Osteoarthritis is the most common form of arthritis in the UK, and it affects millions of people at some stage in their lives. It develops when the cartilage that cushions a joint wears down faster than the body can repair it, leaving bones to rub against each other during movement. The result is pain, stiffness and, over time, a gradual loss of function in the affected joint.

Unlike rheumatoid arthritis or psoriatic arthritis, osteoarthritis is not an autoimmune condition. It is a mechanical and structural problem within the joint itself, which is why treatment tends to focus on protecting the joint, staying active and managing symptoms rather than suppressing the immune system. Understanding what osteoarthritis is, what causes it and how it is diagnosed can help you recognise the early signs and get the right support sooner.

This guide covers the symptoms of osteoarthritis, its causes and risk factors, how doctors diagnose it, the treatment options available and how it compares with other joint conditions such as rheumatoid arthritis, psoriatic arthritis and gout.

What Is Osteoarthritis?

Osteoarthritis develops when the smooth cartilage covering the ends of bones within a joint begins to break down. Cartilage normally allows bones to glide against each other with very little friction. As it thins, the joint loses some of that cushioning, small bony growths called osteophytes can form at the edges of the joint and the surrounding tissue can become inflamed.

Doctors sometimes describe osteoarthritis as a “wear and repair” condition rather than simple wear and tear, because the joint is constantly trying to heal itself. In many people, this repair process keeps pace with the damage for years without causing noticeable symptoms. Problems tend to appear once the damage outpaces the joint’s ability to repair itself.

Osteoarthritis can affect any joint, but it most commonly develops in the:

  • Knees
  • Hips
  • Small joints of the hands and thumb base
  • Spine, particularly the neck and lower back
  • Big toe

Common Symptoms of Osteoarthritis

Symptoms usually build up gradually over months or years rather than appearing suddenly. Severity varies a great deal between individuals and even between joints in the same person.

Typical signs of osteoarthritis include:

  • Joint pain that worsens with activity and eases with rest
  • Stiffness after periods of inactivity, such as first thing in the morning or after sitting for a long time
  • A grating, crackling or grinding sensation when moving the joint, known as crepitus
  • Swelling around the affected joint
  • Reduced range of movement
  • Joint tenderness when light pressure is applied
  • Bony swellings, particularly in the finger joints
  • Muscle weakness or wasting around a badly affected joint

Morning stiffness with this condition is usually brief, often easing within twenty to thirty minutes once the joint starts moving. This is one of the features that helps distinguish it from inflammatory types of arthritis, where stiffness can last considerably longer.

What Causes Osteoarthritis?

The exact cause is not fully understood, and in many cases there is no single obvious trigger. Instead, a combination of factors increases the likelihood that a joint’s natural repair process will fall behind the rate of damage.

Recognised risk factors include:

  1. Age – the risk rises steadily from the mid-forties onwards, as cartilage naturally becomes less resilient over time.
  2. Joint injury – a previous fracture, ligament tear or surgery can leave a joint more vulnerable, even many years later.
  3. Excess weight – carrying extra weight increases mechanical load on weight-bearing joints such as the knees and hips, and fat tissue can also release chemicals that promote joint inflammation.
  4. Genetics – osteoarthritis can run in families, particularly the form affecting the hands.
  5. Repetitive strain – jobs or sports involving repeated bending, kneeling or heavy lifting place extra stress on certain joints.
  6. Being female – women are more likely than men to develop osteoarthritis, especially after the menopause.
  7. Other joint conditions – existing damage from rheumatoid arthritis, gout or a previous infection in the joint can lead to secondary osteoarthritis.

Which Joints Does Osteoarthritis Affect Most?

  • Knee osteoarthritis is one of the most frequent presentations, causing pain when climbing stairs, kneeling or standing up after sitting. Many people also notice their knee giving way or feeling unstable as supporting muscles weaken.
  • Hip osteoarthritis often causes pain felt in the groin, buttock or thigh rather than the outer hip. Difficulty putting on socks and shoes, or a noticeable limp, are common early clues.
  • Hand osteoarthritis typically affects the base of the thumb and the joints closest to the fingertips, sometimes producing firm bony nodules known as Heberden’s and Bouchard’s nodes.
  • Spinal osteoarthritis can cause neck or lower back stiffness and, less commonly, nerve-related symptoms such as tingling or numbness if bony changes press on nearby nerves.

How Is Osteoarthritis Diagnosed?

For most people, a diagnosis can be reached without extensive testing. A GP will usually rely on a detailed history and a physical examination of the joint before considering further investigation.

The typical diagnostic process involves:

  1. A discussion of your symptoms – when the pain started, what makes it better or worse and how it affects daily life.
  2. A physical examination – checking range of movement, swelling, tenderness and any crepitus in the joint.
  3. Ruling out other causes – blood tests are not used to diagnose osteoarthritis itself, but they can help rule out inflammatory conditions such as rheumatoid arthritis or gout if the presentation is unclear.
  4. Imaging where needed – an ultrasound scan can assess soft tissue changes, joint effusion and inflammation around the joint, and is often used alongside a clinical assessment when the diagnosis needs confirming or when guided treatment is being considered.

Most straightforward cases of osteoarthritis are managed entirely through a GP appointment, without the need for a specialist referral. Referral to rheumatology is generally reserved for atypical presentations, unusually young patients or cases where an inflammatory or autoimmune cause cannot be ruled out on history and examination alone.

Osteoarthritis Treatment Options

There is no cure, but a combination of treatments can reduce pain, protect the joint and help maintain independence. Most treatment plans are built around a few core approaches used together rather than any single fix.

