Osteoarthritis is a common long-term joint condition in which the tissues of a joint change over time. It can involve cartilage, bone, ligaments, tendons, muscles, the joint lining, and the surrounding tissues. It is often described as "wear and tear", but that phrase is too simple because inflammation, previous injury, body weight, genetics, age, and joint loading can all contribute.
Osteoarthritis can affect almost any joint. It is common in the knees, hips, hands, spine, and feet. Symptoms vary widely. Some people have changes visible on X-ray with little pain, while others have pain and stiffness that affects work, sleep, walking, grip, or everyday tasks.
Symptoms
Common symptoms include:
- Joint pain, often worse during or after use.
- Stiffness, especially after rest.
- Reduced movement.
- Swelling or tenderness around the joint.
- Grating, clicking, or crackling during movement.
- Weakness in surrounding muscles.
- Difficulty with daily activities, depending on the joint affected.
Symptoms may come and go. Weather, activity level, sleep, injury, body weight, work demands, and other conditions can all affect how severe symptoms feel.
Causes and Risk Factors
Osteoarthritis develops when repair processes in and around a joint cannot keep up with stress, injury, or tissue change. Risk factors include:
- Older age.
- Previous joint injury.
- Repetitive heavy loading of a joint.
- Obesity, especially for knee and hip osteoarthritis.
- Family history or inherited joint shape.
- Reduced muscle strength around the joint.
- Some inflammatory, metabolic, or developmental conditions.
The condition is not an inevitable part of ageing. Many older people do not have disabling osteoarthritis, and younger people can develop it after injury or unusual joint stress.
Diagnosis
Diagnosis is usually based on symptoms, age, affected joints, medical history, and physical examination. X-rays may show joint-space narrowing, bone spurs, or changes in bone shape, but imaging is not always needed.
NICE guidance for adults advises against routinely using imaging for follow-up or to guide non-surgical management. Imaging may still be useful when symptoms are unusual, severe, changing quickly, or when another diagnosis needs to be considered.
Management
Management aims to reduce pain, maintain movement, preserve strength, and support everyday function. It often combines several approaches:
- Information about the condition and pacing activity.
- Exercise to improve strength, mobility, and general fitness.
- Weight management where excess weight is stressing joints.
- Heat or cold packs for short-term symptom relief.
- Physiotherapy, occupational therapy, or aids where useful.
- Pain relief medicines where benefits outweigh risks.
- Joint injections in selected cases.
- Surgery, including joint replacement, when symptoms are severe and other measures have not worked well enough.
Exercise is usually part of management even when joints are painful, but it may need to be adapted. Strengthening and low-impact aerobic activity are commonly used because stronger muscles can help support the joint.
Medication
Medicines can reduce pain but do not reverse the underlying joint changes. Options may include topical non-steroidal anti-inflammatory drugs, oral pain relief, or other medicines depending on the person and joint involved.
Oral anti-inflammatory medicines can cause side effects, including stomach bleeding, kidney strain, raised blood pressure, and cardiovascular risk in some people. That is why age, other medicines, stomach history, kidney function, and heart risk matter when choosing treatment.
Outlook
Osteoarthritis usually changes slowly. Some people remain stable for long periods. Others have worsening pain, loss of function, or joint deformity. The outcome depends on the joint, severity, activity, other health conditions, and access to suitable support.
The condition can be frustrating because pain does not always match imaging results. Good management is practical: keep useful movement, reduce avoidable strain, build strength, and choose treatment based on the person's actual symptoms and goals.
See Also
References
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