Osteoarthritis: How Joint Pain and Osteoarthritis Can Develop, and Which Treatments Help

In addition to the term “osteoarthritis,” the term “arthritis” is also frequently used. Both are joint disorders with similar symptoms (joint pain).

Osteoarthritis is joint degeneration caused by worn-out cartilage and other joint structures. Arthritis, on the other hand, is inflammation of the joint.

This inflammation can have various causes, such as:

• An infection, caused for example by bacteria or fungi
• An autoimmune cause, such as in rheumatism

In principle, all joints can wear out. 

Years of excessive or improper stress on joint structures can cause osteoarthritis.

The following causes are possible:

• Years of being overweight
• Old injuries
• Misalignments, such as bowlegs or knock-knees, or hip dysplasia
• Medications that break down cartilage
• Prolonged, intense physical strain, or
• Genetic predisposition

This is why osteoarthritis most often occurs in older adults. Younger people are rarely affected.

The video shows how osteoarthritis of the hip joint develops:

In principle, all joints can wear out. 

The following are particularly commonly affected:

• Hip joint (coxarthrosis)
• Knee joint (gonarthrosis) or
• Joints in the hand

Osteoarthritis can develop in any joint. However, the hip and knee are most commonly affected © Henrie | AdobeStock

At the onset of the disease, the patient often has no symptoms. Only over time do the joint pains typical of osteoarthritis develop. Initially, they occur only during physical activity, then also during movement, and finally even at rest (rest pain).

Pain may occur at the start of a movement. It then subsides after a few moments (or meters) (start-up pain). The pain may also increase in intensity with age.

Some patients experience limited joint mobility. Morning stiffness is common, with the joints hurting particularly in the morning after getting out of bed. However, the pain usually does not last longer than 30 minutes. Cartilage wear and tear causes irritation of the joint. Fluid accumulates, and the affected joints swell. Symptoms may worsen in cold or wet weather.

In cases of gonarthrosis (knee osteoarthritis), limited mobility accompanies the pain. This, in turn, contributes to muscle atrophy. 

Patients with hip osteoarthritis typically exhibit what is known as a “weight-bearing limp.” In this gait, they place weight on the affected joint for a shorter duration than on the healthy one. The damaged hip joint also tends to rotate outward.

Diagnosis of osteoarthritis

Based on the symptoms and the patient’s medical history, the doctor will relatively quickly consider the possibility of osteoarthritis. An X-ray usually allows for the reliable identification of typical osteoarthritic changes. 

These include:

• Narrowing of the joint space
• Altered joint surfaces and bone structure
• Osteophytes and
• Joint deformity

In some cases, additional imaging procedures (ultrasound, scintigraphy, MRI) may be performed. This allows for a better assessment of complications and the extent of the damage.

Treatment of Osteoarthritis

Osteoarthritis is currently incurable. Therefore, the goal of treatment is to restore joint mobility and relieve pain. In addition to conservative and pharmacological treatments, surgical procedures are also available for this purpose.

Medication for osteoarthritis consists of pain-relieving and anti-inflammatory drugs. In addition, doctors can inject substances directly into the joint to improve its mobility. To relieve pressure on painful joints, people who are overweight should first lose weight.

As part of conservative osteoarthritis treatment, low-impact exercise helps slow the progression of the disease. 

Other components of conservative osteoarthritis treatment include:

• Physical therapy
• Assistive devices to relieve pressure
• Exercise training
• physical therapy (e.g., electrotherapy, massage, heat or cold treatments) and
• occupational therapy

In cases of advanced joint wear, conservative and medication-based osteoarthritis treatments are often no longer sufficient. In such cases, surgical treatment for osteoarthritis may be necessary.

Using arthroscopic procedures, doctors can remove problematic cartilage and tissue debris and smooth the cartilage. For some time now, doctors have been attempting to rebuild cartilage through cartilage transplants. If the joint cannot be saved, an artificial joint replacement (endoprosthesis) is necessary. This leads to pain relief and restored mobility, particularly in older patients.