Osteoarthritis is the most common form of arthritis, affecting over 30 million adults in the United States. It occurs when the cartilage that cushions the ends of bones wears down over time, causing pain, stiffness and swelling in the joints. While osteoarthritis is more common in older adults, it can develop at any age due to joint injury, obesity, or genetics. There is no cure for osteoarthritis, but early treatment is key to managing symptoms and slowing progression. Ignoring the warning signs of osteoarthritis can lead to permanent joint damage, disability, and reduced quality of life.
What are the symptoms of osteoarthritis?
The most common symptoms of osteoarthritis include:
- Joint pain that worsens with use and improves with rest
- Stiffness in the joints after periods of inactivity or upon waking up
- Loss of flexibility and range of motion in the affected joints
- Swelling or tenderness around the joint
- A crunching feeling or sound when using the joint (called crepitus)
- Bone spurs or extra bone growth around joints
Osteoarthritis most often affects the hands, knees, hips and spine. The symptoms tend to develop slowly over years. In the early stages, joint pain may come and go, cause minor aches, and be more aggravating than debilitating. Many people write off these early osteoarthritis symptoms to normal aging. But as cartilage continues to break down, the pain becomes more constant, intense, and limiting. Ignoring the symptoms allows osteoarthritis to progress, making treatment more difficult.
What causes osteoarthritis to get worse?
Several factors can accelerate the breakdown of cartilage and progression of osteoarthritis:
- Injury or overuse – Joint injuries, particularly to the knee, increase the risk of osteoarthritis. Repetitive motions or consistently overloading joints through sports, work or obesity also wears down cartilage over time.
- Improper joint alignment – Issues like bowlegged or knock knees put uneven force on the joints, causing faster cartilage breakdown in those areas.
- Muscle weakness – Strong muscles around the joint help absorb shock. Weak muscles transfer more force directly to the joint, accelerating cartilage damage.
- Lack of mobility – Not using the full range of motion of joints allows the cartilage to soften and wear away faster.
- Age – As we get older, cartilage loses some elasticity and ability to self-repair after use.
Ignoring osteoarthritis symptoms allows these factors to take a greater toll on your joints over time. The cartilage breakdown not only worsens, but can become permanent joint damage.
What are the stages of osteoarthritis?
Osteoarthritis progresses through the following stages:
Early/mild osteoarthritis – Symptoms are mild and come and go. X-rays may appear normal or show very minor joint space narrowing. Cartilage breakdown is occurring but likely not visible.
Moderate osteoarthritis – Symptoms become more persistent. X-rays show joint space narrowing, some bone spur formation, and hardened areas in the cartilage. Breakdown is clearly occurring.
Severe osteoarthritis – Constant joint pain and stiffness severely limits activity and range of motion. Bones may rub together as cartilage is gone in areas. Bone spurs and loose pieces of cartilage float in the joint.
Ignoring even early stage symptoms for too long almost guarantees reaching the severe stage faster, where joint damage can be irreversible.
What joint damage occurs?
Over time, unaddressed osteoarthritis causes several types of permanent joint damage:
- Loss of cartilage – This cushion between bones wears away entirely in some spots, causing bone-on-bone grinding and pain.
- Damaged bones – Bones respond to the increased friction by growing outward with spurs. The joint space between bones shrinks.
- Weakened muscles – Pain and stiffness leads to disuse of the joints, causing muscles to weaken. This worsens joint instability and cartilage breakdown.
- Loose pieces – Bits of cartilage and bone may chip off inside the joint, blocking motion and causing more damage.
This joint damage limits mobility long term. Severe loss of cartilage and bone changes also increase the need later for total joint replacement surgery.
How does osteoarthritis spread?
Osteoarthritis most often occurs first in just one or a few joints, especially after an injury. Ignoring symptoms allows the cartilage breakdown process to spread.
