Osteoarthritis: Symptoms, Causes, and Treatments
Also known as: Degenerative joint disease, OA, Osteoarthrosis
Overview
Osteoarthritis is the most common form of arthritis in the United States, affecting more than 32.5 million adults, according to the Arthritis Foundation. It’s marked by the progressive breakdown of joint cartilage, the protective tissue covering the ends of bones. As cartilage wears away, bones rub against each other, causing pain and stiffness. Any joint can be affected, but the knees, hips, hands, and spine are the most commonly involved. Osteoarthritis progresses slowly, and its impact on quality of life can be substantial.
Causes and risk factors
Osteoarthritis results from an imbalance between the breakdown and repair of joint cartilage. Several factors contribute to its onset:
- Age: risk increases with age
- Excess weight and obesity: mechanical overload speeds up joint wear
- Genetic predisposition: family history of osteoarthritis
- Joint injuries: fractures, repeated sprains, past surgeries
- Jobs involving repetitive mechanical strain (heavy lifting, prolonged kneeling)
- Structural abnormalities such as dysplasia or congenital deformities
Being female is also a risk factor, especially after menopause, due to hormonal changes.
Symptoms
Osteoarthritis symptoms appear gradually and intensify as the disease progresses:
- Mechanical pain: the main complaint, triggered by movement, relieved by rest, and absent at night (except during inflammatory flare-ups)
- Morning joint stiffness, generally brief (less than 30 minutes)
- Cracking or grinding with movement (crepitus)
- Joint swelling during inflammatory flare-ups
- Progressive deformity of affected joints (notably the fingers, with Heberden’s nodes)
- Decreased joint mobility and range of motion
Diagnosis
Osteoarthritis diagnosis is mainly clinical, based on the patient’s history and physical exam. The doctor assesses the location, type, and pattern of pain. A standard X-ray remains the go-to test: it shows joint space narrowing, bone spurs (osteophytes), and bone hardening beneath the cartilage. An MRI may be ordered to assess soft tissue. Blood tests help rule out other joint diseases like rheumatoid arthritis.
Treatments
There’s no cure for osteoarthritis, but several options relieve symptoms and preserve mobility:
- Pain relievers and NSAIDs: acetaminophen and NSAIDs such as ibuprofen or naproxen for pain; NSAIDs also help reduce inflammation
- Corticosteroid injections: intra-articular injections for severe painful flare-ups
- Hyaluronic acid injections (viscosupplementation): mainly for knee osteoarthritis
- Physical therapy: strengthening muscles around the joint, maintaining mobility
- Heat therapy and cold therapy: for everyday pain
- Surgery (total joint replacement): a last resort for severe, disabling forms, especially of the knee and hip
Weight loss is a treatment priority for patients who are overweight.
Prevention
While osteoarthritis can’t always be avoided, certain measures reduce the risk of developing it or slow its progression:
- Maintain a healthy weight to reduce joint strain
- Get regular, appropriate exercise: swimming, cycling, and gentle walking are the best low-impact options
- Strengthen the muscles around joints to stabilize and protect them
- Avoid repetitive strain and adjust your workstation for higher-risk jobs
- Wear supportive shoes with good cushioning
- Treat joint injuries promptly to prevent long-term damage
When should you see a doctor?
See a doctor if you’ve had persistent joint pain for more than a few weeks, prolonged morning stiffness, joint swelling, or increasing difficulty with movement. Early care can slow the disease’s progression and improve quality of life.
Sources
- Arthritis Foundation, states osteoarthritis is by far the most common form of arthritis and affects more than 32.5 million U.S. adults
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), most affected joints, risk factors (age, weight, family history, prior injury, female sex and menopause), and symptoms including morning stiffness lasting less than 30 minutes
- MedlinePlus, overview, risk factors, diagnosis, and treatment overview from the U.S. National Library of Medicine
- MedlinePlus Medical Encyclopedia: Osteoarthritis, names acetaminophen and NSAIDs (ibuprofen, naproxen) and steroid injections, X-ray findings (joint space loss, bone spurs), and blood tests used to rule out rheumatoid arthritis
- StatPearls: Osteoarthritis (NCBI Bookshelf), Heberden’s nodes, crepitus, X-ray findings (osteophytes, joint space narrowing, subchondral sclerosis), and MRI for earlier-stage assessment
- OrthoInfo (American Academy of Orthopaedic Surgeons): Viscosupplementation Treatment for Knee Arthritis, hyaluronic acid injections (viscosupplementation) for knee osteoarthritis