Diary of a Medic

Introduction

Interestingly, there are different types of arthritis. Osteoarthritis (OA) is the most common form of arthritis, causing joint pain, stiffness, and reduced movement. In this guide, we break down the causes, signs, treatments, and how people cope—and I’ll share real patient stories along the way. I have also referenced up to date guidelines, and resources which you can find at the bottom of the page.

A very common complaint I see in clinic, is a patient developing knee or hip pains. Usually the pain has been present for many months or longer, and following taking a detailed history or assessment, I would be able to diagnose osteoarthritis. Lets talk about the condition in a bit more detail:

What Is Osteoarthritis?

Osteoarthritis occurs when cartilage (strong protective tissue) in joints breaks down, leading to pain, swelling, and difficulty moving the joint. Doctors often call this wear and tear, however, bony growths (osteophytes), joint capsule changes, and inflammation can also occur—even deeper than a simple “wear-and-tear.”

Who Does It Affect & Why?

• OA risk increases with age, especially from late-40s onward.
• Women are affected more than men.
• Obesity, joint injuries, genetics, and prior joint diseases (like gout or rheumatoid arthritis) raise risk.

Globally, over 528 million people had osteoarthritis in 2019, with around 73 % over age 55 and 60 % being women. The knee is the most commonly affected joint, followed by hip and hand.

This week, I remember seeing a 65 year old women who was experiencing both sided knee pains. I felt each knee as she straightened her legs and I felt a grating/crackling sensation. This was an indicator of knee arthritis. There are other symptoms to be aware of:

Symptoms to Watch For

Osteoarthritis often comes on slowly or after an injury. Key symptoms include:

• Joint pain, especially with movement or at day’s end
• Stiffness, particularly after rest, usually improving within minutes
• Swelling, tenderness, or “knobbly” joints (especially fingers)
• Grating or crackling (crepitus) sound or feeling
• Reduced range of motion, weakness, or muscles wasting
• Joints that feel unstable or “give way”

Symptoms may flare up unexpectedly—weather or activity can influence them.

How It’s Diagnosed

• Mainly through clinical assessment: pain that worsens with use, short morning stiffness (<30 minutes), age over 45, joint enlargement, limited motion.
• Blood tests and X-rays are mostly used to exclude other conditions, not to confirm OA.

In the case of the 65 year lady that I described earlier (who had knee pains and a grating sensation when straightening her legs), we diagnosed arthritis without the need of an Xray. However, if she had different symptoms, for example stiffness of the joint lasting longer, or had she of been very young, I would have been concerned about other conditions. I will be regularly blogging about other health conditions in our ‘health’ section.

Treatment & Symptom Relief

While there’s no cure, osteoarthritis has various treatments help manage symptoms:

Lifestyle

• Exercise: Strength and general fitness workouts help reduce pain and improve mobility. It also aids weight control and posture.
• Healthy weight: Losing weight lightens joint load, especially on knees and hips.

I often refer patients for physiotherapy, or give them self guided exercises to strengthen muscles around the joint. Depending on their weight, we would offer support on managing this too.

Medications & Topical Treatments

• Paracetamol (In USA this is called acetaminophen) First-line pain relief but not always effective.
• NSAIDs: Available in creams or tablets (for example ibuprofen); reduce inflammation—tablets often paired with stomach-protecting medications (PPIs)
• Opioids: These are strong. Used only short-term due to side effects like drowsiness and constipation.
• Capsaicin cream: Applied to joints (but may cause burning sensation initially). Short supply issues exist and I therefore I have had trouble sourcing it for patients.
• Steroid injections: Offer quick, temporary relief lasting weeks to months. Not everyone can give this injection, we have to be specially trained.

Supportive Therapies

• Hot or cold packs can ease symptoms.
• Assistive devices—insoles, braces, walking aids, tap turners—help with mobility or daily tasks.
• Manual therapy from physiotherapists can maintain flexibility and reduce stiffness.

Surgery

If other treatments aren’t enough, surgical options include:

• Joint replacement (e.g., hip or knee arthroplasty)—artificial joints lasting up to 20 years.
• Joint fusion—stabilises the joint but removes movement.

Living with Osteoarthritis

You can lead an active, healthy life with OA:

• Stick to diet and exercise routines to maintain muscle strength and weight.
• Take medications as prescribed, even during symptom-free periods. Ask about side effects or supplements.
• Have regular reviews with your healthcare team to adjust care as needed.
• Stay up-to-date with vaccinations like flu or pneumococcal, especially if OA affects daily life.
• Connect with others: helplines, forums (e.g. Versus Arthritis) offer emotional support and practical tips.
• Explore financial support if OA affects work or daily function (statutory sick pay, allowances, etc.).

Your GP would be able to advise on support networks available locally. Many practices also have social prescribers that can help you get support in the community.

Highlights & Global Perspective

• Osteoarthritis affects hundreds of millions globally and is a major cause of disability.
• Though common with age or injury, it’s not an inevitable part of aging.
• Early diagnosis and a tailored, multi-professional care plan (including rehab, assistive tools, weight control, exercise) help slow progression and maintain quality of life.

Conclusion

Osteoarthritis is common yet highly individual. While there’s no cure, a combination of lifestyle changes, therapies, support, and—in some cases—surgery can help people manage symptoms and live well.

Patients are excited to learn that there are numerous ways to alleviate their pain beyond medications. This is why embracing lifestyle changes and engaging in physiotherapy early on is so beneficial. We invite you to share your experiences with arthritis in the comments (below) and subscribe to our website for the latest articles.

References

• NHS: Overview of osteoarthritis nhs.uk
• NHS: Symptoms of osteoarthritis nhs.uk
• NHS: Treatment and support nhs.uk
• NHS: Living with osteoarthritis nhs.uk
• NCBI / StatPearls: Osteoarthritis clinical insights NCBI
• WHO: Global osteoarthritis fact sheet World Health Organization
• Versus Arthritis: OA causes and symptoms Versus Arthritis