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What Causes Osteoarthritis Symptoms?

Degenerative Joint Disease: How Osteoarthritis Affects Joints

Cartilage is a strong, protective connective tissue that is present at the ends of bones in joints. Also called the synovium, it acts as a shock absorber and lubricant, reduces friction, and prevents bones from rubbing against each other.

Osteoarthritis (OA) occurs when the joint cartilage breaks or becomes worn down over time, and as a result, the bones rub against each other in the joint space. That’s why osteoarthritis is a degenerative joint disease. This type of wear and tear arthritis is called primary osteoarthritis. Less commonly, direct joint damage, for example, a joint injury due to trauma, can cause secondary osteoarthritis. 

Osteoarthritis is the most common form of arthritis and affects over 32.5 million adults in the United States. Experts estimate that at least 80% of people over the age of 55 have some amount of osteoarthritis, although not everyone experiences osteoarthritis symptoms. Women are more likely than men to develop osteoarthritis. 

Another common form of arthritis, rheumatoid arthritis, is an autoimmune condition in which defective cartilage results when the body’s immune system mistakenly attacks healthy joint tissue.

Check out our blog: Is Osteoarthritis Genetic?

Common Areas Affected

The most common areas affected by osteoarthritis are the hands, knees, hips, cervical spine (neck), lumbar spine (lower back), and shoulder.

Importance of Identifying OA Symptoms

Recognizing the symptoms of OA (osteoarthritis) can help you understand what’s causing them and seek timely medical care. While osteoarthritis will not kill you, it will continue to progress over time. Left untreated, it can lead to physical and mental health complications. For example, severe pain from osteoarthritis can lead to depression and anxiety. Joint stiffness can lead to poor balance and reduced mobility, putting you at risk of falls and injuries.

Symptoms of Osteoarthritis

Pain in the affected joints is the most common symptom of osteoarthritis. Other symptoms of osteoarthritis include stiffness, swelling, inflammation, and decreased range of motion. OA symptoms develop gradually and get worse over time. (Check out What Does Arthritis Feel Like? Symptoms and Treatment)

Joint Pain

The affected joint typically hurts or aches during or after movement or activities. The joint might also feel tender when you apply pressure on or near it.

Joint Stiffness

Stiffness in an arthritic joint usually occurs first thing in the morning or after a period of rest. It can result in difficulty with joint movement. There may also be a popping or clicking sound when you bend the joint.

Swelling and Inflammation

Affected joints can become inflamed (swollen, red, warm to touch, and tender) due to activation of the immune system.

Reduced Range of Motion and Joint Instability

You may not be able to take an affected joint through its full range of motion (how far a joint can normally move). For example, it may be difficult to completely flex your knee joint or fully extend your hip joint. There may be a grating or scraping sensation when you try to move the joint. In addition, there may be joint instability, for example, buckling of the knee or the knee “giving out.”

Bone Spurs

Bone spurs (osteophytes) are bony growths that form in a joint as a result of osteoarthritis. An osteophyte develops when the body tries to repair the cartilage by forming new bone material. Osteophytes can feel like knobby or bumpy areas, especially in the fingers and toes. These bone growths can rub against other tissues in the joint or press upon nerves and cause pain, numbness, and weakness.

Joint Deformity

The affected joints can become enlarged and misshapen due to swelling, loss of cartilage, and changes in the bones.

Specific Symptoms by Joint

Hand Osteoarthritis Symptoms

• Pain in one or both hands and fingers, including the base of the thumb and wrist joint. (Foot osteoarthritis can cause pain at the base of the big toe).

• Swelling, redness, and tenderness in the hand or wrist joint due to formation of bone spurs.

• Clicking and cracking sounds when you move your hands.

• Numbness and tingling (pins and needles sensation).

• Limited range of motion and weakness in the hands (for example, trouble opening jars).

Knee Osteoarthritis Symptoms

• Osteoarthritis pain can be present in one or both knees.

• Movement and activity cause pain related to osteoarthritis of the knee to flare-up. Rest makes the pain better.

• Stiffness in the knee joint when you first get out of bed or after you’ve been sitting for a long time.

• Your knees appear swollen or puffy.

• You feel your knees are unstable (wobbly) as if they could buckle or give out.

• The affected joint gets locked or stuck.

• There’s a cracking or grinding noise with knee movement.

• You get a scraping or grating feeling with the movement of the joint.

Hip Osteoarthritis Symptoms

• Pain in the hip joint that develops slowly and gradually worsens over time.

• Pain in the groin or thigh area that may radiate (spread) to the buttock or knee.

• Osteoarthritis of the hips typically causes pain that is worse with activity or movement. It may also be worse in rainy weather.

• Stiffness in the hip joint, which makes it difficult to walk or bend your leg.

• Crepitus (a grinding noise) during joint movement.

• Locking or the hip joint (getting stuck).

• Decreased range of motion, resulting in limping or difficulty walking.

Spinal Osteoarthritis Symptoms

• Pain in the neck or lower back that is worse with activity and better with rest.

• Swelling and tenderness (soreness with touch) in the affected areas.

• Stiffness and loss of flexibility (difficulty turning your neck or straightening your back).

• Crepitus (a grinding sensation) with movement.

• Weakness or numbness in the arms and legs if the nerves are affected.

Shoulder Osteoarthritis Symptoms

• Pain in the shoulder joint that develops gradually and gets worse over time.

• The pain may be located at the back of the shoulder or on top of the shoulder joint (the shoulder is a ball-and-socket joint like the hip).

