Knee Osteoarthritis: Symptoms, Causes & Treatment Guide

What Is Knee Osteoarthritis?

Knee osteoarthritis is a degenerative joint disease where the cartilage that cushions the knee joint gradually breaks down, leading to pain, stiffness, and reduced mobility. It is the most common form of arthritis, affecting approximately 10-15% of adults over 60, and is a leading cause of disability worldwide.

Osteoarthritis, sometimes called "wear and tear" arthritis, is actually a complex condition involving the entire joint structure. While cartilage breakdown is the hallmark feature, the disease also affects the underlying bone, the synovial membrane (joint lining), ligaments, and surrounding muscles. This understanding has transformed how we approach treatment, moving from simply managing symptoms to actively working to preserve joint function.

The knee is the most commonly affected large joint because it bears significant weight and experiences repetitive stress throughout life. The knee joint is where the thigh bone (femur) meets the shin bone (tibia), with a smooth layer of cartilage covering the bone surfaces. This cartilage normally provides a nearly frictionless surface for movement and absorbs shock during activities like walking and climbing stairs.

In knee osteoarthritis, this cartilage gradually becomes roughened and develops grooves and pits. As the cartilage wears away, bone may be exposed, leading to bone-on-bone contact that causes pain. The body attempts to repair this damage by forming bone spurs (osteophytes) and sometimes producing excess joint fluid, which causes swelling. The joint capsule may also become inflamed, contributing to pain and stiffness.

Importantly, the degree of cartilage damage seen on imaging does not always correlate with symptoms. Some people with significant X-ray changes experience minimal discomfort, while others with mild radiographic findings have severe pain. This suggests that factors beyond structural damage – including inflammation, muscle strength, psychological factors, and central pain sensitization – play important roles in the symptom experience.

How Common Is Knee Osteoarthritis?

Knee osteoarthritis is remarkably common and its prevalence is increasing globally. Approximately 250 million people worldwide are affected by knee osteoarthritis, making it one of the leading causes of disability. In the United States alone, over 32 million adults have some form of osteoarthritis, with the knee being the most frequently affected joint.

The prevalence increases dramatically with age: while only about 5% of people under 40 have radiographic evidence of knee osteoarthritis, this rises to over 50% in those over 65. However, it's important to note that not everyone with X-ray changes experiences symptoms – only about half of those with radiographic osteoarthritis report knee pain.

Medical Classification

Knee osteoarthritis is classified using the ICD-10 code M17 (Gonarthrosis). More specific codes include M17.0 for primary bilateral gonarthrosis, M17.1 for other primary gonarthrosis, and M17.2-M17.5 for secondary forms. The SNOMED CT code is 239873007 (Osteoarthritis of knee), and the MeSH identifier is D020370.

What Causes Knee Osteoarthritis?

Knee osteoarthritis develops from a combination of factors including age over 45, previous knee injuries (ACL tears, meniscus damage, fractures), obesity, genetic predisposition, female sex, and occupational factors involving repetitive knee loading. The condition typically develops gradually over many years.

While we often think of osteoarthritis as simply a consequence of aging, the reality is more nuanced. Age is indeed a major risk factor, but it's not inevitable – many older adults maintain healthy knee joints throughout their lives. Rather than age itself, the accumulated exposure to risk factors over time determines who develops the condition.

The development of knee osteoarthritis involves a complex interplay between mechanical factors, biological processes, and genetic susceptibility. Understanding these factors is important because many are modifiable, offering opportunities for prevention and slowing progression.

Previous Knee Injuries

Prior knee injuries are among the strongest risk factors for developing osteoarthritis, often leading to what is called "post-traumatic osteoarthritis." Injuries that disrupt the normal mechanics of the knee joint create abnormal stress patterns that accelerate cartilage breakdown.

ACL (anterior cruciate ligament) tears significantly increase osteoarthritis risk, even when surgically repaired. Studies show that 50-70% of people who tear their ACL develop knee osteoarthritis within 10-20 years. This occurs partly because the initial injury damages cartilage directly and partly because altered joint mechanics after the injury create ongoing stress.

Meniscus injuries are particularly damaging because the menisci serve as crucial shock absorbers. Meniscus tears can directly damage cartilage and, when part of the meniscus is removed surgically, the remaining cartilage experiences significantly higher stress. Research suggests that even partial meniscectomy substantially increases long-term osteoarthritis risk.

