Osteoarthritis is the gradual wear and tear of your joints, which causes pain and stiffness. Normally the surfaces of your joints are surrounded by a tissue called cartilage, which prevents your bones from rubbing against each other. Over time cartilage can wear away, causing joint pain and stiffness, spinal stenosis, as well as swelling.
The most common osteoarthritis symptoms are pain and stiffness in your joints. It's also common to notice knee pain or hip pain but it can affect any joint, including your neck, back, hands and feet. This can make it hard to move your affected joints, which may affect your ability to carry out everyday activities.
Symptoms usually only affect one or a few joints at any one time. Stiffness is usually worse in the mornings and eases after about 30 minutes.
Osteoarthritis of the knee
This usually affects both knees over time unless one of your knees is more vulnerable due to a past injury or another condition. Knee pain is often worse when walking, especially up or down hills and stairs. Your knees may give way or you may struggle to straighten your legs. When you move your affected knee joints, you may hear a soft, grating sound.
Osteoarthritis of the hip
This makes moving your hip joints difficult eg you may struggle to put your shoes on or get in and out of a car. Pain usually affects the outer side of your hip and your groin area and worsens when you move your hip joints. However, you may also have hip pain when resting or sleeping.
Osteoarthritis of the hand
This usually affects the:
In addition to painful, stiff and swollen fingers, you may develop:
Over time, your pain may decrease and eventually stop, however, any bumps and swelling of your fingers may remain.
Osteoarthritis of the foot
Your foot has 33 joints, including your ankle, which connects the two long bones of your lower leg to the rest of your foot. Osteoarthritis commonly affects the big toe.
Osteoarthritis can cause other foot problems:
It is important to take good care of your feet if you have osteoarthritis. This includes:
Other symptoms of osteoarthritis
Pain and stiffness may worsen if you haven't moved your joints in a while. Your joints may also appear more knobbly or slightly larger than usual. Less commonly, you may develop joint deformities.
Some people find that their symptoms are worse at night, in cold and/or damp weather. Symptoms can come and go, varying in severity according to your activity levels and the weather. In severe cases of osteoarthritis, symptoms can be continuous.
Some people may have no symptoms despite an X-ray showing osteoarthritis. The reverse can also occur ie you may have severe symptoms but only minor changes showing on your X-ray.
You should see your GP if you have persistent problems with your joints, particularly if they are:
Your GP can give you a diagnosis from a simple examination of your affected joints, factoring in your age and symptoms. See your GP or use the consultant finder below to book an appointment with a specialist at your nearest Spire hospital.
It's important that you get an accurate diagnosis for osteoarthritis as it can be confused with other forms of arthritis, such as rheumatoid arthritis. In some cases, you may need further tests such as an X-ray or blood test to rule out other causes.
Healthy joints are constantly repairing themselves due to wear and tear from daily activities. However, this repair process can become faulty or fail to keep up with severe wear and tear.
In osteoarthritis — often referred to as a 'wear and tear' disease — the cartilage surrounding the joints is damaged and worn down. The joint bones, which they cover, can then become damaged and develop growths at their edges (spurs). Connective tissues that hold the joints together and connect bones to muscle can also deteriorate. Additionally, inflammation of the joint linings develops.
There are many factors that may increase your risk of osteoarthritis; often it is a mixture of the following:
Previous injuries also affect your risk of osteoarthritis later in life, such as fractures, dislocated joints and ligament injuries. Even having an operation can increase your risk.
Certain medical conditions can increase your risk too, specifically metabolic diseases, including:
Who gets osteoarthritis?
Around 8.5 million people in the UK have joint pain due to osteoarthritis. There are two types of osteoarthritis:
Osteoarthritis can't be cured, however, it often doesn’t worsen over time. There are treatments that can help and things you can do yourself to manage it. Simple things such as exercise, over-the-counter painkillers, supportive therapies and weight loss can make everyday activities easier.
Osteoarthritis treatment aims to:
Although osteoarthritis is more common in older people, you don’t need to simply accept it as a part of growing older — treatments are available so you don't have to live with disability or pain.
Treatments that can help with osteoarthritis vary depending on the severity of your condition and the affected joints, but they include:
This is an important part of osteoarthritis treatment, whatever your age or fitness level. Exercises should include those that improve your general fitness and strengthen your muscles. Regular exercise will build up your muscles and consequently strengthen your joints, which will improve your symptoms. Exercise also helps with weight loss, improves posture and reduces stress, which can all help ease your symptoms.
