Osteoarthritis is change in the cartilage and bone of a joint, most often the knees, hips, hands and spine. The single most useful thing to understand is that the degree of change on imaging correlates poorly with how much pain someone has. Exercise is first-line treatment in every major guideline. It will not reverse the changes, but it reliably reduces pain and improves what you can do.

Does this sound like you?

Most people have several of these, not all of them.

Joint pain that builds with use through the day
Morning stiffness that eases within about half an hour
Reduced range of movement in the affected joint
Grinding or creaking on movement
Swelling after heavier activity

Why it happens

Age-related change in the joint surfaces
Previous joint injury or surgery
Years of heavy or repetitive loading
Higher body weight, particularly for knees and hips
Family history and genetic factors

What we would do about it

Roughly in this order — each step waits for the one before it.

Progressive strengthening, the most effective treatment available
Range of movement work to preserve what is there
Load and pacing advice so activity is steady rather than swinging
Manual therapy and hydrotherapy for symptom relief
Aids, bracing or footwear where they reduce joint load
Pre-operative strengthening if a joint replacement is planned

See a doctor first if

Your pain followed a significant injury
It is getting worse rather than settling
It comes with numbness, weakness or unexplained weight loss

This page is general information, not a diagnosis. Symptoms overlap between conditions, so the right treatment depends on an assessment.

Wear and tear is not the whole story

People with significant changes on scans often walk comfortably, and people with mild changes are sometimes in a great deal of pain. Strength is a large part of the difference.

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Other chronic conditions we treat

Persistent Pain Fibromyalgia Post-Viral Fatigue Rheumatoid Arthritis

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General information only, not advice about your own problem — nothing here replaces an assessment. Source: Osteoarthritis on Physiopedia.

Osteoarthritis