Early-Onset Osteoarthritis: Symptoms, Causes, and More - Verywell Health

Osteoarthritis is the most common form of arthritis, affecting more than 30 million Americans. While osteoarthritis more commonly occurs at an older age, more than half of Americans affected by osteoarthritis are under the age of 65. Early-onset osteoarthritis can occur at any age under 50 years old more likely to occur in people with certain risk factors.

This article discusses the symptoms and causes of osteoarthritis, as well as treatment options and how to cope with the condition.

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Osteoarthritis Symptoms

Osteoarthritis can affect any joint, although it's most common in the back and spine, hips, knees, neck and shoulders, and fingers and hands.

Am I At Risk of Osteoarthritis?

Anyone who repetitively overuses their joints, including athletes, military personnel, and those with physically demanding jobs, may be at an increased risk of developing early-onset osteoarthritis.

Common symptoms of early-onset osteoarthritis include:

• Pain: Joint pain is the most common symptom of osteoarthritis that results from the breakdown of cartilage within joints. This lack of protective cushioning and shock absorption from cartilage loss causes the end bones to grind against each other with increased friction. 
• Stiffness: Cartilage helps provide cushioning within joints that allows bones to glide smoothly on one another. When cartilage breaks down with osteoarthritis, joints can stiffen up, especially in the morning upon waking or after periods of inactivity. You may feel a sensation of increased pressure in your joints and have difficulty with joint mobility.
• Crepitus: Joint crepitus, a popping, cracking, clicking, or grinding sound that accompanies the movement of a joint, can occur due to increased joint stiffness. You may experience a grating or grinding sensation of the joints every time you move them or larger cracks or pops when moving a stiff joint after a period of inactivity.
• Tenderness: Increased pain and inflammation that results from osteoarthritis can cause tenderness in the soft tissue, such as muscles, tendons, and ligaments surrounding joints. Joint line tenderness at the union of the bones where they join to form a joint is also commonly experienced with osteoarthritis.
• Decreased range of motion: Osteoarthritis can cause a decreased range of motion of joints, making it difficult to fully bend or extend affected body parts due to joint stiffness and pain with movement.

As osteoarthritis progresses, it can lead to increased joint inflammation and disability. With advanced stages of osteoarthritis, you may experience:

• Swelling: Osteoarthritis can cause swelling within joints as a result of joint inflammation that develops due to increased friction between bones from cartilage loss. 
• Weakness: Osteoarthritis can cause weakness in the supporting muscles that surround joints. Because moving arthritic joints can be difficult and painful, people with osteoarthritis often avoid certain activities or movements, which leads to muscle atrophy and weakness from lack of muscle use. If one side of the body is affected by osteoarthritis, people will often compensate by using the other side of their body. This can lead to muscle weakness on the affected side from muscle disuse.
• Difficulty with daily functions: Due to acquired muscle weakness and decreased use of arthritic joints, advanced stages of osteoarthritis can lead to significant disability that impacts daily functioning. This can include activities of daily living that require fine motor movements of the hands or gross motor skills like walking and using the stairs.

According to the Kellgren-Lawrence classification for diagnosing osteoarthritis, joints most commonly affected by osteoarthritis include:

• Carpometacarpal (CMC) joint of the thumb
• Cervical spine (neck)
• Distal interphalangeal (DIP) joint of the fingers
• Hips
• Knees
• Lumbar spine (lower back)
• Metacarpophalangeal (MCP) joints of the hands
• Wrist

Causes

Early-onset osteoarthritis often develops from wear and tear on joints that occurs over time, although certain risk factors increase the likelihood of developing osteoarthritis. These include:

• History of trauma or joint injury: Direct injury to joints, especially meniscus and ACL tears of the knee, can significantly increase your risk of developing osteoarthritis within 10 to 20 years after the injury.
• Being overweight: Excess body weight places increased loading and pressure at joints, especially the knees and hips. Without adequate muscle strength to support the joints, being overweight can accelerate the development of osteoarthritis. Excess fat cells are hormonally active cells that increase inflammation throughout the body, contributing to osteoarthritis as well.
• Joint malalignment: Malaligned joints can cause unequally distributed loading and friction within joints, which can accelerate joint degradation and cartilage loss.
• Genetics: Certain genetic factors can be inherited and increase the risk of developing osteoarthritis.
• Sex: Women are more likely than men to develop osteoarthritis and have more joint pain. This difference is typically seen after menopause due to changing levels of the hormone estrogen and its protective effects on bones.

Diagnosis 

To diagnose osteoarthritis, you'll first want to schedule a visit with your primary healthcare provider to discuss your symptoms, medical history, the medications you use, and any other medical concerns.

Preventing Joint Damage

An early diagnosis of osteoarthritis can delay the progression of the disease and promote quality of life.

Your healthcare provider will conduct a physical examination to assess your joint mobility, strength, and range of motion and check for joint or soft tissue tenderness.

Typically, an X-ray of the joints in which you're experiencing symptoms is the standard for diagnosing osteoarthritis. When the space between joints is shown to be decreased on X-ray images, it indicates joint space narrowing from cartilage degradation.

Besides X-rays, your healthcare provider may also perform the following tests to make a diagnosis:

• Joint aspiration: After numbing the area, your healthcare provider will insert a needle into the affected joint to remove synovial fluid (joint fluid). This test can detect infection, red and white blood cell counts, and whether crystals are present in the fluid. The results can help rule out other medical conditions or forms of arthritis.
• MRI: Magnetic resonance imaging (MRI) gives a better view of the cartilage and soft tissue within and surrounding a joint to assess for damage.