Fractures involving the joint surface can damage cartilage directly and may lead to malalignment that causes uneven wear. Even well-healed fractures near the knee joint can alter biomechanics enough to promote osteoarthritis development.

Obesity and Body Weight

Excess body weight is one of the most important modifiable risk factors for knee osteoarthritis. The relationship between weight and knee stress is multiplicative rather than additive: during walking, the knee experiences forces of 2-4 times body weight, and during stair climbing or running, forces can reach 4-8 times body weight.

This means that every additional kilogram of body weight adds 4 kilograms of stress to the knee during walking. Conversely, weight loss provides proportional relief – losing 5 kg reduces knee force by 20 kg during walking. Clinical studies consistently show that even modest weight loss of 5-10% of body weight can significantly reduce pain and improve function in people with knee osteoarthritis.

Beyond mechanical stress, obesity contributes to osteoarthritis through metabolic and inflammatory pathways. Adipose tissue produces inflammatory chemicals (adipokines) that can directly damage cartilage and promote the inflammatory component of osteoarthritis. This explains why obesity is also a risk factor for hand osteoarthritis, where weight-bearing isn't relevant.

Age and Time Exposure

Age is strongly associated with knee osteoarthritis, with prevalence increasing substantially after age 45 and continuing to rise with advancing years. However, age itself doesn't cause osteoarthritis – rather, it represents accumulated exposure time to various risk factors and gradual decline in the body's repair mechanisms.

With age, cartilage becomes less resilient and more susceptible to damage. The cells responsible for maintaining cartilage (chondrocytes) become less active and produce lower-quality matrix components. Additionally, the balance between cartilage breakdown and repair tilts toward breakdown, making it harder to recover from damage.

Sex and Hormonal Factors

Women have a higher risk of knee osteoarthritis than men, particularly after age 50. Before menopause, rates are similar between sexes, but post-menopausal women have approximately twice the risk of men. This pattern suggests that estrogen plays a protective role in cartilage health.

Anatomical differences may also contribute. Women generally have wider hips relative to their knees, creating a larger "Q-angle" that can increase stress on the knee joint. Women also tend to have weaker quadriceps muscles relative to body weight, which may provide less joint protection.

Genetic Factors

Genetic predisposition accounts for an estimated 40-60% of osteoarthritis risk. If you have a close relative with osteoarthritis, your risk is significantly elevated. Specific genes involved include those affecting cartilage structure, inflammatory responses, and bone metabolism.

However, having a genetic predisposition doesn't mean osteoarthritis is inevitable. Genes interact with environmental and behavioral factors, meaning that healthy lifestyle choices can help offset genetic risk.

Occupational and Activity Factors

Occupations involving repetitive knee bending, squatting, kneeling, or heavy lifting increase knee osteoarthritis risk. Jobs commonly associated with higher rates include farming, construction, carpet laying, and professional sports. The risk is related to cumulative lifetime exposure, with longer work histories in these occupations carrying greater risk.

Interestingly, recreational exercise appears to have different effects than occupational loading. Moderate exercise, including running, does not increase osteoarthritis risk in people with healthy joints and may actually be protective by strengthening muscles and maintaining cartilage health. However, high-level competitive sports, particularly those involving pivoting, jumping, or contact, do increase risk.

Muscle Weakness

Weak muscles around the knee, particularly the quadriceps, are both a cause and consequence of knee osteoarthritis. Strong muscles absorb shock and stabilize the joint, reducing stress on cartilage and other structures. When muscles are weak, more force is transmitted directly through the joint.

This creates a problematic cycle: pain leads to reduced activity, which causes muscle weakness, which increases joint stress, which worsens symptoms. Breaking this cycle through exercise is one of the most effective strategies for managing knee osteoarthritis.

What Are the Symptoms of Knee Osteoarthritis?

The main symptoms of knee osteoarthritis include pain during or after activity, joint stiffness (especially in the morning or after sitting), swelling around the knee, a grinding or crackling sensation (crepitus) during movement, reduced range of motion, and "start-up pain" when beginning to move after rest.

Knee osteoarthritis symptoms typically develop gradually over months to years rather than appearing suddenly. Most people first notice mild discomfort that seems to come and go, often attributed to "overdoing it" during certain activities. Over time, symptoms may become more persistent and begin to affect daily activities.

