What is Osteoarthritis? A Beginner's Guide to Understanding Your Diagnosis

Key Takeaways

Osteoarthritis is the breakdown of cartilage, the cushioning in your joints—not just “wear and tear” from aging
OA is different from rheumatoid arthritis (RA), which is an autoimmune disease
Most people develop OA gradually over years, often starting after age 50
Your diagnosis doesn’t mean you’ll end up in a wheelchair—many people manage OA successfully with the right approach
Treatment options range from lifestyle changes to medications, injections, and in severe cases, surgery

If you’ve just been told you have osteoarthritis (often shortened to “OA”), you probably have a lot of questions. What exactly is happening inside your joint? Why does it hurt? Will it get worse? And most importantly, what can you do about it?

The good news is that osteoarthritis is one of the most common joint conditions—affecting over 32 million Americans—and we know a lot about how to manage it effectively. Let’s break down what you need to know in plain language.

What Exactly Is Osteoarthritis?

Think of your joints as hinges that need proper cushioning to work smoothly. Healthy joints have a layer of smooth, slippery tissue called cartilage that covers the ends of your bones. This cartilage acts like a shock absorber, letting your joints glide smoothly and protecting the bone underneath.

When you have osteoarthritis, this protective cartilage gradually breaks down and wears away. As the cushioning disappears, you may start to experience:

Bone rubbing against bone
Pain during or after movement
Stiffness, especially in the morning or after sitting
Swelling around the joint
A grating or grinding sensation
Loss of flexibility

The joints most commonly affected by OA are the knees, hips, hands, and spine—basically, the joints that carry weight or get used the most throughout your life.

Why Is It Called “Degenerative” Arthritis?

You might hear osteoarthritis called “degenerative joint disease” or “wear-and-tear arthritis.” These terms can sound scary, but they simply mean that OA develops gradually over time as your joints age and experience use.

Here’s what’s important to understand: Osteoarthritis is not an inevitable part of aging. While it’s more common as we get older, plenty of people in their 70s, 80s, and beyond have healthy joints. OA happens when certain factors—injury, genetics, weight, joint stress—tip the balance toward cartilage breakdown faster than your body can repair it.

How Is Osteoarthritis Different from Other Types of Arthritis?

Many people confuse osteoarthritis with rheumatoid arthritis (RA), but they’re actually quite different:

Osteoarthritis (OA)

Caused by: Cartilage breakdown from mechanical wear, injury, or stress
Affects: Usually specific joints (knees, hips, hands)
Pattern: Symptoms typically worsen with activity
Develops: Gradually over years
Morning stiffness: Usually less than 30 minutes

Rheumatoid Arthritis (RA)

Caused by: Autoimmune disease where your immune system attacks joint lining
Affects: Multiple joints symmetrically (both hands, both feet)
Pattern: Can affect whole body, causes fatigue and fever
Develops: Can come on more suddenly
Morning stiffness: Often lasts more than an hour

Your doctor can tell the difference through a physical exam, your symptom history, and sometimes blood tests or X-rays. The treatments differ significantly, so getting the right diagnosis is important.

Why Does Osteoarthritis Happen?

Understanding what causes OA can help you make sense of your diagnosis. While we can’t always pinpoint one specific cause, several factors typically contribute:

1. Age and Cumulative Use

Over decades, your joints handle millions of movements. Cartilage naturally experiences some wear from this lifetime of use. After age 50, the cartilage may not repair itself as efficiently as it once did.

2. Previous Injuries

A significant knee injury from sports in your 20s or 30s can increase your risk of developing knee OA later in life. Injuries can change how weight distributes across the joint or damage cartilage directly.

3. Excess Weight

Extra weight puts additional stress on weight-bearing joints, especially knees and hips. Research shows that losing even 10-15 pounds can significantly reduce knee pain in people with OA.

4. Genetics

OA tends to run in families. If your parents or siblings have it, you may have inherited cartilage that’s more prone to breaking down or joints shaped in ways that create extra stress.

5. Joint Alignment

Some people are born with joints that don’t align perfectly—like being bow-legged or knock-kneed. These variations can cause uneven wear on cartilage over time.

6. Repetitive Stress

Certain occupations or activities that repeatedly stress specific joints—like kneeling, squatting, heavy lifting, or running on hard surfaces for years—can contribute to OA development.

The Four Stages of Osteoarthritis

Doctors often describe OA in stages based on X-ray findings and symptoms. Understanding where you fall can help set realistic expectations:

Stage 1: Minor

Very little cartilage wear
Usually no pain yet
May only be detected on X-rays by chance

Stage 2: Mild

Cartilage begins to thin
May notice stiffness after sitting or mild pain after activity
Joint space starts to narrow on X-rays
Small bone spurs may begin forming

Stage 3: Moderate

Cartilage damage is more obvious
Regular pain, especially with activity
Frequent stiffness
Inflammation and swelling may occur
Reduced range of motion

Stage 4: Severe

Cartilage is severely worn away
Significant pain even at rest
Joint space is very narrow
Large bone spurs present
May have bone-on-bone contact

Here’s the important part: Most people with OA fall into Stages 2 or 3. These stages respond well to treatment. Stage 4 is actually less common than many people fear.