The earlier a diagnosis is made, the sooner you can begin treatment to prevent worsening of your osteoarthritis. This can help you to avoid more significant and permanent joint damage. 

Treatment

Early diagnosis and proper treatment of early-onset osteoarthritis are key to preventing or minimizing permanent joint damage.

Treatment options for managing symptoms of early-onset arthritis and preventing disease progression include:

• Rest: Resting your arthritic joints by limiting activity and avoiding repetitive movements can help ease pain and inflammation. 
• Immobilization: Wearing a hand splint to immobilize the finger joints can reduce pain and inflammation in arthritis of the hands and fingers, especially if it's aggravated by activity.
• Heat: Heat therapy is best used for chronic arthritis to help loosen and relax tight muscles and stiff joints.
• Ice: Applying ice to arthritic joints can help relieve pain and inflammation, especially if swelling is present.
• Medication: Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help with symptoms and pain.
• Topical pain relievers: OTC creams and ointments can be applied topically to joints to help relieve pain.
• Paraffin: Warm paraffin wax application to the hands and fingers can help decrease arthritis pain and joint stiffness.
• Exercises: Stretches and exercises can help ease pain, improve range of motion and joint mobility, and increase the strength of the muscles surrounding your joints.
• Prescription medication: Higher-strength medications may be prescribed to reduce pain and inflammation.
• Physical or occupational therapy: Your healthcare provider may refer you to physical or occupational therapy to improve the mobility of your joints, increase the strength and flexibility of surrounding muscles, and apply therapeutic modalities to alleviate pain, stiffness, and swelling.
• Corticosteroid injections: Your healthcare provider may suggest administering a corticosteroid injection into your arthritic joints to help decrease inflammation and relieve pain if other methods aren't effective at improving symptoms.
• Surgery: Surgery is used as a last resort to manage severe arthritis when other methods have failed to relieve symptoms. Arthroscopies, commonly called "scopes," may be used to debride joints and remove torn pieces of cartilage. When severe arthritis has significantly worn away cartilage, especially in the hips, knees, or shoulders, joint replacement surgery may be considered to reduce pain and improve your overall level of physical functioning.
• Supplements: Certain dietary supplements can help support healthy cartilage cells to protect the knee joint from wear and tear. Glucosamine and chondroitin can help repair damaged cartilage in the hip joint and prevent enzymes from further breaking down cartilage. Vitamin D3 is also important for maintaining good bone health and supporting immune system functioning to decrease inflammation throughout the body.

How to Cope With Early-Onset Osteoarthritis

In addition to the above treatment options, maintaining healthy lifestyle habits can help manage your osteoarthritis by decreasing inflammation throughout your body and promoting a healthy environment for healing.

Tips for a healthy lifestyle include:

• Prioritizing getting at least seven to eight hours of sleep each night to promote healing
• Eating a healthy diet
• Maintaining a healthy weight
• Staying adequately hydrated
• Staying active and following an exercise program as prescribed by a physical therapist
• Maintaining a positive attitude and learning how to cope with and manage stress
• Having a supportive social support system of family and friends

Summary

Osteoarthritis is the most common form of arthritis. Early-onset osteoarthritis can occur at any age under 50 years old and is more likely to occur in people with certain risk factors. Osteoarthritis is a progressive condition that can worsen over time if left untreated. Early diagnosis and treatment are key to slowing disease progression and promoting quality of life.

Osteoarthritis can affect any joint, although it's most common in the back and spine, hips, knees, neck and shoulders, and fingers and hands. Treatment for the condition includes rest, natural remedies like supplements and physical therapy, OTC medications, and prescription drugs or surgery when necessary.

It's also important to keep a healthy lifestyle. Having a strong support network of friends and family can also help you manage your condition and improve your overall quality of life.

A Word From Verywell 

There's currently no known cure for osteoarthritis, but treatment can help manage symptoms and slow disease progression.

If you've been experiencing chronic joint pain, stiffness, decreased mobility, or swelling for more than three months, it's important to see a healthcare provider and address your symptoms.

Detecting and effectively managing your early-onset osteoarthritis early on in the disease process can prevent it from progressing further.

Frequently Asked Questions

• The World Health Organization (WHO) adopted the Kellgren-Lawrence classification as the standardized criteria for diagnosing osteoarthritis. The Kellgren-Lawrence classification is the most widely used clinical tool for diagnosing osteoarthritis and categorizes osteoarthritis into the following stages:

  • Stage one (minor): Minimal or no joint space narrowing with possible bone spurs
  • Stage two (mild): Possible joint space narrowing with definite osteophyte formation
  • Stage three (moderate): Definite joint space narrowing, moderate osteophyte formation, mild sclerosis, and possible deformation of bone ends
  • Stage four (severe): Severe joint space narrowing, large osteophyte formation, marked sclerosis, definite deformation of bone ends

• Early-onset osteoarthritis can be diagnosed at any age under 50 years old.

• The main causes of early-onset osteoarthritis include a history of joint trauma or injury, being overweight, and joint malalignment.

• While early-onset osteoarthritis isn't reversible, joint protection strategies and strengthening exercises can help decrease symptoms and prevent progression and worsening of joint damage.

• In progressive stages of osteoarthritis, any weight-bearing activity, such as standing and walking, can increase pain in arthritic hips and knees. Walking, however, is important and shouldn't be avoided. Exercises that work to strengthen the supporting muscles of the hip and knees should be performed to help decrease pressure within joints, make walking more comfortable, and prevent the worsening of osteoarthritis symptoms.

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