What Does Osteoarthritis Look Like — Signs And Symptoms

Anyone can develop osteoarthritis (OA), but it's more common as you age. Women have a higher risk than men of developing OA, particularly after 50¹. Younger people can also develop OA, typically due to trouble with how a joint formed or because of a joint injury.

According to the CDC, osteoarthritis affects more than 32.5 million adults in the United States².

How can you recognize osteoarthritis?

OA is the most common form of arthritis, leading to swelling, pain, and decreased joint motion. You can develop it in any joint, but it typically affects your hips, knees, hands, or spine. OA affects everyone differently. Some people have no problems with their daily activities, while others experience disability and substantial pain from OA.

OA breaks your joint cartilage down. Your cartilage is slippery tissue covering the ends of your joint bones. Healthy cartilage shock absorbs motion, but when you lose cartilage, your bones rub together. This rubbing can permanently damage your joint over time.

Osteoarthritis pain typically develops slowly over months or years, unlike other arthritis types. It often worsens with activities that stress your joints, such as prolonged walking or running.

Joint swelling and pain tend to gradually increase over time. When the condition is more advanced, you may notice a grinding or crunching sensation in the affected joints. Prolonged morning stiffness is rare in OA, unlike inflammatory arthritides such as psoriatic or rheumatoid arthritis. Morning stiffness in OA typically lasts less than 30 minutes if it occurs at all.

OA also doesn't typically cause:

• Weight loss

• Fever

• Extremely red and hot joints

These symptoms appear in other types of arthritis or other conditions.

Genetic causes are a factor in the development of OA. However, it’s important to recognize the interaction between different genetic and environmental factors³, such as:

• Occupation

• Excessive joint stress

• Obesity

OA has primary or secondary classification depending on its cause.

Primary OA, such as nodular osteoarthritis of the hands, is not associated with a preexisting joint abnormality.

Secondary OA is related to another disease or joint disorder, such as hypermobility. Infectious and inflammatory arthritis can lead to secondary OA due to chronic joint destruction. Past joint traumas, including repetitive motions and sports-related injuries, can contribute to OA.

While the precise mechanisms of bone changes and cartilage loss are not totally understood, researchers have made progress recently. It's thought that the body’s inflammatory response to injury slowly wears joint cartilage down. Other changes cause joints to lose function and mobility, resulting in joint pain during activity.

Your doctor can usually diagnose OA by examining your joints and learning about your symptom history. They may take X-rays to ensure there are no other causes of your pain. Generally, magnetic resonance imaging (MRI) isn't necessary. However, if your doctor suspects a cartilage or neighboring ligament tear or there are unusual circumstances, you may need an MRI.

An OA diagnosis doesn't require any blood tests. If you have a particularly swollen joint, your doctor may have to drain the fluid. They can perform tests on the fluid to check for signs of other arthritis types, such as gout.

What are the symptoms of each type of osteoarthritis?

There are several types of OA, and each one presents unique symptoms. Symptoms of each type include:

1. Knee osteoarthritis

Osteoarthritis often affects the knee, and common knee OA symptoms include:

• Trouble bending the knee

• Knee swelling and stiffness

• Increased pain in wet weather or after physical activity

• More swelling or pain after resting or in the morning

• Feeling like the knee is buckling or weak

• Clicking, creaking, snapping, locking, or grinding of the knee

When you have knee OA, you feel pain all over your knee, and it can restrict and affect your mobility.

2. Neck osteoarthritis

Neck OA can lead to pain and stiffness in the neck. Symptoms include:

• Balance impairments

• Pain when holding your neck in the same position for long periods

• Difficulty walking

• Weakness or numbness in your fingers, hands, or arms

• Headaches

• Muscle spasms in your neck and shoulders

• Popping noise or grinding sensation when turning your neck

3. Hip osteoarthritis

Hip osteoarthritis is a painful disease, often affecting people's mobility. People with hip OA experience worsening pain around their hip joint, which usually becomes more severe and frequent as time goes by. The pain may become more intense after rest or during the night.

Symptoms of hip OA include:

• Joint stiffness, or trouble bending and walking

• Pain in your thigh or groin that radiates to your knee or buttocks

• Limping

• Locking, grinding, or sticking of your hip joint

• Pain following physical activity

• Stiffness after standing, resting, or in the morning

• Increased pain in wet weather

• Decreased range of motion

4. Toe osteoarthritis

Stiffness and pain typically develop slowly in your toe joints.

