Complications of Osteoarthritis

Medically Reviewed by David Zelman, MD on September 10, 2022
Written by Paul Frysh
3 min read

In osteoarthritis, or OA, the smooth, slippery cartilage that covers the ends of your bones, and helps them glide over each other, slowly wears away. This allows the bones to rub and grind on each other.

Age, injury, and repeated motion can play a part in osteoarthritis, but the most common cause is the normal wear and tear of living, especially after age 50. It can happen to any joint, but it’s most common in your hands, knees, hips, and spine.

Osteoarthritis is a chronic condition. There’s no cure for OA. Once cartilage breaks down, it doesn’t grow back in its own. Over time, you can develop other problems, or complications, from living with OA.

The main complication with OA is pain and stiffness in your joints that worsens over time. It’s typically most uncomfortable when you wake up in the morning. You might not be able to move your joints as freely as you could in the past, and you may notice a scraping or crunching feeling when you do. Doctors call this crepitus.

Over time, osteoarthritis makes your joints more stiff, weak, and painful. As a result, you might not be able to do what you did in the past. Just getting around could get a lot harder. You also might find it more difficult to:

  • Grasp household items
  • Bend down
  • Climb up and down stairs

OA can make you more likely to fall and hurt yourself in the course of your daily life. Your doctor can help you come up with a plan to lessen the effect of your symptoms and the risk of falls.

Lack of movement also typically means less exercise, which raises your risk for weight gain, high blood pressure, heart disease, diabetes, and high cholesterol.

Your medical team should be able to help you manage these conditions with medication and changes in diet and exercise habits.

OA pain often makes it tough to sleep. You might wake during the night from the pain or find it harder to fall asleep in the first place.

And the lack of sleep can make your pain seem worse. This raises your risk for depression and may worsen OA symptoms that limit how well you get around.

In addition to treatment for your OA, there are a number of things you could do:

  • Try to go to bed, and wake up, at same time each day.
  • Get sunlight in the morning to keep your sleep cycle on track.
  • Avoid caffeine or alcohol in late afternoon and evening.
  • Keep your bedroom cool, dark, and quiet.
  • Maintain a soothing pre-bedtime routine: hot bath, reading, light stretching.
  • Avoid loud activities or difficult discussions close to bedtime.
  • Exercise earlier in the day.
  • Avoid heavy, fatty foods late at night.

Talk to your doctor about any medications you take that might keep you from getting good sleep.

Possible problems include:

  • Pinched nerve in the spine (acquired spondylolisthesis or spinal stenosis)
  • Infected joint, but this is rare
  • Thinning or tearing of the tendons and ligaments around the joint, which can make the joint unstable
  • Chondrolysis, a sudden, complete breakdown of cartilage that leaves loose tissue in the joint
  • Stress fracture, a hairline crack in the bone that happens slowly due to repeated stress
  • Baker’s cysts, soft fluid-filled lumps behind the knee. They're mostly painless, but they can press on blood vessels and cause leg swelling, or burst and cause pain.

Your doctor can help you treat and manage these OA complications, but the nature of that treatment depends on which you have.

The first step is to manage your OA symptoms with medicines, heat, ice, physical therapy, shots, and joint-supporting devices like braces. Your doctor might also suggest surgery in serious cases or as a last resort.