Understanding Osteoarthritis

What you should know about arthritis

There are numerous forms of arthritis. The most common form is called osteoarthritis.

Did you know?

Osteoarthritis can develop as a result of a previous injury to a joint.

Osteoarthritis is a chronic, degenerative joint disease characterized by the breakdown of joint cartilage (the cushioning tissue between the bones that form a joint). It is not simply “wear and tear”, but rather chemical changes in joint cartilage that cause it to break down and new bone in the form of bone spurs to form.

Osteoarthritis is an active biochemical process that dissolves joint cartilage. Cartilage has no nerves, so the break-down itself does not directly cause pain. However, the decreased “shock absorption” that results from a loss of cartilage causes increased stress to surrounding structures such as bones, muscles and the lining of the joint. This can lead to sudden “flares” of pain when these tissues get irritated.

In this brief video, Dr. Middleton talks about osteoarthritis.

Osteoarthritis can affect the hips, knees, hands, elbows, wrists, fingers, shoulders, neck and low back. In other words, any joint in the body. Osteoarthritis may develop as a result of another condition, such as a previous injury to the joint, or excess weight that puts extra strain on the joint. Genetic factors also play a strong role in the development of osteoarthritis.

An important part of the treatment of osteoarthritis is understanding the nature of the arthritis itself, and knowing what's going on in your joints. Also just as important is being aware of the myths that exist about arthritis, so that you can make the best decisions regarding your health.

For some patients, an ultrasound done in the office at your clinic visit can help confirm the correct diagnosis.

Joint Care Excellence

Why trust the Center for Joint Care for your joint health?

Receiving leading-edge arthritis evaluation and treatment with a rheumatologist who works alongside our surgical specialists here at UC San Diego Health has its advantages:

  • Rheumatologists are often the "go-to" consultants for sorting out complex medical problems due to the big picture, whole-body approach they take to treating arthritis and systemic illnesses. Believe it or not, arthritis pain is not always as simple as it seems, and getting a fresh and thorough diagnostic evaluation can be very important to understanding your pain and its sources.
  • We treat pain for a living and can help coordinate many approaches to eliminating it.
  • If you are not ready to consider surgery, keep in mind that a rheumatologist is a medical arthritis specialist, not a surgeon, and can help you decide what treatment approach or medical therapy is right for you.

Medical management of arthritis

Medications such as acetaminophen, non-steroidal anti-inflammatories and analgesics are the first-line medications used to treat arthritis pain.

Exercise to reduce pain. Really.

Couple hiking on beach 

Exercise keeps your joints mobile and helps treat the pain itself. The research in this area has been so compelling that the Arthritis Foundation has begun an initiative to encourage and support people with arthritis in choosing an active lifestyle. We work closely with UC San Diego's orthopedic rehabilitation team to keep you moving.


Corticosteroid (cortisone) injections can be performed as often as every three months. The risks associated with these injections are actually much less than those associated with taking oral medication for arthritis pain. Corticosteroid injections help by relieving inflammation, which can be a major cause of pain.

Hyaluronic acid injections are usually administered in a series of three injections, each about one week apart. They can be repeated as often as every six months. Hyaluronic acid injections are safe, and reactions are extremely rare. It had previously been thought that they help lubricate the joint, but recent research has shown that is not the case. However, they seem to help relieve inflammation, but through a different pathway than corticosteroid injections. Hyaluronic acid injections take longer to provide relief than corticosteroid injections, but the relief tends to last longer.

Surgical Treatment of Joint Degeneration

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