Osteoarthritis affects more than 33 million American adults. A Texas board-certified physician explains what's happening inside your joints, what the latest guidelines recommend, and how to manage osteoarthritis effectively.
By Dr. Casey Dean, DO · Board-Certified Family Medicine Physician (ABFM) · Published 2026-07-01 · Updated 2026-07-01
Osteoarthritis affects more than 33 million American adults — making it the single most common form of arthritis and one of the leading causes of disability worldwide. Yet most patients don't receive the treatment that evidence says works best. According to recent research, fewer than 40 percent of people with osteoarthritis are ever offered the recommended first-line treatment of structured exercise and education.
If your joints ache when you climb stairs, stiffen up after sitting too long, or creak when you bend your knees, this guide is for you. Below, we'll explain what's happening inside your joints, what the latest guidelines recommend, and what you can do about it — starting today.
Osteoarthritis (OA) is a degenerative joint disease in which the cartilage that cushions the ends of your bones gradually breaks down. Cartilage is remarkably smooth — about five times more slippery than ice — and it allows your joints to glide painlessly through millions of movements over a lifetime. When that cartilage wears away, the underlying bone is exposed. Your body tries to repair the damage by growing new bone, but these bony growths (called osteophytes or bone spurs) often make things worse, causing stiffness, swelling, and pain.
The best treatment is a combination approach: regular exercise (the single most effective intervention), weight management if overweight, and topical or oral anti-inflammatory medications as needed. The 2019 ACR/Arthritis Foundation guidelines strongly recommend exercise, topical NSAIDs, and oral NSAIDs as core treatments. No single pill or injection works as well as a consistent exercise program paired with weight management.
Osteoarthritis cannot currently be reversed — once cartilage is lost, it does not regenerate on its own. However, the disease can be effectively managed to reduce pain, preserve function, and slow progression. Exercise, weight loss, and appropriate medication can dramatically improve quality of life even with existing joint damage.
Osteoarthritis is caused by cartilage breakdown from mechanical wear and metabolic factors, typically affecting one joint at a time and worsening with activity. Rheumatoid arthritis is an autoimmune disease where the immune system attacks joint linings, typically affecting joints symmetrically and causing prolonged morning stiffness lasting an hour or more. Rheumatoid arthritis requires blood tests for diagnosis and is treated with immune-modulating medications.
Osteoarthritis is graded using the Kellgren-Lawrence scale: Stage 1 (minor bone spur formation, usually painless), Stage 2 (mild joint space narrowing with more pronounced bone spurs), Stage 3 (moderate cartilage loss with noticeable joint space narrowing and daily pain), and Stage 4 (severe cartilage loss with bone-on-bone contact, significant pain, and disability).
Yes — the vast majority of people with osteoarthritis never need surgery. Exercise, weight management, physical therapy, topical and oral anti-inflammatory medications, and lifestyle modifications effectively manage symptoms for most patients. Joint replacement is reserved for severe, end-stage OA that hasn't responded to these conservative approaches.
Many patients report worsened symptoms with cold, damp weather or changes in barometric pressure. While the research is mixed, a large 2019 study published in npj Digital Medicine found a statistically significant association between weather changes and joint pain severity. Regardless of the mechanism, if weather affects your symptoms, adjusting your activity level and medication use around weather patterns can help.