Osteoarthritis Symptoms: A Complete List

We spoke to KEVII’s own orthopaedic surgeon Mr Jamie Griffths MBBS, BSc, MRCS, FRCS (Tr&Orth) to get a detailed look at each symptom, its manifestation, underlying causes, and its relation to osteoarthritis.

Joint Pain

This is a central symptom of OA, reflecting the direct impact of cartilage breakdown. For many, the pain associated with osteoarthritis is a deep, aching soreness that intensifies during or after movement and typically subsides with rest. The pain might feel sharper when initiating movement after a period of inactivity, such as upon waking in the morning. It’s often described as a constant dull ache with periods of more intense pain spikes.

• How and When: Pain typically occurs during or after movement and may lessen with rest.
• Why: It’s caused by the deterioration of cartilage that cushions the ends of bones in joints, leading to bones rubbing against each other.

READ: How exercise can minimise arthritis joint pain

Stiffness

Stiffness in the joints can feel like a significant restriction in movement, especially first thing in the morning or after sitting for prolonged periods. It’s as if the joints are “locked” in place, requiring time and gentle movement to loosen up and become more flexible. This symptom indicates the loss of joint flexibility and health.

• How and When: Most noticeable upon waking or after a period of inactivity, usually improving with movement.
• Why: Due to decreased fluid in the joint, which is necessary for smooth movement, and changes in the cartilage.

READ: How to reduce your risk of arthritis

Tenderness

Tenderness is experienced as a sharp pain or discomfort when pressure is applied to the joint or the area surrounding it. This sensation can make even light touches or mild pressure feel uncomfortable or painful and reflects inflammation and the beginning of structural changes in the joint.

• How and When: When pressing near or on the joint, even without movement.
• Why: Inflammation and changes in the joint structure make it sensitive to pressure.

Loss of Flexibility

Those with osteoarthritis often notice a gradual decrease in their ability to move their joints through a full range of motion. It can feel like an invisible barrier is preventing the joint from moving as it used to, making everyday activities more challenging.

• How and When: Difficulty moving the joint through its full range of motion.
• Why: Degradation of cartilage and development of bone spurs limit movement.

READ: 39 Things You Can Do To Help Prevent Arthritis

Grating Sensation

This sensation is described as a gritty or grinding feeling within the joint during movement. Some people hear a corresponding noise. It can be unsettling or uncomfortable, contributing to a sense of the joint being worn down or damaged. This comes as a direct result of the deterioration of smooth cartilage surfaces.

• How and When: A feeling or sound of grinding during joint movement.
• Why: Caused by rough surfaces moving against each other as the cartilage wears away.

Bone Spurs

Bone spurs might not always be felt directly, but when they are, they can feel like hard bumps under the skin near the joints. They can create points of pressure and pain, especially when they interfere with movement or are pressed upon. This indicates the body’s response to joint degradation.

• How and When: Extra bits of bone, which can be felt as hard lumps, may form around the affected joint.
• Why: The body attempts to repair the joint damage by growing more bone.

READ: Osteoarthritis in young people: it doesn’t just affect the elderly

Swelling

Swelling in the joint area can feel tight and uncomfortable as if the skin and tissues around the joint are being stretched. It can add to the sensation of stiffness and decrease the range of motion further. This is a sign of the body’s inflammatory response to joint damage.

• How and When: Soft tissue around the joint becomes inflamed, leading to swelling, often after extended activity.
• Why: Caused by inflammation due to cartilage breakdown and increased joint fluid.

Muscle Weakness

Muscle weakness around the affected joint can make the limb feel unsteady or incapable of performing usual tasks. This is a secondary effect of joint pain and loss of function, leading to decreased physical activity.
It’s often described as the muscles feeling tired or unable to support the joint properly.

• How and When: The muscles around the joint may feel weaker, especially after periods of inactivity or prolonged use.
• Why: Due to less use of the joint because of pain and stiffness, leading to muscle atrophy.

