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Osteoarthritis Primer

Osteoarthritis (OA) is caused by wear and tear on your joints over time, and it affects some 32 million adults in the USA.  If you have a family history of OA, you have a higher risk of developing it, which implies it has a genetic component.

There is cushioning (joint cartilage) between the bones throughout your body. In OA, these tissues degrade over time. When the cushioning breaks down, pain can ensue and everyday tasks may become harder and less comfortable to do.

Symptoms include:

  • joint pain that gets better when you’re not using the joint
  • stiffness in your joints in the morning or after periods of rest
  • swelling of the joint with use
  • instability and limited mobility in your joints
  • pain during sleep (in later stages of OA)


While there’s no cure for OA, lifestyle changes, medication, surgery, and other treatments may help, and remission is possible.

Genes do not directly cause OA. There are also other factors, such as lifestyle, weight, and occupation.

“Heritability” is a term geneticists use to measure how the differences in a person’s genes influence their traits. The higher the percentage, the more likely it is that the influence is related to genetics.  The heritability of OA in the spine is some 70%; in the hand, 65%; in the hip, 60%; and in the knee, 40%.

Some 100 gene variants contribute to the development of OA, such as–

Cartilage extracellular matrix structure

Variations in the genes COL2A1, COL9A3, and COL11A1 may affect the cartilage and connective tissues that stabilize your muscles and joints. Mutations in these genes are linked to faster wear in your knees and hips.

Bone density

The genes vitamin D receptor (VDR) and estrogen receptor alpha (ESR1) affect the estrogen receptors and may increase the overall risk of developing OA and knee OA. Changes to VDR can influence the development of OA in your hands.

Chondrocyte cell signaling

Variations in the genes BMP5, FRZB, and IL-4Rα primarily affect females, increasing the likelihood of developing OA in the hips, knees, and other joints.

Inflammatory cytokine

The genes IL-1, IL-10, TGFB1, IL-6, and TNFα affect inflammation in the synovium (lining) of your joints. Inflammation can lead to a breakdown of cartilage that affects your hands, knees, and hips.

Jobs that require kneeling, heavy lifting, and other physical labor may also contribute to OA.  And risk increases with age and is highest in people ages 50 years and older.  Obesity can also be a risk factor — excess weight burdens joints in the knees and hips.

Providers such as from Remission Medical will prescribe medications to treat OA (over-the-counter or prescription), to ease arthritis pain and inflammation. Other possible treatments include physical therapy, joint injections, and even joint replacement surgery.  Our Rheumatologists and NPs will also recommend exercise to help patients retain mobility and strength.