Symptoms of toe OA include:

• Pain that worsens following physical activity

• Pain when moving your toe

• Joint swelling, warmth, tenderness, or redness

• Trouble walking

• Reduced range of motion

Osteoarthritis in your foot, ankle, or toe can impair mobility and make it hard to walk and engage in activities⁴ you once enjoyed. It can even immobilize you in severe cases.

5. Hand osteoarthritis

Your wrists and hands include various small joints that work together to move. When these joints become impaired, it can result in pain and other restrictive symptoms. It can also decrease or limit your hands' mobility⁵.

Symptoms of hand OA include:

• Increased pain after repetitive use over long periods

• Burning or dull hand sensation

• Cysts

• Swelling, stiffness, or enlargement of the joint

• Pain in the morning

• A grinding feeling between your joints

6. Back osteoarthritis

Back osteoarthritis can lead to pain in your lower back⁶ and spine.

Symptoms of back OA include:

• Lower back pain that's worse after periods of inactivity or in the morning

• Back pain that's deep in your muscles

• Limited motion and stiffness in your spine

• Increased pain when standing upright or sitting and decreased pain when you lie down

What is the difference between osteoarthritis and rheumatoid arthritis?

Osteoarthritis and rheumatoid arthritis (RA) are different diseases, but they share some symptoms. OA is a degenerative disease, becoming more severe over time, while RA is an autoimmune disease. Your immune system attacks your body by mistake in autoimmune diseases, and in the case of RA, your immune system attacks your joints.

If you have RA, your immune system considers the joints' soft lining (the synovial fluid and the synovium) a "threat" to the body. This causes the body to attack that specific area, causing fluid build-up in the joints, resulting in pain, stiffness, inflammation, and swelling.

Other differences between OA and RA

When it starts:

RA: Any age.

OA: Typically later in life.

How it develops: 

RA: Relatively fast, over weeks or months.

OA: Gradually over many years.

Risk factors:

RA: 

• Two to three times more common in females

• Can run in families

OA: 

• More common in females over 45 years old and males under 45 years old. 

• Joint deformities

• Excess weight

• Gout

• Diabetes

• Traumatic joint injuries

Symptoms:

RA: Along with swelling and joint pain, you might experience a low-grade fever, fatigue, and muscle aches. RA can affect your whole body, including your lungs and heart. In advanced RA cases, you may develop rheumatoid nodules (hard lumps) under the skin near your joints.

OA: You’ll experience joint pain the most. Excessive bone growths known as bone spurs might develop on the edges of your affected joints. 

Characteristics of RA

Rheumatoid arthritis is a systemic condition, and it doesn't just affect your joints, but it can impact your whole body (heart, lungs, eyes, etc.).

RA can include:

• Excessive fatigue

• Low-grade fever, particularly in children

• Muscle aches

Individuals with advanced RA may notice rheumatoid nodules, which can be tender.

Characteristics of OA

Individuals with OA are unlikely to have systemic symptoms. OA's degenerative nature is limited exclusively to the joints.

You may develop lumps around the joints underneath your skin, but these lumps aren't the same as rheumatoid nodules. People with OA frequently develop bone spurs on their affected joints.

Joints affected in RA

Rheumatoid arthritis starts in your smaller joints, and you may experience stiffness, pain, and swelling in your finger joints. With the progression of RA, symptoms may develop in your larger joints like your shoulders, knees, and ankles.

Because rheumatoid arthritis is a symmetrical condition, the symptoms can occur simultaneously on both sides of your body.

Joints affected in OA

Osteoarthritis is less symmetrical. Because of this, you may experience pain in both your right and left knee, for instance, but one joint or one side is worse.

Like rheumatoid arthritis, osteoarthritis is common in the fingers and hands, and OA often affects the hips, spine, and knees.

Can you develop both OA and RA?

You can develop both conditions. While OA tends to develop after years of cartilage wear and tear, individuals with RA may develop it earlier in life. Sports injuries and other joint trauma can lead to cartilage, ligament, or joint damage.

Individuals with RA can also develop OA⁷. Older individuals diagnosed with OA may develop elderly-onset RA (EORA). EORA affects the large joints more often, unlike RA.

Which causes more pain?

The pain of arthritis can vary in intensity. Those with RA and OA may experience mild to severe pain and trouble moving the affected joints.

The lowdown

Because OA is a degenerative condition, it worsens over time and can lead to chronic pain. Stiffness and pain in the joints can become so severe that day-to-day tasks can be challenging. Sleep disturbances and depression can result from the disability and pain of OA. Your coping ability can often determine how much OA affects your life; not all people who have OA can cope with their symptoms well.

You should talk with your doctor about your symptoms and how it’s affecting your mental health. In addition to OA treatment, they can also provide you with coping strategies or refer you to a specialist who can help.