Joint Deformity

As osteoarthritis progresses, joint deformity might develop, which can feel like the joint is misaligned or shaped incorrectly. This is an advanced osteoarthritis symptom, indicating significant joint damage and can lead to a sense of imbalance or awkwardness when using the affected joint.

• How and When: Changes in the shape of the joint, noticeable over time.
• Why: Result of the ongoing wear and tear on the joint, including cartilage loss, bone spurs, and changes in bone structure.

Joint Instability

Instability can make the joint feel as if it’s going to give out or isn’t capable of supporting weight or movement reliably and reflects the cumulative impact of osteoarthritis on joint integrity.. This can lead to a lack of confidence in the joint’s ability to perform tasks without causing pain or injury.

• How and When: The joint may feel like it’s giving way or not supporting movements as it should.
• Why: Due to weakened muscles, loss of cartilage, and changes in joint structure.

Reduced Function

The cumulative effect of OA symptoms can lead to a noticeable reduction in the ability to perform daily activities, which can feel frustrating and limiting. Tasks that were once easy and thoughtless become challenging or impossible. This symptom highlights the impact of OA on quality of life and independence.

• How and When: Difficulty performing daily activities that require joint movement.
• Why: A combination of pain, stiffness, and loss of flexibility limits joint function.

Crepitus

Crepitus is a medical term that refers to a crackling, popping, or grating sound or sensation within a joint or under the skin. Crepitus can add to the discomfort of movement, with the sensation of the joint crackling or popping with use. It’s a constant reminder of the joint’s condition.

• How and When: A crackling or popping sound or feeling in the joint during movement.
• Why: Caused by roughened cartilage surfaces or the presence of bone spurs.

Increased Pain After Activity

After periods of activity, the pain can flare up, feeling more intense and sometimes throbbing. It’s as if the joint is protesting the activity it just underwent and reflects the joint’s reduced capacity to handle stress.

• How and When: Pain flares up following physical activity or at the end of the day.
• Why: Activities stress the already damaged joint, leading to inflammation and pain.

READ: Arthritis and exercise: a guide

Weather-Related Pain

Changes in weather can make the joints feel more painful and stiff, often described as a deep, penetrating ache that is hard to alleviate. This is a common anecdotal observation among those with OA, though mechanisms are not fully understood.

• How and When: Pain and stiffness increase in cold, damp weather or with changes in barometric pressure.
• Why: Theories suggest changes in atmospheric pressure can affect joint pressure, or cold may increase joint stiffness.

Sleep Disturbances

The discomfort and pain of osteoarthritis can make finding a comfortable sleeping position difficult, leading to nights of restless sleep and the feeling of being tired or fatigued during the day – it indicates the extent to which OA can affect overall well-being.

• How and When: Difficulty falling or staying asleep due to joint pain and discomfort.
• Why: Pain and discomfort disrupt normal sleep patterns.

Mood Changes

The chronic nature of OA pain and its impact on lifestyle and activities can lead to feelings of sadness, frustration, or anxiety. It’s a mental and emotional strain that accompanies the physical symptoms.

• How and When: Feelings of depression or anxiety due to chronic pain and reduced quality of life.
• Why: Chronic pain and loss of function can lead to significant psychological stress.

Muscle Atrophy

With decreased use and activity, muscles may weaken and shrink, making the limb feel less capable and more vulnerable. This can contribute to an overall sense of weakness or debilitation. This is a secondary effect of reduced joint use and activity levels.

• How and When: Muscles around the joint become weaker and smaller from disuse or decreased activity.
• Why: Pain and stiffness lead to less movement, causing muscles to weaken and shrink.

Understanding these symptoms can help individuals recognise the signs of osteoarthritis and seek early intervention, potentially slowing the progression of the disease and improving quality of life.

More information

• If you don’t have access to a GP, you can make an appointment with a same day private GP here at King Edward VII’s Hospital. 
• Get in touch to discuss your osteoarthritis symptoms and explore treatment