The symptom experience varies considerably between individuals. Some people maintain relatively mild symptoms for years, while others experience rapid progression. Understanding the typical pattern of symptoms helps in recognizing the condition and seeking appropriate care.

Pain Patterns

Pain is the most common and troublesome symptom of knee osteoarthritis. The pain typically has several characteristic features:

Activity-related pain is the hallmark of early-to-moderate osteoarthritis. Pain is usually worst during or shortly after activities that stress the knee, such as walking (especially on uneven ground), climbing stairs, getting up from chairs, or squatting. The pain often improves with rest.

Start-up pain or "gelling" is a characteristic phenomenon where the knee feels stiff and painful when you first begin moving after a period of rest. This might occur when getting out of bed in the morning or standing up after sitting for a while. Unlike inflammatory arthritis, the stiffness typically resolves within 20-30 minutes of movement.

Nighttime and rest pain may develop as the condition progresses. When pain occurs at rest or disturbs sleep, it often indicates more advanced disease. This type of pain can significantly impact quality of life and is an important factor in considering treatment options.

Weather-related symptoms are commonly reported, with many people noticing increased pain before weather changes, particularly before rain or when barometric pressure drops. While the mechanism isn't fully understood, this is a genuine phenomenon experienced by many people with joint conditions.

Stiffness and Reduced Motion

Joint stiffness is another cardinal symptom, often accompanying pain. Morning stiffness lasting less than 30 minutes is typical of osteoarthritis, distinguishing it from inflammatory conditions like rheumatoid arthritis where morning stiffness may last for hours.

Over time, the knee may lose range of motion, making it difficult to fully straighten or bend the joint. This can affect activities like climbing stairs, getting in and out of cars, or sitting comfortably with bent knees. Loss of full extension (straightening) is particularly problematic as it affects walking efficiency.

Swelling and Physical Changes

The knee may become swollen, particularly after activity. This swelling occurs when the joint produces excess fluid (effusion) in response to irritation. Sometimes the swelling is obvious and the knee looks visibly larger; other times it may be subtle and felt more as a sense of fullness or tightness.

The joint may feel warm to the touch during flares, indicating inflammation of the joint lining (synovitis). While warmth is more characteristic of inflammatory arthritis, it can occur in osteoarthritis, particularly when the condition is active.

Crepitus – a grinding, crackling, or creaking sensation during movement – is common in knee osteoarthritis. This occurs as roughened joint surfaces move against each other. While concerning to many patients, crepitus alone without pain or other symptoms is not necessarily problematic.

Joint Instability and Deformity

As knee osteoarthritis progresses, some people experience a sense that the knee might "give way" or feel unstable. This can occur when muscles weaken or when joint surfaces become uneven.

Visible deformity may develop in advanced cases. If the inside of the knee (medial compartment) is more affected, the leg may bow outward (varus deformity or "bow-legged"). If the outside (lateral compartment) is more affected, the leg may angle inward (valgus deformity or "knock-kneed"). These changes alter weight distribution and can accelerate further joint damage.

When Should You See a Doctor for Knee Pain?

Seek medical evaluation if you have persistent knee pain lasting more than a few weeks, especially if accompanied by swelling, stiffness that doesn't improve with movement, or difficulty with daily activities like walking or climbing stairs. Seek immediate care for sudden severe pain, inability to bear weight, or signs of infection (redness, warmth, fever).

Many people with knee pain delay seeking medical attention, either hoping it will resolve on its own or accepting it as an inevitable part of aging. While mild, occasional knee discomfort may indeed be self-limiting, persistent symptoms warrant evaluation to establish a diagnosis and begin appropriate management before the condition progresses.

Early intervention in knee osteoarthritis is valuable because treatments like exercise and weight loss are more effective when started earlier. Additionally, proper diagnosis helps rule out other conditions that might require different treatment approaches.

Signs That Warrant Medical Evaluation

• Persistent pain: Knee pain that doesn't improve within 2-3 weeks of self-care measures
• Pain affecting activities: Difficulty walking, climbing stairs, or performing usual activities due to knee pain
• Morning stiffness: Stiffness in the knee that occurs regularly, especially if lasting more than 30 minutes
• Swelling: Visible or palpable swelling around the knee joint
• Mechanical symptoms: Locking, catching, or a sense that the knee gives way
• Reduced motion: Difficulty fully straightening or bending the knee

How Is Knee Osteoarthritis Diagnosed?

