Osteoarthritis
Also called: OA, degenerative joint disease, wear and tear arthritis, knee osteoarthritis, hip osteoarthritis
Osteoarthritis is a long-term joint condition that causes pain, stiffness and trouble moving, most often in the knees, hips and hands. There is no cure, but exercise, weight loss and the right pain relief help most people stay active.
General health information for Pakistan. It does not give doses or brand advice. If you are worried, or symptoms are severe, see a doctor. When to see a doctor
Overview
Osteoarthritis (often called OA) is the most common type of arthritis. It affects the whole joint, not only the bones. The smooth cartilage (the slippery layer that covers the ends of the bones) slowly thins and breaks down. The bone underneath gets thicker, and small bony growths called osteophytes can form at the edges. The lining of the joint can also become irritated. These changes make the joint painful, stiff and harder to move.
The knee is the joint most often affected, followed by the hip and the small joints of the hand. The spine can also be involved. Worldwide, more than 500 million people live with osteoarthritis, and the number is rising as people live longer and more people carry extra weight. Most are over 55, and women are affected more often than men. Experts stress that it is not simply a normal part of getting older.
Osteoarthritis is long-lasting, but it does not always get worse, and symptoms can settle for long periods. Doctors usually diagnose it from your symptoms and an examination, without needing an X-ray. The main treatments are regular, tailored exercise and, if needed, weight loss. Pain medicines are added when they help. A joint replacement is considered when the joint is badly damaged and daily life is seriously affected despite other treatment.
In Pakistan
A 2024 survey of 409 adults in Hayatabad, Peshawar found that about 41% reported knee osteoarthritis, with more women affected (56%) than men (31%), and higher rates in people over 40 and those with obesity.
Symptoms
- Joint pain that is worse when you use the joint and eases with rest
- Stiffness after resting, which usually lasts less than 30 minutes in the morning
- Difficulty moving the joint fully, for example bending the knee or turning the hip
- Swelling in or around the joint, often after heavy use
- A grating or crackling feeling or sound when the joint moves (crepitus)
- The joint feeling loose or giving way
- Hard, bony lumps on the finger joints, and a square-looking base of the thumb
- Weak muscles around the joint and poorer balance
- In more advanced disease, pain even at rest or at night
Causes and risk factors
Causes
- The protective cartilage at the ends of the bones breaks down faster than the body can repair it
- Changes in the whole joint, including thickening of the bone underneath and bony growths at the edges
- An earlier joint injury, or using a joint heavily before it has healed
- Another joint disease that damaged the joint first, such as rheumatoid arthritis or gout (called secondary osteoarthritis)
- Extra load on weight-bearing joints such as the knees and hips from excess body weight
What makes it more likely
- Older age, especially over 45
- Being female, particularly after the age of 50
- Being overweight or obese, especially for knee and hip osteoarthritis
- Previous joint injury or repeated strain on a joint from work or sport
- Family history of osteoarthritis
- Other joint diseases such as rheumatoid arthritis or gout
- Metabolic diseases such as diabetes
- Weak muscles around the joint, or already having osteoarthritis in another joint
Complications
Over time, osteoarthritis can change the shape of a joint and make it unstable or out of line. Pain and stiffness can make walking hard, and weak muscles and poor balance raise the risk of falls. Some people struggle with work, housework and daily tasks, and may lose independence. Being less active because of pain can lead to weight gain, heart disease and diabetes. Long-term pain can also disturb sleep, mood and relationships. When the spine is affected, bony growths can press on nerves and cause pain or tingling down an arm or leg (radiculopathy).
When to see a doctor
- A hot, red, swollen joint, especially with fever or feeling unwell, as this can be a joint infection and needs same-day medical care
- Sudden severe joint pain or swelling after a fall or injury, or not being able to put weight on the leg
- Symptoms or joint deformity that get worse quickly over days or weeks
- Morning stiffness lasting much longer than 30 minutes, or several swollen joints, which may point to another type of arthritis
- Joint or bone pain with unexplained weight loss, night sweats or pain that keeps you awake every night
- Pain that is not controlled and stops you doing your normal daily activities
Diagnosis
Most people do not need tests. A doctor can usually diagnose osteoarthritis from your story and an examination if you are 45 or older, your joint pain is linked to activity, and you have no morning stiffness or stiffness that lasts 30 minutes or less. The doctor will check how the joint moves, look for swelling, tenderness, crackling and bony enlargement, and ask how the pain affects your daily life.
X-rays are not routinely needed. They are used when the picture is unusual, for example after a recent injury, with long morning stiffness, a hot swollen joint, or fast-worsening symptoms. X-ray changes, such as narrowing of the joint space and bony growths, often do not match how much pain a person has. Blood tests are usually normal in osteoarthritis and are used mainly to rule out rheumatoid arthritis or other causes. Fluid may be taken from a swollen joint if infection or gout is suspected.
