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Osteoarthritis
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Osteoarthritis

Osteoarthritis is a highly prevalent joint disease characterized by the breakdown of protective cartilage, leading to pain, stiffness, and impaired mobility primarily in older adults.

Overview

Osteoarthritis is a very common disease of the joints that primarily occurs in older adults, affecting about 23 percent of adults in the United States. In middle age, it affects more women than men, but by about age 70, most people of both sexes experience some symptoms of the condition. Severe osteoarthritis is a major contributor to disability worldwide.

The prevalence of osteoarthritis has doubled in the United States since the 1940s. Research indicates that longer lifespans and higher rates of obesity do not fully explain this increase, suggesting that other, undetermined features of modern life are involved in the development of the condition.

Symptoms

Osteoarthritis usually develops slowly, causing pain, stiffness, and restricted movement as the condition gets worse. Key features include:

  • Pain and stiffness in the affected joints, most often the hands, shoulders, spine, knees, or hips.
  • Stiffness following periods of inactivity, such as upon awakening or rising from a chair, which typically improves as the individual moves around.
  • Joint tissue inflammation caused by the immune system's response to joint damage.
  • Abnormal growths of bone (osteophytes) and other tissue, which can cause visible enlargement of the joints, particularly in the fingers.
  • Impaired mobility and difficulty performing daily tasks in severe cases, which can affect quality of life and increase the risk of other health conditions, such as cardiovascular disease.

Causes & Risk Factors

The condition was once believed to be caused primarily by "wear and tear" damage to the joints over time. However, it is now thought to be mainly the result of the body's failed attempts to repair this damage. In healthy cartilage (the tough but flexible tissue covering the ends of bones at the joints), there is a balance between tissue buildup and breakdown. In osteoarthritis, this balance is lost, leading to cartilage damage and eventual complete breakdown. Without the cushioning of cartilage, bones rub against each other, causing bone damage, joint overgrowth, and an immune response that triggers inflammation and further joint damage.

Genetic Factors

Common variations that affect many genes, some of which are unidentified, contribute to the risk of developing osteoarthritis. Most of these variations are thought to act by subtly changing the amount, timing, and location of gene activity (expression). The genes involved are typically responsible for the formation and maintenance of bone and cartilage. If these genes are not expressed in the right location, at the right time, or in the right amount, tissue function may be impaired.

Genes associated with osteoarthritis risk include:

  • COL11A1
  • ALDH1A2
  • ASTN2
  • DOT1L
  • GDF5
  • MCF2L
  • NCOA3

In most cases, multiple genetic changes, each with a small effect, combine to increase the risk of developing the disorder.

Environmental & Lifestyle Factors

Genetic changes can interact with environmental and lifestyle factors associated with osteoarthritis risk, including:

  • Aging, as cartilage naturally begins to thin over time.
  • Joint injuries, such as an anterior cruciate ligament (ACL) tear.
  • Being overweight or obese.
  • Activities or occupations that place excessive, repetitive stress on the joints.

Inheritance

People inherit an increased risk of developing osteoarthritis, rather than the condition itself. This genetic predisposition can be passed through generations in families, but the exact inheritance pattern is unknown.

Other Names for This Condition

  • Arthritis, degenerative
  • Arthropathy
  • Degenerative joint disease
  • Degenerative polyarthritis
  • Hypertrophic arthritis
  • OA
  • Osteoarthritis deformans
  • Osteoarthrosis

Frequently Asked Questions

In osteoarthritis, stiffness is typically "gelling" stiffness, which occurs because the synovial fluid (joint lubricant) becomes thicker and less effective during periods of inactivity. As you move, the fluid circulates, and the stiffness usually resolves within 15 to 30 minutes. This is a key distinction from inflammatory arthritides like rheumatoid arthritis, where stiffness often lasts longer than 45 minutes and is accompanied by significant swelling and warmth due to active immune system inflammation.
Normal aging may involve occasional joint creaking or mild discomfort after unusual activity, but it does not typically cause persistent pain, visible swelling, or functional limitation. Early osteoarthritis is characterized by progressive pain that worsens with use, stiffness that lasts more than a few minutes after inactivity, and a gradual decline in the ability to perform tasks like climbing stairs or gripping objects. If you notice these patterns persisting for more than a few weeks, a medical evaluation is warranted to confirm the diagnosis and start early management to slow progression.
Surgery is generally considered when conservative treatments (weight loss, exercise, medications, injections) have failed to control pain and significantly impair your ability to perform daily activities or sleep. It is not based on the severity of X-ray findings alone, as many people have severe radiographic changes but manageable symptoms. Recovery typically involves six to eight weeks of physical therapy to regain strength and range of motion. Most patients experience significant pain relief and improved mobility, but it is important to understand that the new joint has a lifespan and may eventually need revision.
Weight loss is the single most effective non-pharmacological intervention for knee osteoarthritis in overweight individuals. For every pound of weight lost, the force on the knee joint during walking is reduced by four pounds. Combining weight loss with low-impact aerobic exercise (such as swimming or cycling) and strengthening exercises for the quadriceps and hamstrings helps stabilize the joint, reduce pain, and improve function. Physical therapy can provide specific exercises to maintain range of motion and muscle strength.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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