Osteoarthritis: symptoms, treatment and exercise

In short

• Osteoarthritis is a joint disease affecting the whole joint, and the NIAMS says it is not simply wear and tear.
• Common signs are pain with use, stiffness after rest, swelling and reduced movement.
• Exercise, a healthy weight and education come first. Medicines and braces add to them.
• There is no single test. A clinician combines your story, an exam and sometimes imaging.
• Surgery, including joint replacement, is for severe cases when other treatments have not worked.

What osteoarthritis is and how common it is

Osteoarthritis is a degenerative joint disease in which the cartilage that cushions the ends of bones breaks down, and bone spurs may form. It affects the whole joint, including surrounding tissues. It most often affects the hands, knees, hips, neck and lower back.

The World Health Organization estimates that about 528 million people worldwide had osteoarthritis in 2019. About 73 percent are over 55 and about 60 percent are women. The knee is the joint affected most often, followed by the hip and the hand.

Symptoms

• Joint pain during use that often eases with rest, and later may be worse at night.
• Stiffness in the morning or after rest, usually lasting less than 30 minutes.
• Swelling after heavy use, and reduced range of motion.
• A grating or crackling sound, or a feeling that the joint is loose or unstable.
• Bony enlargements in the hands.
• Fatigue, sleep problems and low mood in some people.

Symptoms vary and can come and go. Joint damage usually develops slowly over years, and not everyone has pain.

Where it hurts depends on the joint. In the knee you may notice grinding or buckling, in the hip pain in the groin, and in the neck or lower back stiffness. Spinal changes can sometimes lead to spinal stenosis.

Causes and risk factors

Researchers do not yet know what exactly triggers the changes in the joint. Known risk factors include:

• Older age.
• Being overweight or obese.
• A past joint injury or surgery.
• Repetitive overuse of a joint.
• A joint that did not form correctly.
• Family history.
• Being a woman, especially after age 50.
• Other conditions such as rheumatoid arthritis, gout or diabetes.

What you can do

1. Learn about it.Classes or online programs on osteoarthritis help you manage it. The WHO lists education and counseling among the core measures.
2. Move regularly.Strengthening, stretching, balance work, water exercise and low-impact activity such as walking, cycling, swimming or tai chi all help. Start slowly and check with your clinician or physical therapist first.
3. Manage your weight.Less weight means less stress on the knees and hips.
4. Use supports.Braces, shoe inserts, a cane or other aids can take pressure off a painful joint.
5. Try heat or cold.Heat can ease stiffness and pain, and cold can numb pain. Both are simple options.

The NHS suggests aiming for at least 150 minutes of moderate aerobic activity a week plus strength exercises on 2 or more days, adjusted to what your joints allow.

When to see a doctor, and red flags

See a primary care provider for persistent joint pain or stiffness. The NHS notes that doctors consider osteoarthritis likely if you are 45 or older, the pain gets worse with joint use, and morning stiffness is absent or lasts under 30 minutes.

Get same-day care for a joint that suddenly becomes hot, red and very swollen, especially with fever, because other causes such as infection or gout need to be ruled out. Call 911 after an injury with obvious deformity or if you cannot put any weight on the leg.

How a clinician confirms it

There is no single test for osteoarthritis. Diagnosis combines your medical history, a physical exam and sometimes imaging. X-rays show loss of joint space and bone spurs, though early damage often does not show up. An MRI may be used for a joint that locks or gives way.

Blood tests are used to rule out other causes, and a sample of joint fluid can check for infection or gout. The NHS adds that X-rays and blood tests are usually not needed unless another cause is suspected.

Treatment options in general terms

• Goals are to reduce pain, improve function, slow progression and prevent disability.
• Oral pain relievers and anti-inflammatory medicines, and creams, rubs or sprays for the skin over the joint, as advised by a clinician.
• Corticosteroid injections for temporary pain relief, with the number of injections set by your doctor.
• Some clinicians use hyaluronic acid injections for the knee. The WHO says viscosupplementation, opioid painkillers and glucosamine are not considered effective.
• Physical therapy and occupational therapy, plus a structured exercise plan.
• Surgery is considered when other treatments fail and the damage is extensive. Options include partial or total joint replacement, mainly for the hip and the knee.

What to expect

The NHS says osteoarthritis cannot be reversed, but it does not necessarily get worse and can sometimes improve. Early diagnosis and a plan made for you can slow progression, according to the WHO. Reduced activity weakens muscles, so staying active also protects the heart and helps with weight.

You cannot fully prevent it, but avoiding injury, keeping a healthy weight, good posture and regular breaks from desk work may lower your risk.

Questions and answers

Sources

1. WHO — Osteoarthritis fact sheet
2. NIAMS — Osteoarthritis
3. NIAMS — Osteoarthritis: Diagnosis, Treatment, and Steps to Take
4. NHS — Osteoarthritis
5. MedlinePlus — Osteoarthritis

Sources checked on 29 October 2026.