Treatment
- Learn about the condition and agree a plan with your doctor or physiotherapist based on your symptoms and what you want to be able to do
- Start regular, tailored exercise to strengthen the muscles around the joint and improve fitness; pain may rise a little at first but long-term exercise helps
- If you are overweight, lose weight; any weight loss helps, and losing more helps more
- Use a walking stick or other aids if a hip or knee is affected, and wear comfortable, supportive shoes
- For pain, a doctor may first suggest an anti-inflammatory gel (topical NSAID), especially for the knee; if this is not enough, NSAID tablets may be used with a stomach-protecting medicine, at the lowest dose that works and for the shortest time
- A corticosteroid injection into the joint may be offered when other treatments are not working or to help you exercise; the relief is usually short-term
- If pain and stiffness still seriously affect your quality of life, your doctor may refer you to discuss joint replacement surgery, mainly for the hip or knee
Medicines in Pakistan
Medicines a doctor may use, by group. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.
| Group | Role | Medicines |
|---|---|---|
| Topical NSAIDs (anti-inflammatory gels) | first medicine to try for knee osteoarthritis and can be considered for other joints; less effect on the whole body than tablets | Diclofenac (26 brands) |
| Oral NSAIDs | considered when gels do not work or are not suitable; your doctor weighs risks to the stomach, kidneys, liver and heart and decides the dose | Ibuprofen (378 brands), Naproxen (5 brands), Diclofenac (26 brands) |
| Proton pump inhibitors | given alongside NSAID tablets to protect the stomach | Omeprazole (498 brands), Esomeprazole (9 brands) |
| Corticosteroid injections into the joint | given by a doctor when other treatments are not working or to support exercise; relief usually lasts a few weeks | Chosen by your specialist |
| Paracetamol and weak opioids | not used routinely; only for occasional short-term relief when other medicines are unsuitable or have not worked, as the evidence of benefit is weak | Paracetamol (350 brands), Tramadol HCl (2 brands), Paracetamol + Codeine (8 brands) |
Also used (not yet in our price list): Triamcinolone acetonide (joint injection)
Self-care and prevention
Self-care
- Keep moving: do strengthening exercises and some aerobic activity such as walking, cycling or swimming most days
- Aim for a healthy weight to take load off your knees and hips
- Wear comfortable, supportive, flat shoes
- Pace yourself: spread heavy tasks through the day and take regular breaks
- Avoid staying in one position for long; if you sit a lot, get up and move often
- Keep a good posture when sitting, standing and lifting
- Use aids such as a walking stick, rails or raised seats if they make daily tasks easier
- Ask your doctor or pharmacist before using painkillers regularly, especially if you have stomach, kidney or heart problems
Prevention
- Stay physically active, aiming for about 150 minutes of moderate activity each week plus muscle-strengthening exercises on two or more days
- Keep to a healthy body weight
- Protect your joints from injury at work and in sport, and let injuries heal before heavy use
- Avoid overusing joints with excessive repetitive heavy work where you can
Common questions
Is osteoarthritis just a normal part of getting old?
No. It is more common with age, but health agencies say it is not a normal or unavoidable part of ageing. Weight, past injuries, family history and muscle strength all play a part, and many older people have healthy joints.
Will exercise damage my joints further?
No. Regular, suitable exercise is one of the main treatments. It strengthens the muscles that support the joint and usually reduces pain over time. Pain may increase a little when you first start, so build up slowly, ideally with advice from a physiotherapist.
Do glucosamine or other joint supplements help?
UK and WHO guidance says there is no good evidence that glucosamine helps osteoarthritis, so it is not recommended. Joint injections of hyaluronic acid are also not recommended by NICE. Speak to your doctor before spending money on supplements.
Do I need an X-ray to know I have osteoarthritis?
Usually not. If you are 45 or older, your pain comes with activity and morning stiffness is short, a doctor can diagnose it from your symptoms and an examination. X-rays are kept for unusual cases or when another problem is suspected.
Will I need a knee or hip replacement?
Most people manage well with exercise, weight control and pain relief. A joint replacement is considered when symptoms seriously affect your quality of life and other treatments have not helped. Age or weight alone should not stop you being considered.
Sources
- NICE. Osteoarthritis in over 16s: diagnosis and management (NICE guideline NG226) (2022).
- World Health Organization (fact sheet). Osteoarthritis (2023).
- CDC. Osteoarthritis | Arthritis | CDC (2024).
- NHS. Osteoarthritis (2023).
- StatPearls (NCBI Bookshelf). Osteoarthritis (2023).
- Journal of Riphah College of Rehabilitation Sciences. Frequency and Risk Factors of Knee Osteoarthritis (KOA) in Hayatabad Peshawar, Pakistan (2024).
Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.