Osteoarthritis
Wear and tear joint disease — symptoms, management and when to seek help
Osteoarthritis is the most common form of arthritis in the UK, affecting around 10 million people. It occurs when the protective cartilage on the ends of your bones gradually breaks down, causing pain, stiffness and swelling in the affected joints. The knees, hips, hands and spine are most commonly affected.
What is Osteoarthritis?
Osteoarthritis is a degenerative joint condition in which the smooth cartilage lining the ends of bones gradually wears away. As the cartilage thins and roughens, the bones begin to rub against each other, leading to pain, swelling and reduced range of movement. The joint may also develop bony outgrowths called osteophytes. While osteoarthritis is often described as 'wear and tear', it is more accurately understood as a dynamic process in which the joint attempts — but ultimately fails — to repair itself. It is not simply an inevitable part of ageing, and many people with joint changes on X-ray have few or no symptoms.
Causes & Risk Factors
Osteoarthritis develops when the balance between cartilage breakdown and repair is disrupted. Risk factors include older age, being overweight or obese (excess weight increases load on joints), previous joint injuries or repetitive occupational strain, family history of osteoarthritis, and being female (particularly for hand and knee OA after menopause). Secondary osteoarthritis can develop from other joint conditions such as inflammatory arthritis, gout or previous septic arthritis. Muscle weakness around a joint — particularly around the knee — is both a risk factor and a consequence of osteoarthritis.
Signs & Diagnosis
The main symptoms of osteoarthritis are joint pain (worse with activity, better with rest in early disease), morning stiffness lasting less than 30 minutes, joint swelling and tenderness, a grating or crackling sensation (crepitus), and reduced range of movement. Diagnosis is usually clinical — based on age, symptoms and examination findings. X-rays may show joint space narrowing, osteophytes and subchondral sclerosis, but are not always needed. A thorough evaluation of joint function, pain severity and impact on daily life guides management decisions far more than imaging alone. Blood tests are usually normal and are mainly used to exclude other forms of arthritis.
Living with Osteoarthritis
Most people with osteoarthritis can lead active, fulfilling lives with the right management. Exercise is the most effective treatment and should be encouraged regardless of age, severity or X-ray findings — it reduces pain, improves joint function and strengthens the surrounding muscles. Weight loss is strongly recommended if BMI is above 25, as even modest weight reduction significantly reduces knee joint load. Pacing activities, using supportive footwear, and accessing physiotherapy or self-management programmes all contribute to better outcomes. Seek help from your GP or practice nurse if joint pain is significantly limiting your daily activities, if you develop sudden severe joint pain or swelling (which may suggest a different diagnosis), or if your symptoms are no longer controlled with simple measures.