Pathophysiology of Osteoarthritis: Symptoms, Diagnosis, and Treatment

Fact checked by Olga Sadouskaya, MD
Clinical Pharmacologist, Chief Medical Officer

If you regularly experience stiffness, pain, or inflammation in your joints, the most likely cause is osteoarthritis.

The good news is that there are treatments available that can help relieve the symptoms of osteoarthritis and improve your quality of life. In this article, we’ll take a look at the pathophysiology of osteoarthritis, its symptoms, different stages of osteoarthritis of the hip, and treatment options.

Symptoms of osteoarthritis

Osteoarthritis is one of the most common kinds of arthritis and affects millions of people worldwide. It occurs when the cartilage that covers the end points of each joint starts to wear off, reducing lubrication in the joints and causing pain and stiffness. The most commonly affected areas of the body include the hands, spine, hips, and knees.

It usually starts slowly and worsens over time. Some of the more common symptoms include:

  • Stiffness in the morning. This usually lasts less than an hour but often comes back at the end of the day.
  • Pain in the joints. This is usually a sharp or burning sensation that worsens with prolonged activity. The joints do not usually swell, unlike rheumatoid arthritis, which involves painful swelling of the joints.
  • Tenderness in the joints when slight pressure is applied to the affected joint.
  • Loss of flexibility in the affected region. The patient might not be able to move as freely as they used to.
  • Popping or cracking sounds that emanate from the affected joint. Furthermore, there might be a grating sensation in the joint whenever the joint is used.

Stages of osteoarthritis of the hip

The joint in the hip is a ball-and-socket synovial joint. A ring of cartilage provides shock absorption and stability in the joint. Several ligaments are attached to the joint along with muscles that move them and provide more stability.

Hip osteoarthritis is a normal aging process in the hip joint that occurs when the cartilage that acts as a shock absorber starts to wear out, causing the bones to clash and grate against each other.

People doing physiotherapy as treatment for osteoarthritis

Studying osteoarthritis hip X-rays, it has been found that 1 in 10 people over the age of 65 has osteoarthritis of the hip; however, only half report any symptoms.

Let’s take a look at the different stages of osteoarthritis of the hip.

  • Stage 1: This is the stage when joints have only experienced minor deterioration. In this stage, patients often feel little to no pain at all.
  • Stage 2: This stage is also known as mild hip osteoarthritis. In this stage, the cartilage starts breaking down. Bone spur growth becomes more visible on X-ray scans, and patients often feel stiffness, pain, and other discomfort.
  • Stage 3: Also known as moderate hip osteoarthritis, this is the stage when the cartilage begins to wear off. The bones become more exposed, and simple activities like walking, jogging, and squatting become more painful.
  • Stage 4: This is the severe stage when the bone cartilage has almost wholly disappeared. Chronic inflammation sets in, and pain is continually felt in the joints.

You should visit an osteoarthritis doctor for treatment if you notice any of these symptoms. By engaging in simple hip osteoarthritis exercises, you can often manage your symptoms.

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Who’s at risk of early-onset osteoarthritis?

Osteoarthritis is a disease that advances with age; early-onset osteoarthritis describes arthritis that appears in adults under 50. Certain risk factors can contribute to the development of early-onset osteoarthritis:

  • Genetics: The disease can also be hereditary and passed from one generation to the next through your genes.
  • Weight gain: Weight gain is another factor that can contribute to the fast development of osteoarthritis. The more overweight an individual gets, the more load is placed on load-bearing joints, such as the hips and knees. Fat in the body also increases the chances of inflammation in the affected joint.
  • Serious injuries: Injuries can also make someone more susceptible to osteoarthritis. Even years after it might have healed, a previous injury can still increase the chances of developing osteoarthritis.
  • Sex: Osteoarthritis is more common in women; however, the reason for this is not known.
  • Bone deformities: Individuals with congenital joints and musculoskeletal abnormalities are more likely to wear out their cartilage sooner than others.
  • Joint overuse and muscle weakness: Repetitive use of the same joints increases your risk of osteoarthritis.
  • Being an athlete: While athletes do not often develop the disease, it is not uncommon in the world of sports. Because osteoarthritis is a disease that worsens with age, the condition is most likely to kick in in their later years because they have overworked their joints and put stress on them.