1. Exercise and Physiotherapy

Staying active is one of the most effective osteoarthritis treatments available, even though it can feel counterintuitive when a joint is painful. Strengthening the muscles around an affected joint helps share the load more evenly and can significantly reduce pain over time. A tailored programme through sports injury and physiotherapy services can identify which movements help most and which to modify.

2. Weight Management

Losing even a modest amount of weight can meaningfully reduce the load on the knees and hips. Weight loss of around five to ten percent of body weight is frequently enough to produce a noticeable improvement in knee osteoarthritis symptoms.

3. Pain Relief

Paracetamol, topical anti-inflammatory gels and, where suitable, oral non-steroidal anti-inflammatory drugs are commonly used to manage osteoarthritis pain. These should be discussed with a GP, particularly for anyone with other health conditions or taking additional medication.

4. Ultrasound-Guided Steroid Injections

For a painful flare that has not responded well to exercise and pain relief, an ultrasound-guided steroid injection can deliver targeted anti-inflammatory treatment directly into the joint. Ultrasound guidance allows the needle to be placed precisely, which improves accuracy compared with a landmark-guided injection.

5. Surgery

Joint replacement or other surgical procedures are usually considered only when non-surgical treatment has not controlled symptoms and quality of life is significantly affected. This route is typically explored through an orthopaedic referral once conservative options have been fully tried.

Living With Osteoarthritis: Practical Tips

Alongside formal treatment, small daily adjustments can make a real difference to comfort and confidence.

  • Pace activities across the day rather than doing everything at once
  • Use supportive, well-fitted footwear with good cushioning
  • Try heat for stiffness and cold packs for swelling after activity
  • Consider aids such as a raised toilet seat, jar opener or walking stick if a joint is significantly affected
  • Keep moving even on a bad day, adjusting intensity rather than stopping activity altogether
  • Build regular, low-impact exercise such as swimming or cycling into your week

Osteoarthritis vs Rheumatoid Arthritis, Psoriatic Arthritis and Gout

Several conditions share the word “arthritis,” but they behave very differently and need different treatment. The table below outlines the main distinguishing features.

Feature Osteoarthritis Rheumatoid Arthritis Psoriatic Arthritis Gout
Underlying process Mechanical wear of cartilage Autoimmune Autoimmune, linked to psoriasis Uric acid crystal build-up
Typical onset Gradual, over years Can develop over weeks to months Gradual or sudden Sudden, often overnight
Morning stiffness Usually under 30 minutes Often over an hour Variable Not a typical feature
Commonly affected joints Knees, hips, hands, spine Small joints of hands and feet, often symmetrical Joints and entheses, sometimes one side Big toe, ankle, knee
Referral required Rarely, GP-led in most cases Yes Yes No

When to See a Doctor About Osteoarthritis

Persistent joint pain and stiffness are worth discussing with a GP, particularly if symptoms are affecting your daily activities, sleep or mood. Book a GP appointment if you notice any of the following:

  • Joint pain that lasts more than a few weeks
  • Swelling that does not settle
  • Symptoms that are getting steadily worse despite rest and simple pain relief
  • Difficulty with everyday tasks such as walking, dressing or climbing stairs
  • Joint pain alongside unexplained fatigue, fever or widespread swelling in several joints, which may point to an inflammatory condition rather than osteoarthritis

How Friends Medical Service Can Help

Friends Medical Service supports patients through every stage of an osteoarthritis journey, from an initial GP appointment and clinical assessment through to targeted treatment. Our sports injury and physiotherapy team can build a personalised exercise plan to protect an affected joint, while our ultrasound and guided injection service offers precise, image-guided treatment for joints that need extra support. Where symptoms are atypical or unclear, our rheumatology service provides specialist assessment to confirm the diagnosis and rule out other causes of joint pain.

Frequently Asked Questions

Is osteoarthritis the same as normal wear and tear?

Not quite. While ageing plays a role, osteoarthritis reflects an imbalance between joint damage and the body’s ability to repair it, rather than simple mechanical wear. Many people develop age-related joint changes on a scan without ever experiencing symptoms.

Can osteoarthritis be reversed?

There is currently no way to regrow lost cartilage or reverse existing joint damage. Treatment instead focuses on managing pain, maintaining movement and slowing further deterioration through exercise, weight management and, where needed, medical intervention.

What is the best exercise for osteoarthritis?

Low-impact activities such as swimming, cycling and walking are usually well tolerated, alongside targeted strengthening exercises for the muscles supporting the affected joint. A physiotherapist can tailor a programme to your specific joint and fitness level.

Does osteoarthritis always get worse over time?

Not necessarily. Some people experience long periods where symptoms stay stable or even improve, particularly with consistent exercise and weight management. Others notice a more gradual decline, which is why ongoing management matters.

Can you get a steroid injection for osteoarthritis?

Yes. Ultrasound-guided steroid injections are commonly used for osteoarthritis flares that have not responded to exercise and pain relief, particularly in the knee, hip and shoulder.

Is osteoarthritis hereditary?

Genetics can play a part, particularly for osteoarthritis affecting the hands, though lifestyle and joint history also influence individual risk.

When is surgery needed for osteoarthritis?

Surgery, such as joint replacement, is generally considered only after non-surgical treatments have been tried and symptoms continue to significantly limit daily life.

Further Reading

For further trusted information on osteoarthritis, the following resources from the NHS and Arthritis UK are worth exploring:

Take the Next Step

Joint pain does not have to be something you simply live with. If stiffness, swelling or discomfort are starting to affect your daily routine, an early conversation with a GP can help you get on top of it before it progresses further. Book a GP appointment with Friends Medical Service today and take the first step towards a clear diagnosis and a treatment plan built around your joints and your lifestyle.