Knee osteoarthritis is typically diagnosed through a combination of medical history, physical examination, and sometimes imaging studies. A doctor or physical therapist can often diagnose the condition clinically based on symptoms and examination findings. X-rays can confirm the diagnosis but are not always necessary, as early osteoarthritis may not show on imaging.

The diagnosis of knee osteoarthritis usually begins with a thorough discussion of your symptoms, their pattern, duration, and impact on daily activities. Your healthcare provider will ask about risk factors including previous injuries, family history, occupation, and activity level. This history often provides important clues about the likely diagnosis.

Physical Examination

The physical examination is a crucial part of the diagnostic process. Your doctor or physical therapist will assess:

Gait and alignment: How you walk can reveal compensation patterns and suggest which part of the knee is most affected. The alignment of your legs (whether bow-legged or knock-kneed) influences the distribution of stress across the joint.

Range of motion: Both how far the knee bends and straightens, and whether movement is smooth or catches. Loss of full extension (straightening) is particularly significant.

Swelling: The knee is examined for effusion (excess fluid) and other signs of swelling.

Tenderness: Specific areas of tenderness can help localize the problem. In knee osteoarthritis, tenderness is typically felt along the joint line.

Crepitus: The examiner may place a hand on the knee while you bend and straighten it to feel for grinding or crackling sensations.

Stability: Ligament stability is tested to assess whether other conditions might be contributing to symptoms.

Muscle strength: Quadriceps and hamstring strength is assessed, as weakness is both a contributor to and consequence of knee osteoarthritis.

Imaging Studies

X-rays are the most commonly used imaging study for suspected knee osteoarthritis. Standing (weight-bearing) X-rays are preferred as they show the joint under functional load. Classic X-ray findings include:

• Joint space narrowing (indicating cartilage loss)
• Bone spurs (osteophytes) at the joint margins
• Subchondral sclerosis (increased bone density beneath the cartilage)
• Subchondral cysts (fluid-filled areas in the bone)

However, it's important to understand that X-ray findings don't always correlate with symptoms. Many people with significant X-ray changes have minimal pain, while others with mild changes on X-ray have severe symptoms. For this reason, X-rays are used to confirm a clinical diagnosis rather than to determine the severity of symptoms.

MRI (magnetic resonance imaging) provides detailed images of soft tissues including cartilage, menisci, and ligaments. MRI can detect early cartilage damage not visible on X-ray and can identify other problems that might be contributing to knee symptoms. However, MRI is not routinely needed for diagnosing osteoarthritis and is typically reserved for cases where the diagnosis is uncertain or surgery is being considered.

Laboratory Tests

Blood tests are not needed to diagnose knee osteoarthritis, as it does not cause abnormalities in routine blood work. However, blood tests may be ordered if other conditions, such as inflammatory arthritis or gout, are being considered.

If the knee is significantly swollen, joint fluid may be removed (arthrocentesis) and analyzed. This can help rule out infection or crystal-related conditions like gout. Osteoarthritic fluid is typically clear and has normal cell counts, helping distinguish it from inflammatory or infectious conditions.

How Is Knee Osteoarthritis Treated?

Treatment for knee osteoarthritis focuses on reducing pain, improving function, and slowing disease progression. The cornerstone of treatment is exercise and education, which are more effective than medication alone. Additional options include weight loss, pain medications, joint injections, and surgery for severe cases.

Modern treatment of knee osteoarthritis emphasizes active management strategies over passive treatments. Research consistently shows that combining exercise, education, and weight loss (when appropriate) produces better outcomes than relying solely on medications or waiting for surgery. Most people with knee osteoarthritis can effectively manage their condition and maintain an active lifestyle without surgery.

Treatment is typically staged, starting with conservative approaches and progressing to more invasive options only when simpler treatments are insufficient. The goal is not just to reduce pain but to improve function and quality of life while slowing disease progression.

Exercise and Physical Activity

Exercise is the single most important treatment for knee osteoarthritis, supported by strong evidence from numerous clinical trials. Structured exercise programs have been shown to reduce pain by 30-40% and improve physical function significantly. These benefits are comparable to or greater than those achieved with pain medications, without the side effects.

The types of exercise that help include:

Strengthening exercises: Building muscle strength, particularly in the quadriceps (front thigh muscles), is crucial. Strong muscles act as shock absorbers, reducing stress on the joint. Effective exercises include straight leg raises, wall squats, step-ups, and resistance band exercises. A physical therapist can design a program tailored to your abilities and needs.

