The joints most commonly affected by osteoarthritis (OA) are the neck, hips, knees, back and small joints of the fingers. Initially osteoarthritis may be associated with an inflammatory process and the onset is seen with mild swelling and stiffness in the hands and affected joints. It’s usually subtle and gradual.
Pain is the main symptom in OA. It starts gradually and is often described as a deep ache, made worse by exercise and using the joint.
Stiffness of the joints usually doesn’t last long. Usually it’s less than 30 minutes in the morning and may recur after periods of sitting or inactivity. It usually improves with exercise.
Swelling around the affected joints due to inflammation is a common symptom of osteoarthritis.
As the disease progresses, the motion of the joints becomes restricted and the person may notice tenderness and grinding noises in the joint. Pain can be experienced even when the person is inactive or resting.The joint eventually becomes enlarged as a result of bony outgrowth. This enlargement is irreversible.
If the ligaments become lax, for example around the knee, the joint becomes increasingly unstable with more pain. Tenderness to the touch and pain when the doctor moves the joint are both signs of advanced disease. At this stage muscle spasm and contraction of the muscles around the joints add to the pain.
Osteoarthritis of the hip is characterised by increasing stiffness and loss of range of motion. You may experience difficulty in climbing stairs or tying your shoelaces. This is in contrast to osteoarthritis of the knee in which the ligaments tend to become lax.
Reviewed by Dr Stella Botha, rheumatologist at Groote Schuur Hospital, Cape Town (MBChB, MRCP, PhD), November 2017.