Understanding Osteoarthritis: Causes, Symptoms, and Treatment Options

Introduction

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide — especially adults over the age of 40. It develops gradually as the protective cartilage in joints wears down over time, leading to pain, stiffness, and reduced mobility. In South Africa Juvenile-Onset Osteoarthritis is commonly seen in pain clinics with young people in younger than 20 or 30 years developing osteoarthritis.

While osteoarthritis cannot be cured, early recognition and proactive management can dramatically slow its progression and improve quality of life. This guide explains what osteoarthritis is, what causes it, how it’s diagnosed, and the full range of treatment options available.

 

What Is Osteoarthritis?

Osteoarthritis is a degenerative joint condition that occurs when the cartilage covering the ends of bones breaks down. Cartilage acts as a cushion, allowing bones to glide smoothly during movement.

As cartilage wears away:

• Bones begin to rub directly against each other
• The joint becomes inflamed, stiff, and painful
• Over time, the joint can change shape, develop bony growths (spurs), and lose its normal function

Unlike rheumatoid arthritis — which is autoimmune — osteoarthritis is primarily wear-and-tear related.

 

What Causes Osteoarthritis?

Several factors contribute to the development of osteoarthritis:

• Age: Risk increases significantly after 40 due to natural cartilage wear
• Genetics: A family history of osteoarthritis increases risk
• Joint injuries: Previous fractures, ligament tears, or surgery can accelerate degeneration
• Obesity: Excess body weight puts extra stress on weight-bearing joints like knees and hips
• Repetitive stress: Occupations or sports that involve repetitive joint movements can cause cumulative damage

Most cases result from a combination of these factors over time.

 

Common Symptoms of Osteoarthritis

Symptoms often develop gradually and worsen over time. Key signs include:

• Joint pain: Especially during or after movement
• Stiffness: Most noticeable after periods of inactivity or first thing in the morning
• Swelling and inflammation: Around the affected joints
• Loss of flexibility: Difficulty moving the joint fully
• Grating or grinding sensation: When moving the joint
• Bone spurs: Hard lumps that form around the joint edges

 

Areas of the Body Most Affected

Osteoarthritis can affect any joint, but it most commonly occurs in:

• Knees: Pain when walking, climbing stairs, or getting up from a chair
• Hips: Pain radiating to the groin, thigh, or buttock
• Hands: Stiffness, swelling, and bony enlargements in finger joints
• Spine: Lower back or neck stiffness, with possible nerve compression

Symptoms vary depending on the joint involved and the stage of progression.

 

How Is Osteoarthritis Diagnosed?

Diagnosis involves:

• Physical examination: Checking for swelling, tenderness, range of motion, and joint changes
• Medical history: Reviewing symptom patterns and risk factors
• Imaging tests:
• X-rays to detect joint space narrowing, bone spurs, and alignment changes
• MRI scans to show cartilage and soft tissue damage
• Lab tests: Sometimes used to rule out other types of arthritis

Early diagnosis is crucial to prevent further joint damage and start treatment promptly.

 

Treatment Options for Osteoarthritis

There is no cure for osteoarthritis, but many treatments can reduce pain, improve mobility, and slow progression. These can be used alone or in combination.

Lifestyle Changes

• Regular low-impact exercise (walking, cycling, swimming) strengthens muscles around joints
• Weight loss to reduce pressure on knees and hips
• Balanced diet rich in anti-inflammatory foods (fruit, vegetables, omega-3 fatty acids)

Medications

• Pain relievers: Paracetamol or topical creams for mild pain
• NSAIDs: Such as ibuprofen to reduce pain and inflammation
• Corticosteroids: Short-term injections for severe flare-ups

Physiotherapy

• Individualised exercise programmes to improve strength, flexibility, and posture
• Joint mobilisation and pain management strategies

Minimally Invasive Procedures

• Steroid injections to reduce inflammation
• Pain procedures such as pulsed radiofrequency neuromodulation is very successful in treating the chronic pain that this condition causes
• Viscosupplementation (hyaluronic acid) injections to lubricate the joint
• Arthroscopy in selected cases to clean damaged tissue

Surgery

• Joint replacement (arthroplasty) for severely damaged joints, especially hips or knees
• Usually considered only when other treatments fail and pain is disabling

 

Alternative and Complementary Therapies

Some people find additional relief from:

• Acupuncture to reduce pain perception
• Nutritional supplements like glucosamine, chondroitin, or turmeric (curcumin) — evidence is mixed, and they should be used with medical guidance
• Massage therapy to relieve muscle tension around affected joints

Always consult a healthcare provider before starting supplements or complementary therapies.

 

Living Well with Osteoarthritis

Practical strategies can make day-to-day life easier:

• Use ergonomic aids such as supportive shoes, jar openers, or walking aids
• Choose joint-friendly activities like swimming, yoga, or tai chi
• Pace yourself — alternate rest and activity to avoid flare-ups
• Focus on mental wellbeing, as chronic pain can affect mood and motivation
• Join support groups to stay connected and share coping tips

 

When to See a Doctor

Seek medical advice if you experience:

• Persistent joint pain lasting more than a few weeks
• Swelling or stiffness that limits daily activities
• Sudden joint pain with redness, warmth, or fever (could indicate infection)
• Progressive loss of mobility or joint deformity

Early medical assessment can prevent further joint damage and improve long-term outcomes.

 

Final Thoughts

Osteoarthritis is common, progressive, and often misunderstood — but it does not have to mean living with constant pain.

With early diagnosis, lifestyle adjustments, medical treatment, and ongoing support, many people are able to manage their symptoms and stay active for years. Speak to your healthcare provider to build a personalised plan that fits your condition, goals, and lifestyle.

 

FAQs

What is the main cause of osteoarthritis?
Age-related wear and tear is the most common cause, but genetics, injuries, and excess weight also contribute.

How do I know if I have osteoarthritis or another type of arthritis?
Osteoarthritis usually causes gradual joint pain and stiffness without systemic symptoms like fatigue or fever, which are more common in autoimmune arthritis. A doctor can confirm the diagnosis.

Can osteoarthritis be reversed?
No, joint damage cannot be reversed, but progression can be slowed and symptoms well controlled.

What is the best treatment for osteoarthritis in knees?
Weight management, strengthening exercises, physiotherapy, anti-inflammatories, and joint injections are effective; joint replacement is considered in severe cases.

Is exercise safe for people with osteoarthritis?
Yes — low-impact exercise is recommended to strengthen muscles, reduce stiffness, and support joint function.