Q: Four years ago, I was diagnosed with osteoarthritis (OA) in my right ankle. Now X-rays show OA in my spine, neck, knuckles, wrists and knees. Can you tell me what caused OA to spread this way, and is there anything I can do to stop it?

A: OA is a degenerative disease of cartilage and results in overgrowth of bone underneath the cartilage. In some people, a traumatic joint injury can lead to OA, while in others genetics may play a role. The disease usually begins with a single large joint, such as a hip or knee. But it is not uncommon for a smaller joint, such as an ankle, to be affected initially – particularly if that joint has had a significant injury, such as a sprain or cartilage tear.

While OA can be limited to a single joint, in many cases it progresses to involve other joints, often in a sequential fashion as you describe. In some cases, pain from OA in one joint (such as an ankle or knee) can prompt you to walk, stand or move differently, which can, in turn, force other joints (such as the hip or joints of the spine) out of alignment and predispose them to OA as well.

Unfortunately, we don't fully understand the reasons OA progresses or have therapies to effectively stop the progression. For OA in general, the most helpful advice is to maintain an ideal weight, avoid overusing joints that are damaged and follow a plan of exercise that strengthens the muscles supporting the joint. Your doctor or physical therapist should be able to help you with any of these.

Grant W. Cannon, MD, Rheumatologist