Osteoarthritis Symptoms
The World Health Organization (WHO) adopted the Kellgren-Lawrence classification system as the standardized criteria for diagnosing OA. It was originally used to grade osteoarthritis of only the knee, but it’s now used to grade OA in other joints commonly affected by arthritis, including:
Carpometacarpal joint (CMC) of the thumb Cervical spine (neck) Distal interphalangeal joints (DIP) of the fingers Hips Knees Lumbar spine (lower back) Metacarpophalangeal joints (MCP) of the hands Wrists
The Kellgren-Lawrence classification system is the most widely used clinical tool for diagnosing OA using radiographic imaging like X-rays. It categorizes OA into the following grades:
Grade 1 (Minor): Minimal or no joint space narrowing, with possible bone spur formationGrade 2 (Mild): Possible joint space narrowing, with definite bone spur formationGrade 3 (Moderate): Definite joint space narrowing, moderate bone spur formation, mild sclerosis (hardening of tissue), and possible deformation of bone endsGrade 4 (Severe): Severe joint space narrowing, large bone spur formation, marked sclerosis, definite deformation of bone ends
Grade 1
Minor osteoarthritis, or grade 1, is when OA begins and there is little to no pain. Many people are unaware that they have OA at this time until they have X-rays of a joint taken for some other reason, such as a broken bone, or fracture. Any symptoms during grade 1 typically only include minor discomfort that does not interfere with or limit your ability to perform daily activities.
Grade 2
Grade 2 osteoarthritis is the first stage of OA in which a person begins to experience joint pain and stiffness, especially upon waking in the morning. Stiffness at this time of day often lasts less than 30 minutes, as joints begin to loosen up as you start moving.
Grade 3
Moderate osteoarthritis, or grade 3 OA, is when your cartilage breaks down even further, causing increased joint pain and stiffness. Pain and stiffness, especially in the hips and knees, are noticeable after resting, such as from sitting for a long time. Symptoms can also worsen with activity like standing, walking, squatting, and going up and down stairs.
Grade 4
Severe OA, or grade 4 osteoarthritis, is the highest level of progression of osteoarthritis. There is severe joint space narrowing, large osteophyte formation, and significant bone deformation and sclerosis. Joint degradation is severe, and surgical management, including joint replacement, called arthroplasty, or joint fusion, called arthrodesis, is often indicated to manage severe symptoms.
Causes of Mild OA
Mild OA often develops from age-related wear and tear in joints over time. Anyone who repetitively uses their joints, including athletes, military personnel, and people with physically demanding jobs, are at risk for developing osteoarthritis.
Risk factors that increase the likelihood of mild OA or progressing symptoms include:
Older age Genetics Obesity History of trauma or joint injury Low levels of physical activity
Diagnosis
Mild OA, or grade 2 osteoarthritis, is distinguished from other stages of osteoarthritis by the extent of joint damage observed through X-rays. In this stage, joint damage becomes evident as joint spaces begin to narrow from cartilage degradation.
Cartilage lines the ends of bones between joints and provides protective cushioning and shock absorption. As cartilage begins to break down and wear away, the space within joints becomes smaller. This causes increased friction between bones, which can also lead to the development of bone spurs.
You may first speak to your primary care provider about your joint pain. Your healthcare provider will go over your medical history, symptoms, how the pain affects your activities, the medications you use, and any other medical problems you may be experiencing. Your healthcare provider also will examine and move your joints.
Besides X-rays, your healthcare provider may also perform the following tests to make a diagnosis:
Joint aspiration: After numbing the area, your healthcare provider will insert a needle into the affected joint to remove synovial fluid, or joint fluid. This test can detect infection, red and white blood cell counts, and whether crystals are present in the fluid. The results can help rule out other medical conditions or other forms of arthritis. MRI: MRI gives a better view of cartilage and soft tissue and can show damage and inflammation of the joint.
Your healthcare provider may refer you to a specialist, such as an orthopedist or a rheumatologist, depending on the cause and symptoms of your OA. For instance, an orthopedist may treat you if your OA needs surgical intervention, and a rheumatologist may treat you if you have an autoimmune disorder.
Treatment
A variety of treatment methods helps to manage symptoms of mild OA. Based on clinical research, the American College of Rheumatology strongly recommends the following interventions for managing symptoms:
Exercise and physical therapy to improve joint mobility, range of motion, and to strengthen surrounding muscles for joint supportWeight loss to decrease pressure and strain on arthritic joints, especially weight-bearing joints like the hips and kneesModifying activities in order to lessen strain on painful joints
Besides lifestyle changes, your healthcare provider may also recommend medications and devices to help you cope with OA symptoms:
Knee and thumb braces to support painful joints and lessen discomfort from everyday activities Oral nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief and to reduce inflammation Topical NSAIDs to decrease pain signals, especially from OA of the hands and knees Cortisone injections within joints to reduce pain and inflammation
Prognosis
OA is a progressive condition that can slowly get worse over time if left untreated. While there is currently no cure for osteoarthritis, if osteoarthritis is detected early, treatment can help manage symptoms and slow progression and joint degeneration.
Lifestyle changes may be needed to help prevent mild osteoarthritis from progressing further to moderate or even severe levels. These include:
Regular exercise to decrease pain and stiffness and strengthen surrounding muscles to support arthritic jointsJoint protection strategies to rest inflamed joints and prevent overuse, which can increase joint wear and tear
A Word From Verywell
Strengthening the muscles surrounding arthritic joints is essential for decreasing strain on your joints and preventing mild osteoarthritis from progressing to more severe forms of the disease. It is important that you seek medical attention if you have been experiencing joint pain, stiffness, or swelling for more than three months.
An early diagnosis may help you manage your symptoms and prevent further damage. In turn, you should be able to perform all your daily tasks and activities without significant limitations.
