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Osteoarthritis


Expert reviewer, Sundeept Bhalara, Consultant Rheumatologist and General Physician
Next review due May 2024

Osteoarthritis is a condition that can cause your joints to become stiff and painful. Your knees, hips and the small joints in your hands are most commonly affected. It’s the most common form of arthritis.

An image showing how the knee is affected by osteoarthritis

About osteoarthritis

Osteoarthritis affects around a third of people aged 45 and over in the UK. You’re more likely to develop it the older you get.

The condition is thought to develop when your joints get damaged. As your joint tries to repair itself, changes can take place inside the joint. These changes can then lead to the development of pain and stiffness.

There are two different types of osteoarthritis.

  • In primary osteoarthritis, there’s no known underlying disease or injury. It tends to come on gradually and affect older people.
  • Secondary osteoarthritis is linked to a previous injury or another medical condition. It’s more likely to affect younger people.

Osteoarthritis can affect people in different ways, and can affect one joint differently to another. It can sometimes get worse over time, but this isn’t usually the case. It might stay the same for years, or the pain and stiffness may even improve with time.

Causes of osteoarthritis

It’s not clear exactly what makes someone develop osteoarthritis. It’s thought to be down to several different things. However, there are certain factors that are known to increase your risk of developing the condition. You’re more likely to develop osteoarthritis if:

  • you’re over 45 – the risk increases the older you get
  • you’re a woman – although it affects men too, it’s more common in women
  • you’re obese – the extra weight puts more strain on your joints, and chemicals released by fat cells have also been linked to osteoarthritis
  • you have a family history of osteoarthritis
  • you’ve previously had an injury to your joint
  • you have (or used to have) a job that involves a lot of manual work, or a hobby that involves a lot of stress on your joints, such as playing football
  • you have another condition affecting the movement or alignment of your joints – this might mean you put more stress on them
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Symptoms of osteoarthritis

The main symptoms of osteoarthritis are pain and stiffness of the affected joint. You might find you can’t use the joint or move it as well as before. Sometimes the pain can spread, or you may feel it in a different area of your body to the joint that’s affected. For instance, if you have osteoarthritis in your hip, you might feel pain in your groin, thigh, knee or ankle.

You’ll usually only feel pain when you use your joint, and it will tend to feel better when you rest. But if your arthritis is severe, you may be in pain when you’re resting too. Your joint may feel stiff first thing in the morning, or after resting, but this usually wears off quickly.

Sometimes you may notice swelling around the affected joint, and a crunching and grinding feeling or noise when you move it.

These symptoms can sometimes be due to other problems, but if you have any of them, contact your GP for advice.

Diagnosis of osteoarthritis

Your GP will ask about your symptoms, including where and when you feel any pain, how bad it is and how long it’s been going on. They may also ask you about any risk factors you may have for osteoarthritis, including your medical and family history. Your GP will also want to know how much of an impact your symptoms are having on your day-to-day life.

Your GP will also want to examine your joint. They might check how well your joint moves and how stable it is. If your knee or hip is affected, they might look at how well you’re walking or standing. There’s no single test for osteoarthritis and an examination by your GP is usually all that’s needed to diagnose the condition.

X-rays aren’t routinely carried out to diagnose osteoarthritis. They don’t always show early stages of osteoarthritis. But they can sometimes help to confirm a diagnosis, or rule out other conditions.

Self-help

Your GP will talk to you about several things you can do to reduce the pain and stiffness in your joints, and make day-to-day life easier. Some of the main ones are listed below.

  • Exercising regularly can help to improve your symptoms and build up muscle strength. See the section below for more on exercising with osteoarthritis.
  • If you’re overweight or obese, aim to reduce your weight by making changes to your diet and activity levels. Losing even a little weight can reduce the stress on your joints, improving your symptoms. Use our BMI calculator to see if you’re a healthy weight.
  • If you have osteoarthritis in your knee, wearing shoes with a soft, thick, cushioned sole or using an insole will help to reduce any jarring.
  • Try using a heat pad or an ice pack to help relieve pain. Don’t put either of these directly on to your skin as they may damage it or even give you a burn. Wrap them in a towel first.

Exercise and osteoarthritis

Exercising regularly, as much as you’re able to, is one of the most beneficial things you can do. Exercise can help to keep your joints working well and reduce your pain. It will also help to build up your muscle strength and improve your fitness, and may help you to feel better too.

Sometimes, your GP may recommend a structured exercise programme you can join. Other times, they might just give you some advice about what to try. The important thing is to find something that you can stick with and enjoy.

Aim to do a variety of different types of exercise, including the following.

  • Strengthening exercises – to help strengthen your muscles and support your joints.
  • Aerobic exercises, that increase your heart rate and get you a bit out of breath. This is good for overall health and fitness, and to help lose or maintain your weight. You might find it best to do a low-impact aerobic exercise that doesn’t put too much strain on your joints. Examples include swimming, cycling or walking.
  • Flexibility/stretching exercises – to help maintain range of movement of your joints.