Aerobic exercise: Low-impact activities like walking, cycling, and swimming improve cardiovascular health, help with weight management, and maintain joint mobility. Aim for 150 minutes of moderate activity per week, as recommended for general health. Water-based exercise is particularly gentle on the joints while providing resistance for strengthening.

Flexibility and range of motion exercises: Regular stretching helps maintain joint mobility and reduces stiffness. Focus on the muscles around the knee, including quadriceps, hamstrings, and calf muscles.

It's normal to experience some mild discomfort during or after exercise when you have knee osteoarthritis. However, this doesn't mean you're causing damage. The key is to start slowly, progress gradually, and find activities that you enjoy and can sustain long-term. Pain that lasts more than two hours after exercise suggests you may have done too much, and you should reduce intensity or duration.

Education and Self-Management

Understanding your condition is an essential part of managing knee osteoarthritis. Structured education programs, sometimes called "arthritis schools" or self-management programs, teach you about the disease, treatment options, and strategies for managing symptoms day-to-day.

Key concepts covered in these programs include:

• Understanding what osteoarthritis is and isn't (it's not just inevitable "wear and tear")
• The importance of staying active and how exercise helps rather than harms joints
• Pacing activities to avoid overexertion while staying active
• Pain management strategies
• When to use medications and how to use them safely
• Coping with the emotional impact of chronic pain

Weight Management

For people who are overweight or obese, weight loss is one of the most effective treatments for knee osteoarthritis. Clinical studies show that losing 5% of body weight can significantly reduce pain and improve function. The benefits occur through both reduced mechanical stress on the joint and decreased inflammation.

Weight loss is best achieved through a combination of dietary changes and increased physical activity. Working with a dietitian can help develop sustainable eating patterns. The goal is gradual, sustained weight loss rather than rapid results from extreme diets that are difficult to maintain.

Pain Medications

Medications can help manage symptoms but should be viewed as a complement to, not a replacement for, exercise and lifestyle measures.

Paracetamol (acetaminophen) is often recommended as first-line medication for mild-to-moderate pain. It's generally safe when used appropriately but has modest effectiveness for osteoarthritis pain. Maximum doses should not be exceeded to avoid liver damage.

NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen and naproxen are more effective than paracetamol for osteoarthritis pain. They reduce both pain and inflammation. However, they carry risks including gastrointestinal bleeding, kidney problems, and cardiovascular effects. They should be used at the lowest effective dose for the shortest needed time. People over 75, or those with heart disease, kidney problems, or a history of stomach ulcers, should use these medications cautiously and under medical supervision.

Topical NSAIDs (applied to the skin) are an alternative that provides local relief with lower systemic absorption, potentially reducing side effects compared to oral NSAIDs.

Joint Injections

Corticosteroid injections directly into the knee joint can provide temporary relief for many people. The effect typically lasts a few weeks to months. While useful for managing flares or providing short-term relief, repeated injections have diminishing returns and may potentially accelerate cartilage loss with very frequent use. Most guidelines recommend limiting injections to 3-4 per year.

Hyaluronic acid injections (viscosupplementation) involve injecting a lubricating substance into the joint. Evidence for their effectiveness is mixed – some people experience significant benefit while others see little improvement. They are generally considered when other treatments have been insufficient.

Assistive Devices

Various devices can help reduce knee stress and improve function:

• Supportive footwear with cushioned soles can reduce impact on the knee
• Walking aids such as canes can reduce knee loading (use in the hand opposite the affected knee)
• Knee braces may help some people, particularly those with malalignment
• Home modifications like raised toilet seats and grab bars can make daily activities easier

When Is Knee Replacement Surgery Necessary?

Knee replacement surgery is considered when conservative treatments no longer provide adequate relief and quality of life is significantly affected. Typical candidates experience severe pain during daily activities and at rest, substantial functional limitations, and have tried exercise, weight loss, medication, and injections without sufficient improvement. Surgery has over 90% success rates.

While most people with knee osteoarthritis can manage their condition effectively without surgery, some will eventually require surgical intervention. The decision to proceed with surgery is highly individual and depends on the severity of symptoms, their impact on your life, and your overall health and goals.