Several factors cause osteoarthritis to expand to more joints:
- Biomechanical stress – Favoring joints to avoid osteoarthritis pain puts more stress on surrounding joints.
- Inflammation – Cartilage breakdown releases enzymes that cause swelling. This attacks cartilage in other nearby joints.
- Nerve signals – Sensitized nerves from arthritic joints Heighten pain signals sent to the brain, amplifying nerve responses in other areas.
- Metabolic changes – Biochemicals released during cartilage breakdown enter the bloodstream and travel to other joints, triggering changes.
Over the long-term, osteoarthritis untreated in one knee often leads to it developing in the other knee. Hand osteoarthritis spreads across multiple fingers. Spinal osteoarthritis commonly moves up or down the vertebrae. The more joints affected, the greater the disability.
What disability can osteoarthritis cause?
As osteoarthritis worsens over time, it can lead to varying degrees of long-term disability and loss of independence. Effects include:
- Reduced mobility – Stiffness, pain, and loss of flexibility make movements more difficult, particularly climbing stairs, getting up from chairs, or walking distances.
- Impact on daily tasks – From dressing oneself to opening jars, gripping items becomes difficult as hand osteoarthritis advances. Knee osteoarthritis hampers standing up, walking, and using stairs.
- Trouble sleeping – Joints ache and feel immobile at night or after long periods of inactivity.
- Need for assistive devices – Canes, walkers, raised toilet seats, grab bars and other devices become necessary to reduce strain on arthritic joints.
- Job loss – Inability to perform job functions due to reduced mobility or activity limitations.
- Depression – Chronic joint pain and loss of ability lead to mood changes and social isolation.
Severe osteoarthritis untreated can mean complete loss of independent mobility. It accounts for a majority of total hip and knee replacements in the U.S. With early treatment, progression can be slowed enough to maintain better physical function.
What treatments help osteoarthritis?
While no cure exists for osteoarthritis, various treatments can ease symptoms and slow the progression to disability:
- Weight loss – Reducing obesity takes pressure off joints and reduces pain.
- Physical therapy – Stretching, strengthening exercises, and modalities maintain joint mobility and support.
- Assistive devices – Braces, splints, canes and walkers redistribute joint stress and make tasks easier.
- Medications – Over-the-counter and prescription anti-inflammatories and pain relievers reduce swelling and pain.
- Injections – Steroid injections directly into the joints provide temporary pain relief for several months.
- Surgery – Joint repair, realignment, fusion, or replacement surgery corrects underlying issues.
When osteoarthritis is caught early, milder therapies can ease symptoms effectively. But waiting too long until significant joint damage develops may limit treatment options and usefulness.
What complications can severe untreated osteoarthritis cause?
Without treatment intervention, severe end-stage osteoarthritis can lead to complications including:
- Falls and fractures – Joint instability and weakness put seniors at high risk for falls that then fracture fragile osteoporotic bones.
- Cardiovascular disease – Lack of mobility from osteoarthritis limits physical activity needed for heart health.
- Diabetes – Inactivity also increases blood sugar and insulin resistance, raising diabetes risk.
- Obesity – Joint pain often reduces ability to exercise and burn calories, making weight loss hard.
- Depression – Social withdrawal from disability leads to increased depression risk.
- Opioid dependence – Long-term narcotic painkiller use for end-stage osteoarthritis is addictive.
Severe osteoarthritis alone reduces life expectancy by 1-4 years. But it also indirectly causes higher risk of earlier death from heart disease, diabetes and stroke by limiting activity.
Conclusion
Osteoarthritis is a progressive joint disease that only worsens over time without treatment. Ignoring early warning signs allows cartilage breakdown and eventual permanent joint damage to occur. Osteoarthritis can spread across multiple joints, lead to disability, and serious complications. But with early intervention, progression can be slowed enough to maintain quality of life and independence. This makes it critical to see a doctor at the first symptoms before osteoarthritis advances too far. While it can’t be cured, the right treatment helps control osteoarthritis.