The Four Stages Of Osteoarthritis

Osteoarthritis is a very common and painful health condition that affects one or more joints in the body. Around 1 in 5 adults over 45 have osteoarthritis, and the number goes up to 50% for those over 65. Osteoarthritis happens when the cartilage within a joint starts to wear down, which can cause pain, stiffness, tenderness, crackling and lack of mobility in the affected area. Osteoarthritis can occur in any joint, but it is most common in the knees, hips and hands.

As with many health conditions, osteoarthritis is often diagnosed in stages. The earlier stages of arthritis may be mild, whereas more advanced stages can be chronically painful and cause significant mobility issues. We spoke to Dr Antoni Chan, Consultant Rheumatologist & Physician, to find out more
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“The four stages of osteoarthritis are based on the severity of symptoms and the degree of radiographic (X-ray) change. The stages can be graded as Stage 1 - minor, Stage 2 - mild, Stage 3 - moderate and Stage 4 - severe,” says Dr. Chan.

It’s important to visit a doctor if you think you may have arthritis, as an early diagnosis can help you manage your symptoms, teach you how to strengthen the muscle around the joint, and help you try to avoid the later stages of arthritis.

“The main features of osteoarthritis are joint pain, stiffness and reduced range of motion. At each stage of osteoarthritis, the feeling may be different depending on the severity of the disease. There could be mild symptoms such as joint stiffness to more severe pain, restriction of movement and limitation of function,” says Dr. Chan.

“Stages of osteoarthritis are diagnosed on investigations such as x-rays or MRI. The characteristic changes on X-ray are loss of joint space between the cartilage, thinning of the cartilage and new bone spur growth (osteophytes) around the joint. The more severe the X-ray change, the higher the grading and stage of osteoarthritis,” says Dr. Chan.

“The treatment for each will be dependent on the individual and the symptoms they are experiencing,” says Dr.Chan, “ Recommended treatments include exercise, stretching, use of anti-inflammatory and pain medication, injection treatment and surgery.”

Exercise may be the last thing you want to do when you have a long-term pain condition, but it is really important to train and strengthen your muscles where possible. Regular exercise can improve joint mobility, increase muscle strength and flexibility, help you maintain a healthy weight to avoid putting extra pressure on the joints, and keep bone and cartilage tissue healthy.

“Medications that can be given include topical gels and creams as well as oral tablets such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). Orthoses can be helpful to keep joints aligned and this includes splints and braces. Weight loss for those who are overweight will also help alleviate the symptoms of osteoarthritis,” says Dr Chan. For those looking for a drug-free approach FlexiSEQ has helped many people in managing osteoarthritis at all stages as you can see in these users' stories.

“At Stage 1, exercise and stretching will be the main treatment. For Stage 2, a brace and topical treatments are used. In Stage 3, oral medication and steroid joint injections are helpful to control the symptoms. Finally, in Stage 4, available treatment includes surgery such as bone realignment, joint fusion and joint replacement,” he continues.

“Osteoarthritis may affect the physical, social and psychological aspects of an individual person. The higher the stage of osteoarthritis, the greater the impact on these aspects on an individual person. Physical function such as the patient's ability to exercise, walk and do sports may be affected by osteoarthritis. The limitation on movement from pain and stiffness may also have an impact on work. There may also be psychological impact from osteoarthritis such as anxiety and depression. Sleep disturbance from nighttime pain can lead to fatigue and tiredness,” says Dr. Chan.

If you are struggling with any aspect of your mental health, it’s important to know that there are people you can turn to who can help you develop the tools to manage your symptoms. If you are comfortable doing so, reach out to a trusted friend or family member and let them know how you’re feeling and how they can support you.

Your GP may be able to refer you to a therapy service, or in some areas you can self refer. There are also plenty of organisations and hotlines which can help. Find a list of mental health hotlines in the U.K here.

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