This blog post was updated on May 19, 2020. Previous comments have not been removed or edited.
Osteoarthritis (OA) is the most frequently diagnosed type of arthritis, with more than 27 million Americans suffering from the joint disease. OA is devastating to individual quality of life and even to the economy. Along with the hips and hands, knees are one of the primary areas of the body impacted by osteoarthritis.
In the case of knee osteoarthritis, beyond knee pain and reduction in joint function, the disease can lead to:
- Reduced productivity in the workplace
- Artificial joint operations
- High health costs to society.
Furthermore, the Centers for Disease Control and Prevention (CDC) notes that this knee pain disorder is on the rise. “Public health data show that the prevalence, health impact, and economic consequences of osteoarthritis are expected to increase dramatically during the next couple of decades,” reports the agency. “Approximately 1 in 2 people may develop symptomatic knee OA in their lifetime.”
The three stages of osteoarthritis
There are three basic stages of development used to describe osteoarthritis knee pain: mild, moderate, and severe.
1. Mild Osteoarthritis
When osteoarthritis first becomes noticeable on medical images, the patient may feel very little pain or limitation to their mobility. There will be minor bone spurs that have begun to grow around the knee. The cartilage of the knee at this stage will still be at a healthy size, and the space between the bones is normal, with no rubbing between the bones of the knee.
Typically the area around the joints starts to feel stiff and uncomfortable, particularly when the joint is challenged – for example, when a certain sitting posture is held for an extended period, after rising in the morning, during use of a staircase, or following a workout.
When osteoarthritis is mild, the osseous and soft tissue around the joint are essentially the same in x-rays.
2. Moderate Osteoarthritis
As the disease progresses into its moderate form, inflammation at the joint becomes more apparent. It may become difficult to bend the knee or fully extend the leg, and a patient may hear the joint make popping or snapping sounds when they walk. There will also be significant stiffness after sitting for long periods of time, and when waking up in the morning.
At this stage, the bones become rougher and develop more spurs at the joints. The cartilage between the bones will also show obvious damage and the space between the bones is narrowing.
3. Severe Osteoarthritis
At this advanced phase of the disease, it may become challenging and excruciating to use your body in typical everyday ways, including walking and descending stairs.
More spurs may develop, and the cartilage will be almost completely gone, leaving the joint stiff and in some cases completely immobile. The synovial fluid that aids in movement will also be mostly gone and it no longer does its job of helping to reduce the friction among the moving parts of the knee joint. Deformity is also a possibility once osteoarthritis becomes severe.
Medical images vs. pain
The three stages of osteoarthritis are identifiable through x-rays and symptoms, says UK physiotherapist Chloe Wilson, who recommends to focus on how you feel. “Some people … suffering from a great deal of osteoarthritis knee pain may only show mild changes on x-ray,” she says. “It is much more important to concentrate on your symptoms, rather than what your x-ray shows.”
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