5 myths about osteoarthritis

There are more than 100 different types of arthritis, but this article by Jodie Breach, National Lead Physiotherapist, looks at the most common form – osteoarthritis.

Osteoarthritis is the most common joint condition, affecting 520 million people around the world. It most commonly affects the knees, hips and hands, but can affect any joint. It's characterised by pain, stiffness, muscle weakness and difficulty completing activities. In a global study of a range of conditions, hip and knee osteoarthritis was ranked as the 11th highest contributor to disability.

The odds of having osteoarthritis increase with age, but it’s a myth that the condition is an inevitable part of ageing. It’s also a myth that only older people experience symptoms.

To help you understand osteoarthritis and manage its symptoms more effectively, let’s bust five common myths about the condition.

Myth 1 – Arthritis is purely due to wear and tear on your joints

The exact cause of osteoarthritis is still unclear, but it's certainly more complicated than just being due to wear and tear. It's very common to think that our joints are like our cars - the more we use them, the quicker they will wear out. Our joints are human tissue and much more complicated than this. A disease process that involves inflammation interferes with how the cartilage repairs itself, but the joint may still be able to work normally, without any symptoms.

There may be risk factors that make it more likely you will have problems with arthritis that you can influence. Being overweight increases the level of inflammation in your system. This is thought to contribute to joint changes as well as putting more strain on any affected weight-bearing joints. Losing as little as 6% of body weight has been shown to result in reduction in pain and improved function. A 25% weight loss has been shown to improve outcomes by 50%.

Myth 2 – Exercise will make osteoarthritis worse

NICE guidance states that exercise is one of the three core treatments for osteoarthritis. This should involve both strengthening around the affected joint and general cardiovascular exercise. Strengthening muscles around the joint can improve symptoms by protecting it. Improving general fitness can also reduce general inflammation.

We don't know exactly what kind of exercise is best for arthritis at the moment. It seems to be most important to find a form of exercise that you enjoy to maximise the improvement you can get. Ideally, you should include a mixture of strengthening, aerobic and movement exercises.

If you're a runner, osteoarthritis is no reason to stop. A recent study including runners and non-runners concluded that runners were no more likely to experience symptoms associated with osteoarthritis. In fact, runners had more cartilage and less symptoms than non-runners, thought to be due to them stimulating the joint to respond to load.

Myth 3 – Osteoarthritis always requires scans

There’s a common belief that scans and X-rays are inevitable for osteoarthritis patients, but the opposite is the case. X-rays aren’t usually helpful in diagnosing osteoarthritis as there is not a strong relationship between osteoarthritis symptoms and structural changes seen on scans. Some people have osteoarthritis symptoms and no changes on X-ray and others have changes on X-ray but no symptoms.

The best way to diagnose osteoarthritis is to talk to a clinician. If you're over 45 years of age, have joint pain related to activity and stiffness in the joint that lasts less than 30 minutes in the morning, you should be diagnosed without any scans.

Myth 4 – Pain equals damage

Evidence has shown that there’s no correlation between the changes that naturally occur in osteoarthritis and the symptoms that are experienced. If you feel pain, there’s still a huge opportunity for you to control your symptoms. And you can be assured that these symptoms don’t necessarily indicate further damage.

Pain is a complicated sensation that is not directly related to the structural changes in your joint. Pain is influenced by a huge number of factors such as our emotions, level of stress, poor sleep and general inflammation.

It's common to experience flares in pain when you have arthritis and are experiencing increased symptoms. You may be able to identify why this is if you hurt the joint with a twist or fall, or it may seem to be for no reason at all. Regardless, these periods can be challenging and worrying. Most of the times, these flares do not represent the joint getting worse and with some rest and time, the flare will likely improve over time. Exercise can be continued, but at a level that is manageable at the time.

Myth 5 – Osteoarthritis will always need surgery

This stems from the belief that no matter what you do, your osteoarthritis will get worse. Only about a third of people get worse over time but some see improvement in their symptoms of pain and disability. There are many positive things you can do to help with pain and maintaining your function.

In most cases osteoarthritis can be improved without surgery. Physiotherapy is the recommended first-line treatment to advise on the right forms of exercise and ways to manage your pain. Talk with your physio to find the right approach for you. You can learn more about arthritis here.

Last updated Friday 26 August 2022

First published on Wednesday 9 October 2019