Indications for Surgery

Surgery is typically considered when:

• Pain is severe and persistent despite optimal conservative treatment
• Pain occurs at rest or disturbs sleep regularly
• Daily activities like walking, climbing stairs, or getting up from chairs are severely limited
• Quality of life is substantially affected
• Non-surgical treatments including exercise, medication, and injections have been tried and found insufficient

X-ray findings alone don't determine the need for surgery – the decision is based primarily on your symptoms and their impact on your life. Some people with severe X-ray changes function well and don't need surgery, while others with moderate changes have symptoms warranting surgical consideration.

Types of Knee Surgery

Total knee replacement (knee arthroplasty) is the most common surgery for knee osteoarthritis. The damaged joint surfaces are removed and replaced with metal and plastic components that recreate the joint's function. Modern prostheses typically last 15-20 years or longer, and many last the rest of the patient's life.

Success rates are excellent: over 90% of people report significant pain relief and improved function. Most people can return to low-impact activities like walking, swimming, cycling, and golf. High-impact activities like running or jumping are generally not recommended.

Recovery involves a hospital stay of typically 1-3 days, followed by physical therapy to regain strength and motion. Most people walk with support within a day of surgery and progress to independent walking over several weeks. Full recovery takes several months, with continued improvement possible for up to a year.

Partial knee replacement (unicompartmental arthroplasty) is an option when only one compartment of the knee is affected (usually the medial or inside compartment). This preserves more natural bone and ligaments, potentially allowing more natural knee function. Recovery is typically faster than with total knee replacement.

Osteotomy involves cutting and realigning the bone to shift weight away from the damaged part of the knee. This is more commonly performed in younger, active patients with damage limited to one compartment. It can delay or prevent the need for knee replacement but is not suitable for everyone.

After Surgery

Rehabilitation after knee surgery is essential for optimal outcomes. This includes:

• Early mobilization and weight-bearing as directed by your surgeon
• Physical therapy exercises to restore range of motion and strength
• Gradual return to activities over weeks to months
• Following precautions to protect the new joint during healing

Most people can drive after about 4-6 weeks and return to desk work within 6-8 weeks. Physical jobs may require 3 months or more before return. The commitment to rehabilitation significantly influences outcomes.

How Can You Live Well with Knee Osteoarthritis?

Living well with knee osteoarthritis involves staying active through appropriate exercise, maintaining a healthy weight, using pain management strategies effectively, adapting activities as needed, and staying engaged with healthcare providers. Most people can maintain good quality of life by taking an active role in managing their condition.

Knee osteoarthritis is a chronic condition, but having it doesn't mean accepting a declining quality of life. With proper management, most people can remain active, maintain independence, and continue doing the activities they enjoy. The key is taking an active role in your care and working collaboratively with healthcare providers.

Staying Active

Regular physical activity is essential for long-term joint health and overall wellbeing. While it might seem counterintuitive to exercise a painful joint, research consistently shows that appropriate exercise improves rather than worsens knee osteoarthritis outcomes.

Find activities you enjoy and can sustain. Walking, cycling, swimming, and tai chi are all beneficial. If one activity causes too much pain, try another – the goal is to stay moving in whatever way works for you. Consider working with a physical therapist to develop a personalized exercise program.

Pacing Activities

Learning to pace activities helps manage symptoms while remaining productive. This involves:

• Breaking larger tasks into smaller segments with rest periods
• Alternating between activities that stress the knee and those that don't
• Planning more demanding activities for times when you typically feel best
• Avoiding the "boom-bust" pattern of doing too much on good days and paying for it afterward

Managing Flares

Osteoarthritis symptoms often fluctuate, with periods of increased pain (flares) followed by better periods. Flares may be triggered by overactivity, changes in weather, or may occur without obvious cause.

During flares, it's appropriate to reduce activity intensity while maintaining gentle movement. Short-term use of pain medications may be helpful. Ice or heat can provide relief for some people. Don't be discouraged by flares – they're a normal part of the condition and don't necessarily mean your arthritis is getting worse.

Psychological Wellbeing

Living with chronic pain can affect mood and mental health. Depression and anxiety are more common in people with osteoarthritis than in the general population. These conditions can, in turn, worsen the experience of pain.

Addressing psychological wellbeing is an important part of comprehensive osteoarthritis management. This might include:

• Cognitive behavioral therapy or other psychological approaches
• Mindfulness and relaxation techniques
• Support groups or connecting with others who have similar conditions
• Treatment for depression or anxiety when present