How is osteoarthritis diagnosed?

The disease can be diagnosed from the patient’s symptom history. Patients who are diagnosed with the disease usually complain about stiffness and pain in the knees. The pain is generally located around the joint line, the gap between the top and bottom of the knees.

Osteoarthritis can also be easily diagnosed using an X-ray.

This often shows the narrowing of the joints, making it easy to detect if the bones in the joints are grating against each other or if the cartilage is thinning out.

Patients can also be diagnosed using magnetic resonance imagery (MRI), a more detailed version of an X-ray. An MRI can show degeneration and wearing of the cartilage. In some cases, it can show lost pieces of cartilage.

Treatment for osteoarthritis

Treatment for osteoarthritis is centered on symptom management. The best kind of treatment will depend on the severity of the symptoms and location of the disease.

Often, lifestyle changes, over-the-counter medication, and home remedies are enough to help patients with joint stiffness, pain, and swelling.

At-home treatments for osteoarthritis patients include:

  • Adequate sleep
  • Regular exercise
  • Weight management
  • Heat and cold therapy for the joints

Patients can also take over-the-counter medication like oral painkillers, topical painkillers, nonsteroidal anti-inflammatory drugs, etc.

Is a knee brace effective for osteoarthritis?

Using a knee brace for osteoarthritis may have different results for various individuals with the condition.

For most patients, using a knee brace can help reduce pain and improve movement by shifting the weight away from the affected part of the knee.

This can help patients move around more freely. The most commonly used type of knee brace is an unloader knee brace. It is designed to help patients shift their weight from one part of the knee to another.

Exercises for hip osteoarthritis

Daily exercise is an effective way to manage osteoarthritis. This is because physical activity helps to strengthen the muscles around the joints and relieve stiffness. Set a target for at least 20 to 30 minutes of physical activity every other day. Engage in gentle, low-impact activities like swimming or walking.

A woman doing yoga exercises to prevent hip osteoarthritis

Other great exercises that can help with hip osteoarthritis include the following:

  • Yoga and tai chi can improve joint flexibility and balance and can help with pain.
  • Gentle stretching exercises help with stiffness and improve joint mobility and range of motion.
  • Water exercises help strengthen the muscles while being easy on the joints.
  • Rest might not be considered exercise for some; however, it is essential for osteoarthritis patients. It helps prevent inflammation in the joints and helps individuals manage pain more effectively.

Before drawing up an exercise plan, patients should check in with their osteoarthritis doctor to ensure it’s done correctly.

When to see a doctor

Patients should visit a doctor the moment they notice symptoms. Early detection often means the best prognosis for osteoarthritis.

Osteoarthritis doctors understand the ins and outs of osteoarthritis pathophysiology and can help diagnose the condition, prescribe medication as needed, and recommend the right exercises.

Patients should consider seeing a doctor when they notice any of the following symptoms:

  • Locks and buckles in the joints
  • Cracking and popping sounds
  • Grinding in the joints
  • Bony spurs or bumps in the joints

Furthermore, patients should immediately see a doctor if the pain worsens to the point that it’s difficult to perform everyday tasks. Also, if medications and home remedies are no longer effective, patients should not hesitate to see a doctor.

Bottom line

Osteoarthritis is a progressive disease that worsens with time, so it’s most commonly found in older people. Early diagnosis and treatment can often help to prevent or delay the progression of the disease. In addition, engaging in preventive practices such as maintaining a healthy weight and exercising regularly can help to reduce the risk of developing osteoarthritis.

March 10, 2023