Understanding Osteoarthritis

It often begins subtly, an ache in the knees after a long day, a stiffness in the fingers that makes morning routines feel slower, or a twinge in the hip when climbing stairs. These everyday discomforts are easily overlooked and often dismissed as signs of ageing or temporary strain. But over time, the pain becomes more consistent, the joints less cooperative, and the movements once taken for granted require more effort. What was once a minor nuisance gradually became a daily presence.

This slow and steady progression is characteristic of osteoarthritis (OA), a condition that affects millions worldwide. More than just wear and tear, osteoarthritis involves complex changes within the joints that impact mobility and overall quality of life. As the most common form of arthritis, it touches people from all walks of life—particularly as age advances—yet it remains surrounded by misconceptions and underestimated in its impact.

Understanding osteoarthritis means going beyond the surface-level symptoms. It involves recognising the underlying causes, identifying the warning signs early, and exploring a range of treatment options that can help manage pain and preserve movement. This blog offers a comprehensive look at osteoarthritis, why it occurs, and how to live well with it—even as the body changes.

What Is Osteoarthritis?

Osteoarthritis is a chronic, progressive disease primarily affecting cartilage—the slippery tissue covering the ends of bones in a joint. When healthy, cartilage helps bones glide over one another with minimal friction. This cartilage gradually wears away in OA, allowing bones to rub against each other. This can lead to pain, swelling, stiffness, and, in advanced cases, bone spurs and joint deformities.

Unlike other types of arthritis, such as rheumatoid arthritis, osteoarthritis is not an autoimmune disorder. It is considered a “wear-and-tear” condition, although research increasingly points to a complex interplay of mechanical, biochemical, and genetic factors that influence its development.

Causes and Risk Factors

Several risk factors contribute to the development of osteoarthritis, many of which are unavoidable. These include:

1. Age

The risk of developing osteoarthritis increases with age. According to studies, OA is most commonly diagnosed in adults over 50 years old, though younger individuals can also create it, especially following a joint injury or repetitive stress.

2. Joint Injury or Overuse

Injuries from sports, accidents, or repetitive use in certain occupations can accelerate joint wear and tear, mainly if not properly treated.

3. Obesity

Excess weight places added pressure on weight-bearing joints like the knees and hips. It also contributes to inflammation, which can hasten cartilage breakdown.

4. Genetics

A family history of OA may increase your risk. Certain gene variations can make cartilage more susceptible to degeneration.

5. Gender

Women are more likely than men to develop osteoarthritis, particularly after menopause, possibly due to hormonal changes. Explore targeted strategies to manage these symptoms in postmenopausal women.

6. Bone and Joint Disorders

Conditions such as congenital joint deformities or metabolic diseases like hemochromatosis can predispose individuals to early-onset OA.

Common Symptoms of Osteoarthritis

Symptoms of osteoarthritis usually develop slowly and worsen over time. They include:

• Joint Pain: Often experienced during or after movement.
• Stiffness: Especially noticeable after periods of inactivity or first thing in the morning.
• Tenderness: Discomfort when pressing on or near the affected joint.
• Loss of Flexibility: Decreased range of motion.
• Grating Sensation: A crackling sound when using the joint.
• Bone Spurs: Hard lumps around the affected joint caused by extra bone growth.

In advanced cases, the joint may become severely deformed and affect one’s ability to perform daily tasks.

Diagnosing Osteoarthritis

Diagnosis typically begins with a clinical evaluation that includes:

• Medical History and Physical Exam: Your healthcare provider will ask about symptoms, family history, and risk factors, followed by a physical examination of the affected joint.
• Imaging Tests: X-rays can reveal joint space narrowing, bone spurs, or changes in bone shape. MRI scans provide a more detailed image of cartilage and soft tissues.
• Lab Tests: Though no blood test can confirm OA, tests may be done to rule out other causes of joint pain, such as rheumatoid arthritis or infection.

Treatment Options for Osteoarthritis

No cure for osteoarthritis exists, but various treatment options can help manage symptoms and slow disease progression.

