What is Osteoarthritis?
Osteoarthritis (OA) is a condition that causes the joints to become painful and stiff. It is the most common type of arthritis in the UK and affects people of all ages, though it becomes more common as we get older.
Our joints are constantly exposed to a low level of wear and tear as part of normal everyday life. In most people, the body quietly repairs this damage without us ever noticing. In osteoarthritis, however, the smooth protective cartilage that lines the ends of the bones in a joint gradually breaks down. As the cartilage thins and wears away, the bones underneath can begin to rub against one another, causing pain, swelling, and difficulty moving the joint.
Over time, bony growths called osteophytes may develop around the edge of the joint, and the surrounding area can become inflamed and swollen. Osteoarthritis is a long-term condition — but it does not always get progressively worse, and for many people symptoms can be well managed, or even improve over time.
Almost any joint can be affected by osteoarthritis, but the condition most commonly causes problems in the knees, hips and small joints of the hands — the areas that bear the most load during daily life.
Recognising the Symptoms
The main symptoms of osteoarthritis are pain and stiffness in the affected joint, which can make everyday movement difficult. Symptoms may come and go — often related to activity levels or changes in the weather — or they may become more continuous as the condition progresses.
The severity of osteoarthritis varies greatly from person to person. For some, symptoms are mild and only occasionally noticeable. For others, the pain and loss of mobility can have a significant impact on daily life.
Joint Pain
Pain that is typically worse with movement and activity, and eases with rest — particularly in the early stages.
Stiffness
Stiffness after periods of rest or inactivity, such as first thing in the morning, that usually eases within 30 minutes of moving.
Swelling & Tenderness
The joint may appear swollen or feel tender to the touch, particularly after periods of increased activity.
Grating or Crackling
A grating, crackling or crunching sensation when moving the affected joint — caused by roughened cartilage surfaces rubbing together.
Reduced Range of Movement
Difficulty fully bending, straightening or rotating the joint — making everyday tasks such as climbing stairs or dressing more challenging.
Muscle Weakness
The muscles around an arthritic joint can weaken over time (muscle wasting), which in turn places more stress on the joint itself.
How Osteoarthritis Affects the Hip & Knee
While osteoarthritis can affect any joint, the hip and knee are among the most commonly affected — and the most likely to require surgical treatment when conservative management is no longer sufficient.
Osteoarthritis of the hip often causes difficulty moving the hip joint in everyday situations. Patients frequently describe finding it hard to put on shoes and socks, get in and out of a car, or walk any significant distance without pain.
The pain is typically felt in the groin or on the outside of the hip, and may radiate down the thigh towards the knee. It is often worse with movement, but can also be present at rest or during the night, disrupting sleep.
Over time, the hip may lose flexibility and the range of movement available decreases. Walking with a limp is common. Many patients also describe a deep ache in the buttock area.
Osteoarthritis of the knee typically affects both knees over time, though one knee is often worse than the other — particularly if the condition developed following a previous injury or surgery to that knee.
The knees are usually most painful when walking, especially on inclines, stairs, or uneven ground. Some patients describe their knees "giving way" beneath them, making them feel unsteady. Stiffness after sitting for a prolonged period — sometimes called the "theatre sign" — is also a characteristic feature.
A soft grating or crunching sensation when bending the knee is common. In more advanced cases, the knee may develop a visible deformity, often bowing inward (varus) or outward (valgus), as the cartilage wears unevenly across the joint.
Why Does Osteoarthritis Develop?
The exact cause of osteoarthritis is not fully understood, but several factors are known to increase the likelihood of developing it. Having one or more of these risk factors does not mean you will definitely develop OA — but understanding them can help put your diagnosis in context.
- Age — The risk of osteoarthritis increases with age. The protective cartilage naturally becomes less resilient over time, making it more susceptible to damage.
- Previous joint injury — Overusing a joint before it has fully healed from an injury or operation can accelerate cartilage breakdown. Sports injuries, fractures affecting the joint surface and previous surgery are all significant factors.
- Being overweight or obese — Excess body weight places considerable additional strain on weight-bearing joints, particularly the hips and knees. Even modest weight loss can make a meaningful difference to symptoms.
- Family history — Osteoarthritis can run in families, suggesting a genetic component. If a close family member has OA, your own risk may be increased.
- Being female — Women are more likely to develop osteoarthritis than men, and tend to be affected more severely — particularly after the menopause, when the protective effects of oestrogen on cartilage are reduced.
- Other joint conditions — Osteoarthritis can develop as a consequence of other conditions that have previously damaged the joint, such as rheumatoid arthritis or gout. This is sometimes referred to as secondary osteoarthritis.
- Occupational or lifestyle factors — Jobs or activities that place repeated stress on specific joints over many years can increase the risk of OA developing in those joints.
How is Osteoarthritis Diagnosed?
Osteoarthritis is usually diagnosed based on a combination of your symptoms, a physical examination of the affected joint, and X-ray findings. There is no single test that confirms OA, but the diagnosis is typically straightforward.
In clinic, Mr. Lodge will ask in detail about your symptoms — including when the pain started, what makes it better or worse, how it affects your daily activities, and what treatments you have already tried. He will then examine the joint, assessing its range of movement, stability, and any deformity.
X-rays and Further Investigations
X-rays are the most important investigation in assessing osteoarthritis. They allow Mr. Lodge to see the degree of cartilage loss (shown by narrowing of the joint space), the presence of bony growths (osteophytes), and any changes in the underlying bone. Together with your symptoms, X-rays help determine how advanced the condition is and inform decisions about the most appropriate treatment. Blood tests and MRI scans may occasionally be requested to rule out other conditions or provide additional detail.
What Happens Next?
Receiving a diagnosis of osteoarthritis can feel daunting, but it is important to understand that there are many effective ways of managing the condition — and surgery is by no means the only, or always the first, option.
Mr. Lodge will take the time to discuss all available options with you, from lifestyle modifications and physiotherapy through to joint injections and, where appropriate, joint replacement surgery. The right approach depends on the severity of your symptoms, the degree of joint damage visible on X-ray, your overall health, and your personal goals and preferences.
Explore the links below to find out more about the full range of management options available, or contact us to arrange a consultation.