Osteoarthritis is the most common form of chronic joint disease. It is characterized by the progressive wear and tear of cartilage, the protective tissue that covers the ends of bones within a joint. This degradation leads to pain, stiffness, and reduced mobility. Contrary to popular belief, osteoarthritis is not simply an inevitable consequence of aging, but a complex pathology involving mechanical and biological factors. It can affect all joints, although the most frequently affected are the knees, hips, hands, and spine.
What Are the Causes and Risk Factors of Osteoarthritis?
The development of osteoarthritis results from a combination of several factors that accelerate cartilage deterioration. A single cause cannot be identified; rather, it is a set of contributing conditions.
Among the main risk factors are:
- Age: The risk of osteoarthritis increases with age, as the cartilage’s ability to regenerate decreases.
- Overweight and Obesity: Excess weight increases mechanical pressure on weight-bearing joints like the knees and hips, thereby accelerating their wear.
- History of Injuries: A fracture, severe sprain, or joint trauma can weaken cartilage and predispose to osteoarthritis, even years later.
- Genetics: A family predisposition exists, particularly for hand osteoarthritis. Some people inherit lower quality cartilage.
- Occupational or Sports Activities: Repetitive movements or heavy lifting can overstress certain joints and promote wear.
- Certain Diseases: Metabolic disorders or other inflammatory rheumatisms (such as rheumatoid arthritis) can damage cartilage and cause secondary osteoarthritis.
Symptoms and Signs to Recognize
Osteoarthritis symptoms generally develop progressively and can vary from person to person. Pain is the main sign. It is typically “mechanical,” meaning it appears or worsens when the joint is used and subsides at rest.
Other common manifestations include:
- Joint Stiffness: Particularly present in the morning upon waking or after a period of inactivity. This “gelling” sensation usually lasts less than 30 minutes.
- Loss of Mobility: The joint may become less flexible, making certain movements difficult to perform.
- Cracking or Grinding Sounds: Noises may be heard when the affected joint moves.
- Joint Swelling: Sometimes, local inflammation can cause an effusion of synovial fluid, leading to joint swelling.
- Bone Deformities: In an advanced stage, small bony growths, called osteophytes (or “bone spurs”), can form and deform the joint.
How Is the Diagnosis Established?
The diagnosis of osteoarthritis primarily relies on a clinical examination and patient history. The doctor assesses the described symptoms, their onset, and looks for risk factors. Physical examination allows evaluating joint mobility, presence of pain on palpation, or swelling.
To confirm the diagnosis and assess the stage of the disease, the doctor generally prescribes a standard X-ray of the affected joint. This examination helps visualize the characteristic signs of osteoarthritis:
- Narrowing of the joint space, which indicates a reduction in cartilage thickness.
- Presence of osteophytes.
- Increased density of the bone located just beneath the cartilage.
In most cases, a blood test is not necessary to diagnose osteoarthritis, but it can be useful to rule out other joint diseases, such as inflammatory rheumatisms.
Treatments and Management of Osteoarthritis
There is no cure for osteoarthritis that restores worn cartilage. However, appropriate management can effectively relieve pain, improve joint function, and slow the disease’s progression. The therapeutic strategy combines several approaches.
Non-Drug Measures
These are the foundation of treatment. Weight loss in overweight individuals is essential to relieve weight-bearing joints. Adapted physical activity, such as swimming, cycling, or walking, strengthens muscles that support the joint without creating painful impacts. Physiotherapy also plays a crucial role in maintaining mobility and muscle strength. Technical aids (cane, orthoses) may sometimes be offered.
Medication Treatments
To manage painful flare-ups, the doctor may prescribe analgesics (paracetamol/acetaminophen in the first instance) or non-steroidal anti-inflammatory drugs (NSAIDs) for local application (gel, cream) or orally for short periods.
Intra-articular corticosteroid injections may be proposed to calm significant inflammation. Hyaluronic acid injections (viscosupplementation) can also help lubricate the joint and relieve pain, especially in knee osteoarthritis.
Surgery
When osteoarthritis is very advanced, when pain becomes debilitating, and when other treatments are ineffective, joint replacement surgery may be considered. This procedure, most common for the hip and knee, aims to replace the damaged joint with an artificial joint to restore mobility and eliminate pain.
Recent Scientific Advances in Osteoarthritis
Research on osteoarthritis is very active. Publications from late 2024 and early 2025 highlight several promising avenues.
A genomic study of unprecedented scale, published in early 2025, identified over 500 new genetic associations linked to osteoarthritis. This major breakthrough provides a better understanding of the disease’s biological mechanisms. Most importantly, it revealed hundreds of new potential targets for future medications. Researchers have already identified that nearly 10% of these targets could be reached by existing drugs, paving the way for repurposing molecules to treat osteoarthritis.
Furthermore, research is exploring new approaches to pain relief. A 2024 Canadian study showed that visual exposure to low-intensity green light could reduce osteoarthritis pain by increasing the body’s natural analgesic molecules. While preliminary, this non-pharmacological approach offers a new direction for chronic pain management.
Prevention: Is It Possible to Reduce the Risk?
It is possible to act on certain risk factors to prevent the onset of osteoarthritis or slow its progression. Prevention is based on common-sense measures to adopt throughout life.
Maintaining a healthy weight is the most effective preventive measure, especially for knee and hip osteoarthritis. Regular and moderate physical activity is also fundamental. Movement stimulates cartilage nutrition and strengthens the protective muscles around the joints. It is important to favor sports without violent impacts.
Finally, it is advisable to protect your joints daily and at work by avoiding excessive repetitive movements, carrying overly heavy loads, and adopting good postures.
Living with Osteoarthritis
Living with osteoarthritis requires some adaptation. It is important to learn to listen to your body and manage your effort. Alternating periods of activity and rest is essential to avoid overloading painful joints.
A healthy and balanced diet, rich in fruits, vegetables, and omega-3s (fatty fish), can help control weight and reduce general inflammation. It is also advisable to equip yourself with comfortable shoes that absorb shock.
Do not hesitate to use technical aids (cane, etc.) which can greatly improve quality of life by securing walking and relieving the joint. Active involvement in one’s own care, in dialogue with one’s doctor and physical therapist, is key to remaining mobile and independent for as long as possible.
Frequently Asked Questions About Osteoarthritis
Is osteoarthritis an elderly person’s disease?
No, although the risk increases with age, osteoarthritis can occur in younger adults, often as a result of an injury, due to a genetic predisposition, or overweight.
Should one stop moving when one has osteoarthritis?
On the contrary. Inactivity can worsen stiffness and weaken muscles. Gentle and adapted physical activity is strongly recommended to maintain flexibility and strength around the joint.
Do humidity and cold really worsen osteoarthritis?
Many people report an increase in their pain in cold and humid weather. While the mechanism is not perfectly understood, changes in atmospheric pressure might play a role in joint sensitivity.
Can a diet cure osteoarthritis?
No diet can cure osteoarthritis. However, a balanced diet helps maintain a healthy weight, which is crucial. Certain foods with anti-inflammatory properties can also help reduce the intensity of symptoms.
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