1. Lifestyle Changes

• Exercise: Low-impact activities like swimming, cycling, and walking can improve joint flexibility and muscle strength.
• Weight Management: Reducing excess body weight can significantly lessen joint pressure and ease symptoms.
• Rest and Joint Protection: Avoid overusing the affected joint and use braces or assistive devices when needed.
• Using Assistive Devices: Orthotic solutions such as shoe inserts and braces can also help relieve pressure and improve alignment—learn how orthotics support musculoskeletal health.

2. Medications

• Pain Relievers: Over-the-counter options like paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and inflammation.
• Topical Treatments: Creams or gels containing NSAIDs or capsaicin are applied directly to the skin over the joint.
• Corticosteroid Injections: Provide short-term pain relief, particularly for knee or hip OA.

3. Physical and Occupational Therapy

Therapists can design customised exercise programs to improve mobility and teach joint protection techniques that make everyday activities easier.

4. Surgical Interventions

When conservative treatments are no longer effective, surgery may be considered:

• Arthroscopy: Minimally invasive surgery to remove loose cartilage or repair damage.
• Osteotomy: This is the realignment of bones to relieve pressure on the joint.
• Joint Replacement (Arthroplasty): Commonly performed for knees and hips, involving replacement with artificial implants.

Emerging Therapies and Research

Recent research into osteoarthritis's molecular and genetic aspects has opened up new possibilities for treatment. For example, studies published in Bone Research have explored the potential of cartilage homeostasis and regenerative medicine, such as stem cell therapy and tissue engineering.

Biological agents and disease-modifying osteoarthritis drugs (DMOADs) are also under investigation. These treatments aim to modify the course of the disease rather than just manage symptoms, representing a significant advancement in OA care.

Living Well with Osteoarthritis

Living with osteoarthritis can be challenging, but many people manage to maintain a high quality of life through proactive measures:

• Stay Active: Incorporate joint-friendly activities into your daily routine.
• Eat a Balanced Diet: Include anti-inflammatory foods such as omega-3-rich fish, nuts, and leafy greens. For guidance on choosing joint-friendly foods, explore our anti-inflammatory diet guide, which outlines ingredients to help reduce inflammation and support long-term joint health.
• Use Assistive Devices: Walking aids, ergonomic tools, or orthotic inserts can improve independence.
• Practice Mindfulness and Stress Management: Chronic pain can take a toll on mental health, so techniques like meditation or cognitive behavioural therapy (CBT) can be beneficial.
• Stay Informed: Educating yourself about your condition empowers you to make better decisions and advocate for your needs.

When to See a Doctor

You should seek medical advice if joint pain or stiffness persists, interferes with your daily life, or worsens over time. Early intervention can delay progression and reduce the long-term impact on joint function.

Conclusion

Understanding osteoarthritis is the first step towards managing it effectively. Though it is a lifelong condition, many people with OA lead entire and active lives with the right mix of lifestyle changes, medical interventions, and self-care strategies. As science unravels the complexities of joint degeneration, the future holds promise for more effective, targeted treatments.

Whether you're newly diagnosed or supporting someone with OA, staying informed and proactive is key to navigating this common yet complex condition.

References

1. Shen, J., Abu-Amer, Y., O'Keefe, R. J., & McAlinden, A. (2022). Inflammation and epigenetic regulation in osteoarthritis. Bone Research. https://www.nature.com/articles/s41413-022-00226-9
2. Loeser, R. F., Goldring, S. R., Scanzello, C. R., & Goldring, M. B. (2012). Osteoarthritis: A disease of the joint as an organ. Arthritis & Rheumatism. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5240031/
3. Cleveland Clinic. Osteoarthritis. https://my.clevelandclinic.org/health/diseases/5599-osteoarthritis
4. Mayo Clinic. Osteoarthritis. https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925
5. Arthritis Foundation. Osteoarthritis. https://www.arthritis.org/diseases/osteoarthritis
6. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoarthritis. https://www.niams.nih.gov/health-topics/osteoarthritis