Your GP or a physiotherapist can put together an exercise programme for you and explain its benefits. Try to follow the recommended exercise programme as it is easy to overdo it or perform exercises that worsen your symptoms. Swimming is a good exercise if you have osteoarthritis as it doesn’t put too much strain on your joints. Going for regular walks can also help.
Excess weight puts your joints under greater strain and therefore makes osteoarthritis worse. Regular exercise and eating a healthy diet can help you lose weight. Speak to your GP or physiotherapist before you start on your exercise programme or change your diet.
A variety of different painkillers can be taken to manage your pain. Your doctor will recommend which are most appropriate in your case, depending on the severity of your pain and factors such as other medical conditions you have.
Take it at regular intervals, rather than waiting for your pain to become severe, but do not exceed the recommended daily allowance.
Non-steroidal anti-inflammatory drugs (NSAIDs)
These reduce inflammation and therefore also reduce pain and swelling. They're available as creams applied directly to your affected joints (topical NSAIDs) and as tablets.
Topical NSAIDs are particularly effective for treating osteoarthritis in your hands or knees. If they are not effective and paracetamol is not enough to ease your pain, your doctor may recommend NSAID tablets. However, NSAID tablets are not suitable for everyone eg if you have:
If taking NSAID tablets, your doctor will usually also recommend a proton pump inhibitor (PPI) — these are tablets that protect your stomach from excess acid, which is a potential side effect of NSAID tablets.
Opioids eg codeine are strong painkillers but can cause side effects, including constipation, drowsiness and nausea. Opioids can be combined with paracetamol in medicines such as co-codamol.
This is applied directly onto affected joints and blocks pain signals from nerves in the area. You may have to use it for up to two weeks before you start to feel your pain ease and it may take a month for the full effect.
When using capsaicin cream apply a pea-sized amount to your affected joints up to four times a day. Do not apply this cream more often than every four hours. Capsaicin cream is made from chillies so you may feel a burning sensation after applying it. Avoid getting the cream on sensitive areas of your body as this can cause a painful, burning sensation for a few hours.
Steroid joint injections contain an artificial version of the natural hormone cortisol. They are given directly into the affected joint.
These can help relieve your symptoms and/or prevent them from worsening.
Transcutaneous electrical nerve stimulation (TENS)
A TENS machine has sticky patches called electrodes that you attach to your skin. Through these patches, the machine sends electrical impulses to numb nerves that send pain signals and therefore ease your pain.
Hot or cold packs
You can fill a hot-water bottle with either hot or cold water and apply it to the affected joint to reduce your pain. You can also buy hot packs that you can heat up in the microwave and cold packs that you can cool in the freezer.
These cover a variety of devices that can help you with everyday activities, including:
This is a type of physiotherapy. A physiotherapist will use their hands to massage, mobilise and stretch your tissues to keep your joints flexible and supple.
Surgery is rarely needed and is only performed if other treatments have not been effective or a joint is severely damaged. It may not completely resolve all of your symptoms.
The affected joint will be removed and replaced with a prosthetic joint made of special plastics and metal. A prosthetic joint can last up to 20 years and therefore may need to be replaced.
A newer type of joint replacement surgery called resurfacing only uses metal parts. This may be recommended for younger patients.
This is medically called arthrodesis. Your joint pain will be much less after this surgery and your joint will be stronger but you will no longer be able to bend it.
Surgery to add or remove a small section of bone either above or below your knee joint. This helps realign the knee joint so that your weight isn't carried by the damaged part of your knee. You may eventually still need knee replacement surgery.
Other surgical procedures
Complementary and alternative therapies
For example acupuncture and aromatherapy. There is no conclusive evidence that these treatments are effective.
Rubefacients — creams applied to the skin that cause warming and reddening — are available but are not recommended by the National Institute for Health and Care Excellence (NICE).
Glucosamine and chondroitin supplements have been used to treat osteoarthritis. These chemicals are found in healthy cartilage and therefore are taken as supplements with the aim of helping repair damaged cartilage. However, studies have shown little to no effect of taking these supplements to treat osteoarthritis and NICE does not recommend them as an osteoarthritis treatment.
Exercising regularly and eating a healthy diet are important for managing your osteoarthritis as they help keep your muscles strong and help maintain a healthy weight.