What Your Diagnosis Really Means

Let’s address the worry that often comes with an OA diagnosis: This does not mean you’re destined for a wheelchair or that surgery is inevitable.

The reality for most people with osteoarthritis is:

It’s manageable. With the right approach, many people maintain active lives—playing with grandchildren, gardening, golfing, traveling.
It progresses slowly. OA typically develops over years or decades, not months. You have time to try different treatments and find what works.
You have options. Treatment has advanced significantly. From exercise and weight management to medications, injections, and physical therapy, there’s a lot in the toolbox.
You’re not alone. Over 32 million Americans have OA. There are support groups, resources, and doctors who specialize in helping people just like you.
Surgery is usually a last resort. Only a small percentage of people with OA eventually need joint replacement, and even then, it’s typically only after other treatments have been tried.

The Treatment Pathway: What Comes Next

Most doctors follow a stepped approach to OA treatment, starting with the least invasive options:

Step 1: Lifestyle Modifications

Weight loss if needed
Low-impact exercise (walking, swimming, cycling)
Physical therapy to strengthen supporting muscles
Using assistive devices (canes, braces) to reduce joint stress

Step 2: Over-the-Counter Options

Acetaminophen (Tylenol) for pain
NSAIDs like ibuprofen or naproxen for pain and inflammation
Topical creams and gels

Step 3: Prescription Treatments

Stronger NSAIDs or pain medications
Hyaluronic acid injections (gel shots) to restore joint cushioning
Corticosteroid injections for severe inflammation

Step 4: Advanced Interventions

Regenerative treatments (still being researched)
Joint replacement surgery for severe, unmanageable cases

The good news? Most people find relief somewhere in Steps 1-3. You don’t have to jump straight to surgery, and you shouldn’t feel pressured to do so.

Living Well with Osteoarthritis

Your diagnosis is not an ending—it’s the beginning of a new chapter where you take an active role in managing your joint health. Many people find that once they understand what’s happening and start the right treatments, they actually feel better than they did before diagnosis.

Some things that help people thrive with OA:

Stay active. Movement might hurt initially, but gentle exercise actually strengthens the muscles around your joints and can reduce pain over time.
Maintain a healthy weight. Even small amounts of weight loss can make a big difference in how your joints feel.
Work with your doctor. OA management is a partnership. Communicate openly about what’s working and what isn’t.
Give treatments time. Some approaches, like exercise programs or certain injections, can take weeks to show full benefit.
Don’t ignore worsening symptoms. If your pain significantly increases or you notice new symptoms, check in with your doctor.

Frequently Asked Questions

Will my osteoarthritis keep getting worse?

OA is progressive, meaning it tends to worsen gradually over time. However, the rate of progression varies greatly from person to person. Some people have very slow progression that barely impacts their life, while others need more aggressive intervention. Treatment can slow progression and manage symptoms effectively.

Can I still exercise with osteoarthritis?

Absolutely—and you should. Exercise is one of the most effective treatments for OA. Focus on low-impact activities like swimming, water aerobics, cycling, or walking. Avoid high-impact activities that jar the joint, like running or jumping. A physical therapist can design a safe program for you.

Is osteoarthritis curable?

Currently, there’s no cure for OA—once cartilage is lost, we can’t fully regenerate it yet. However, treatments can significantly reduce pain, improve function, and slow disease progression. Research into cartilage regeneration is ongoing.

When should I consider surgery?

Surgery is typically reserved for severe OA that doesn’t respond to other treatments and significantly impacts your quality of life. Most doctors recommend trying 3-6 months of conservative treatment first. If you can’t sleep, can’t perform daily activities, and multiple other treatments have failed, then it might be time to discuss surgical options.

Does cold weather make osteoarthritis worse?

Many people report that their arthritis pain increases in cold, damp weather. While research hasn’t definitively proven a connection, changes in barometric pressure may affect joint fluid pressure. Staying warm and maintaining activity during winter months can help.

Next Steps

Now that you understand what osteoarthritis is, consider:

Learning about your specific joint condition. If you have knee OA, read more about knee osteoarthritis specifically.
Exploring treatment options. Research different approaches, from exercise programs to hyaluronic acid injections.
Understanding insurance coverage. If you’re on Medicare, learn about what treatments Medicare covers.
Partnering with your healthcare team. Ask questions, express concerns, and work together to find the right management plan for your lifestyle.

Remember: osteoarthritis is common, manageable, and doesn’t have to stop you from living the life you want. With the right knowledge and approach, you can stay active, reduce pain, and maintain your independence for years to come.

This article is for informational purposes only and should not replace professional medical advice. Always consult with your healthcare provider about your specific condition and treatment options.

Last medically reviewed: March 2025