2025 Facts about Osteoarthritis

OSTEOARTHRITIS FACTS

• Age on its own has little effect on OA. Exposure to years of modifiable risk factors like obesity, low physical activity, and joint trauma are a more important focus.

• Osteoarthritis (OA) is a whole joint and whole body condition, not just affecting the joint.

• The amount of pain is unlikely to represent the amount of joint changes you have on imaging. The severity of your imaging changes is unlikely to positively correlate with your current symptoms. Yes, you might have been told you have “severe” arthritis based on imaging, but often high quality management can improve your symptoms without changing what your joint looks like on imaging. Your symptoms matter much more then your imaging findings  

• The majority of people over 20 will have pain-free imaging findings in one or more joints in their body. Changing your behavior to avoid imaging changes is not helpful for your joint health despite feeling “protective.” 

• Lack of flexibility does not predict OA pain onset. However, strengthening and movement exercises can still be helpful.

•  Underloading is a more likely and harmful risk factor for OA than overloading. Most strategies to “protect the joint” actually lead to worse joint health long term.

•  Running for fun and within the Australian physcial activity time guidelines is very safe for lower body joints and back. The benefits of running vastly outweigh the risks.

• Strength training is not harmful to the joints and might be protective from OA. More and more research is suggesting cartilage can adapt to stress and load unlike what we used to think. Most who’s symptomatic OA progresses are likely doing too little to find the protective effect of exercise on knee health. Astronauts display worsening joint health after space travel 

• Many unhelpful beliefs like “the body is a machine that wears and tears” are responsible for increased imaging and invasive injection or surgical management-seeking behavior, which has a high cost on the healthcare system, affecting your income and increasing national tax requirements and is not necessary for many. Replace this mind set with “wear and repair” or “bend it to mend it” or “motion is potion” or “don’t use it you lose it” or “move it to lube it.”  

• Most over-the-counter medications like paracetamol work no better than a placebo for OA pain. 

• OA does not inevitably worsen significantly when managed well. Knee Surgery is not inevitable and should become more uncommon as the non-surgical exercise and lifestyle based managements become more popular. You can't cure OA or any OA but you can massively slow down the process of symptom development and prevent severe disability with high quality up to date management. 

• Many joint surgeries for ligament or as a “clean up” do not have strong evidence to be protective of OA development.

• Joint surgery has been not predicted to be needed for 80% of those with symptomatic OA who receive up-to-date high-quality non-surgical management advice.

• Evidence-based lifestyle management including exercise can prevent most from ever needing joint surgery. 

• A joint pain flare-up is not a sign your joint health getting worse. Short term joint flare ups are common and normal while living with a sensitive immune and nervous within our joints. You will respond well to a positively optimistic expectation mindset of flare-up recovery while you modify chosen aggravating activities as you feel is helpful then progress the dosage of fun valued knee loading activities as your immune and nervous system naturally steadies itself and tolerance to movement progresses again. 

• Mood, stress, and sleep have a large influence on your joint symptoms. Perhaps just as important to manage well as progressive exercise for our joint health.

• “Wear and tear” and “bone on bone” are poor descriptors of OA and might be the sign you are talking to an outdated healthcare professional or well-intended but misguided beliefs.