Build up the amount of exercise you do gradually. You might want to consider seeing a physiotherapist, who can help to create an individual exercise programme that works for you.

Treatment for osteoarthritis

As well as the self-help measures above, there are various treatment options for managing osteoarthritis that your GP will discuss with you.

Medicines

Medicines won’t cure your osteoarthritis, but they may help to ease your pain and stiffness. Your doctor may suggest trying some of the following.

  • Creams or gels containing a non-steroidal anti-inflammatory (NSAID) medicine, or a painkilling substance called capsaicin. You can rub these directly on to your joint.
  • Paracetamol. You’ll usually need to take paracetamol regularly, rather than just when you're in pain to get the most benefit.
  • NSAID tablets (e.g. ibuprofen or naproxen), or a similar type of medicine called a COX-2 inhibitor. Your GP may suggest these if creams/gels and paracetamol haven’t helped. You might need to take another medicine called a proton-pump inhibitor alongside these, to help reduce side-effects to your digestive system.
  • Opioids (e.g. codeine). Occasionally, if you have severe symptoms and other medicines aren't helping, your GP may suggest a stronger type of painkiller called an opioid.

Always read the patient information leaflet that comes with your medicine and if you have any questions ask your pharmacist for advice.

If you have a flare-up of severe pain, despite your regular painkillers, your GP may suggest you have a steroid injection into your joint. Your GP may be able to do this themselves, or they may refer you to a musculoskeletal clinic to have it.

Another treatment you may be able to try is hyaluronic acid injections. There’s some research suggesting that these injections can improve osteoarthritis symptoms. But evidence about how well they work is quite mixed, so they aren’t always available on the NHS.

Supportive therapies

Your GP may refer you to other health professionals, who can give you more practical advice and recommend various aids and devices that can help. These may include the following.

  • A physiotherapist can advise you on the best types of exercise to do to keep movement and muscle strength around the affected joints. They can also assess whether braces, splints and supports would be useful.
  • An occupational therapist can give you practical ways to help you manage with everyday tasks. This may include advising you on changes you can make to your car, home or workplace to ease any stress on your joints.
  • A podiatrist can give you advice on the best footwear to use, and whether insoles would help.

Think about whether it would help to rearrange any rooms in your house or make any adaptations. For example, if you have hip or knee arthritis, you may want to install stair rails or grab rails in your bathroom. Raised toilet seats and a bath board/seat may also be helpful. If your hands are affected, you may find gadgets and aids, such as tap turners, kitchen utensils with padded handles and automatic can-openers helpful.

An occupational therapist can give you more advice. You may be eligible for some help towards the cost of any aids or adaptations you need in your home. Contact your local authority for a free assessment.

If you’re in work, ask if your employer has an occupational health department. They’ll be able to help you make adjustments to your way of working, or to your working environment to help you.

Surgery

If your pain is severe or has a large impact on your life, and other treatments aren’t helping, your GP may refer you to an orthopaedic surgeon. The surgeon will meet with you to discuss whether surgery on your joint may be an option for you. Surgery may involve replacing all or part of your joint with an artificial one (e.g. a hip replacement or knee replacement). Another type of surgery involves joining (‘fusing’) bones in your joint together. You may have this for osteoarthritis in your foot or hand. Your doctor will discuss with you what’s best in your particular case.

Complementary therapies

Many people with osteoarthritis try complementary therapies to ease their symptoms. These include dietary supplements, such as glucosamine and chondroitin, acupuncture and massage.

Some people do find a benefit from using these therapies. But overall, there’s not much good evidence that they work. If you decide to give them a try, be aware of possible side-effects and risks. They shouldn’t replace any treatment your doctor recommends. If you’re planning to try a supplement or herbal medicine, it’s worth speaking to your pharmacist first, as they might affect other medicines you’re taking.

Frequently asked questions

  • There’s no specific diet that can help with osteoarthritis. But some people do seem to find that certain foods improve or worsen their symptoms. There’s no scientific evidence to support any of these things though. The most important thing is to have a wide, varied diet, which can give you all the nutrients you need, and keep you in the best possible health. The most important link between diet and arthritis is the effect it has on your weight.

  • If you’re overweight, this will put a strain on your joints, particularly your knees, hips and lower back. It’s also thought that chemicals released by fat cells may cause inflammation around your joints. If you’re overweight or obese, losing even just a little weight may significantly help to reduce pain and stiffness in your joints.

  • Possibly. Splints can make sure that your wrist and hand are held and supported in the correct position.

    A resting splint is worn when you’re asleep or resting. It can help to reduce pain in your hand and wrist if you’re having a flare-up. It might reduce swelling and stiffness when you wake up in the morning.

    A working splint is worn when you’re doing jobs with your hands. It can support and protect your wrist and hand when you’re carrying out these jobs. It may make them easier to manage and less likely to cause you pain.



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Related information

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  • Reviewed by Pippa Coulter, Freelance Health Editor, May 2021
    Expert reviewer Sundeept Bhalara, Consultant Rheumatologist and General Physician
    Next review due May 2024

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