You should take your medication as prescribed by your doctor, even if your symptoms improve. Make sure you talk to your doctor if you:
Your doctor may also recommend that you get the annual flu vaccination to protect you from catching the flu.
Keep up with regular reviews with your healthcare team as the more they know about your condition, the more they can help. You may also want to try talking to others with osteoarthritis, either individually or as part of a support group.
Work and money
Osteoarthritis may affect your ability to work, depending on the type of work you do. You may therefore be entitled to financial support, which includes:
Osteoarthritis usually doesn't worsen over time or cause disability. In many cases, osteoarthritis is mild and you can remain as active as others your age who don't have osteoarthritis.
However, in cases where osteoarthritis is severe, one or more joints can be badly affected and your mobility may be significantly reduced for your age.
What are the 4 stages of osteoarthritis?
The four stages of osteoarthritis are:
What is the best treatment for osteoarthritis?
Regular exercise and eating a healthy, balanced diet are important for treating osteoarthritis as they help strengthen your muscles and maintain a healthy weight — excess weight puts more strain on your joints and can worsen your osteoarthritis symptoms. Over-the-counter painkillers and supportive therapies (eg hot and cold packs, self-help devices, supportive footwear) can also help manage your symptoms.
If these treatments are not effective, see your GP for further advice and treatments, such as prescribed medications and in extreme cases, surgery.
What is the difference between arthritis and osteoarthritis?
Arthritis refers to a group of conditions that cause inflammation, pain and stiffness of the joints. Osteoarthritis is a type of arthritis known as degenerative arthritis. Unlike several other types of arthritis, such as rheumatoid arthritis, is it not an autoimmune disorder ie it is not caused by your immune system mistakenly attacking your own tissues.
Is walking good for osteoarthritis?
Yes, regular exercise, such as walking, is good for osteoarthritis. This will strengthen your muscles and help you maintain a healthy weight — both help ease the strain on your joints.
How can I naturally lubricate my joints?
You can’t naturally lubricate your joints, however, you can keep your joints supple and healthy with regular exercise and eating a healthy, balanced diet. If you have osteoarthritis, you can also see a physiotherapist for manual therapy.
What should you not do with osteoarthritis?
Osteoarthritis needn’t prevent you from living a full, active life. In fact, it is important that you do not stop exercising and staying active. Regular exercise and eating a healthy, balanced diet can improve your symptoms. If you are taking medication for your osteoarthritis, do not stop just because your symptoms are improving.
What vitamins should I take for osteoarthritis?
There aren’t any vitamins that can help relieve osteoarthritis symptoms. However, vitamin D is needed to help maintain strong bones and can be hard to get enough of in your diet. Your body can make vitamin D when exposed to sunlight but as there is less sunlight during autumn and winter, it is recommended that everyone takes vitamin D supplements during these months.
Can you reverse osteoarthritis?
Osteoarthritis can’t be reversed but in many cases, it does not get worse. Lifestyle changes and other treatments can control your symptoms and in some cases improve your joint function.
What are the five worst foods to eat if you have arthritis?
Foods you should avoid if you have arthritis, as they may aggravate your symptoms, include:
Foods high in omega-6 fatty acids eg vegetable oils
Highly processed foods eg breakfast cereals, fast food, ready meals
Processed meat (eg bacon, ham and sausages) and red meat
What causes a flare up of osteoarthritis?
Osteoarthritis usually flares up in response to activity. Some people find pain is worse at night and stiffness is worse in the morning. Cold and/or damp weather can also worsen symptoms.
What is end stage osteoarthritis?
End-stage osteoarthritis occurs when the cartilage of your affected joints has completely worn away and you have multiple bone growths (spurs) on the edges of your joint bones. In some cases, this may cause joint deformities and you may need surgery to relieve your symptoms.
Does osteoarthritis hurt all the time?
This depends on the severity of your osteoarthritis. For most people, osteoarthritis is mild with symptoms coming and going, often depending on activity or even the weather. However, in severe cases of osteoarthritis, joint pain can be constant.
Is osteoarthritis considered a disability?
If your osteoarthritis is severe enough that it prevents you from working or being able to carry out everyday activities, it may be considered a disability. You may therefore be entitled to financial support from the government. However, each case is assessed independently and a diagnosis of osteoarthritis alone is not enough to qualify for disability allowances.