The most common form of arthritis is also among the most painful and crippling. Osteoarthritis, affecting millions of people worldwide, occurs when the protective cartilage on the ends of your bones wears down over time. Cartilage is that firm, slippery tissue that permits nearly frictionless joint motion that we take for granted until we older. If the cartilage wears down enough, bone will rub against bone. This degenerative disease can affect any joint, but most commonly hits us in the hands, knees, hips and spine.

Medicine cannot yet cure or reverse osteoarthritis, but we are able to manage the symptoms somewhat. These symptoms include pain and tenderness in your joints; stiffness and an overall loss of flexibility; a grating sensation, and bone spurs – extra bits of bone which feel like hard lumps and form around the affected joint.

Your doctor will begin to diagnose your symptoms with a physical exam, and may order X-ray and magnetic resonance imaging. Although cartilage does not appear on X-rays, your doctor will still be able to gauge your condition by noting the size of the space between the bones of the affected joint. There is no blood test for osteoarthritis, but blood analysis can rule out other causes of joint pain.

Once diagnosed, the first line of treatment for osteoarthritis is pain medication. Over the counter acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are the go-to meds for mild to moderate pain, and stronger NSAIDs may be prescribed by your doctor, if necessary. The antidepressant duloxetine has also been approved to treat chronic osteoarthritis pain.

If you are diagnosed with osteoarthritis you might very well be a candidate for physical and/or occupational therapy. The former will strengthen the muscles around your affected joints, increase your range of motion, and alleviate some of the pain. The latter will help you learn how to do everyday tasks without putting extra stress on your already painful joint. Tai Chi has also been proven to reduce osteoarthritis pain and improve movement.

On the more extreme side of the treatment spectrum there lay cortisone injections, although these may only be administered 3 to 4 times per year. In some cases, an osteotomy – a procedure in which your bones around the affected joint are re-aligned so as to take pressure off the tender area – may be called for. Finally, arthoplasty – joint replacement surgery – is always an option. In this procedure, the affected joint is replaced with plastic and metal parts.