• A deep ache in the painful joint. The pain may radiate (spread) up the side of the neck.

• Activity can worsen the shoulder pain, and rest can make it better.

Stages of OA: Early and Advanced Osteoarthritis Symptoms

Healthcare providers classify osteoarthritis into four stages:

• Stage 1: Minor wear and tear of the joint with few, if any, symptoms. 

• Stage 2: Further damage to the cartilage, bone spurs visible on X-ray, and symptoms such as pain and stiffness. 

• Stage 3: More severe erosion of the cartilage and problems with daily activities.

• Stage 4: Almost absent cartilage in the joint, chronic inflammation, and near-constant pain and stiffness. 

Early Signs of OA

In the early stages, osteoarthritis can cause symptoms such as pain, tenderness, stiffness, swelling, and loss of flexibility in the joint. Check out How to Prevent Arthritis When You're Young: 5 Ways to Reduce Your Risk.

Symptoms of Advanced Osteoarthritis

In the later stages, osteoarthritis can cause severe pain that is persistent and worsens with time. Other symptoms of osteoarthritis in the advanced stages may include a decreased range of motion, joint instability, numbness and tingling due to pressure on nerves, weakness of the joint, and muscle wasting around the joint.

Osteoarthritis Diagnosis and Treatment

Your primary care doctor or orthopedic specialist can diagnose osteoarthritis based on your symptoms, medical history, physical examination, and imaging tests (X-rays, magnetic resonance imaging (MRI), and computerized tomography (CT) scans). They may also order blood tests to rule out other conditions in your physical exam, and symptoms are not typical for OA.

A diagnostic and therapeutic procedure called joint aspiration is sometimes done to remove joint fluid using a needle and syringe. This can help to relieve swelling and the joint fluid can be analyzed in the laboratory to help with diagnosis of joint problems. Find out the best treatment for arthritis.

Daily Management Tips

• Exercise: Low-impact exercises (walking, cycling, elliptical machine, water aerobics) and range of motion exercises (gentle stretching that takes your joints through their full span of movement) are recommended for people with osteoarthritis. Movement during exercise or physical therapy helps to relieve stiffness and strengthens the muscles around the joint. It may be useful to work with a physical therapist or occupational therapist to learn the best exercises for osteoarthritis as well as the proper techniques for daily activities. 

• Heat and cold treatments: The application of heat or cold to the affected joints can relieve pain and stiffness. Talk to your healthcare provider about how often and how long you should use a heating pad, ice pack, or cool compress.

• Assistive devices: Canes and walkers can relieve stress on weight-bearing joints. Shoe inserts and braces can help to stabilize affected joints.

• Complementary therapies and alternative treatments: Other treatments such as massage, tai-chi, yoga, acupuncture, meditation, and nutritional supplements (for example, glucosamine, chondroitin, fish oil supplements, avocado, and soybean oils) can be used alongside prescribed osteoarthritis treatment. Check with your provider before starting any complementary therapy or dietary supplements.

Activities to Avoid: What Should You Not Do With Osteoarthritis?

The Arthritis Foundation recommends avoiding the following activities which can make osteoarthritis symptoms worse:

• High-impact exercises (running, jogging, jumping rope, stair climbing, tennis, hiking, squats, burpees).

• Repetitive motions (bending, twisting, grasping, reaching movements, typing on a keyboard, hammering nails, working on an assembly line).

• Lifting heavy objects.

• Wearing high-heeled shoes. 

Symptom Management: How To Relieve Pain from Osteoarthritis?

• Medications: Over-the-counter medications such as Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) can be used as pain relievers to reduce pain and inflammation. Examples of NSAIDs are ibuprofen (Motrin, Advil) and naproxen (Aleve). NSAIDs are available as pills as well as in topical formulations (ointments, creams, and pain patches to place directly on the skin near the affected joints). (Check out Arthritis Medication Uses & Side Effects)

• Surgery: In severe cases, if conservative treatments do not provide relief, surgery may be necessary to treat osteoarthritis. An osteotomy to remove a bone spur is recommended in some cases. Joint replacement surgery is a procedure in which an orthopedic surgeon removes the damaged joint and replaces it with an artificial joint. About 1.3 million artificial joints are placed in the hips and knees of Americans each year.

Frequently Asked Questions about Osteoarthritis

What is the best thing to take for osteoarthritis?

Over-the-counter pain relievers such as Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen) are the best way to relieve pain from osteoarthritis. Stronger pain medications are also available by prescription. 

You should talk to your doctor before using OTC medications like Tylenol or Advil to treat OA pain, especially if you have other health conditions. For example, NSAIDs like ibuprofen and naproxen can be harmful if you have kidney problems or heart disease. Tylenol (acetaminophen) may not be safe if you have liver problems. Taking OTC pain medications exactly as instructed by your doctor is essential to prevent harmful adverse events. 

How to stop osteoarthritis from progressing?

You can slow down the progression of osteoarthritis by maintaining a healthy body weight and losing weight if you are overweight or obese. Obesity is a risk factor for osteoarthritis because carrying extra weight increases stress on weight-bearing joints such as the knees and hips.

Other strategies include staying active, keeping your blood sugar levels under control, and protecting yourself from joint injuries by lifting and carrying with the proper techniques. 

What is the life expectancy of someone with osteoarthritis?

Most people with osteoarthritis have a normal life expectancy. This condition does not kill you. However, it can significantly affect your quality of life if it is left untreated. Seeking timely medical care, getting a proper diagnosis, and managing the symptoms of osteoarthritis can help you live a full, active life.