthritis of the spine mainly causes stiffness and pain in the neck or in the lower back.
• Measures that can help relieve the symptoms include exercises that strengthen the muscles of the back and abdomen; heat treatments; and the use of support pillows when sitting.
• In some people, bone spurs growing from the edges of the vertebrae may squeeze the spinal nerves, causing pain, weakness or numbness in the arms or legs.
• When this happens, surgery may be necessary to relieve the pressure on the nerves.