What Are the Four Stages of Osteoarthritis?

Osteoarthritis (OA), or degenerative joint disease, has four stages. The higher the grade indicates more severe signs of OA and the need for surgery.

Osteoarthritis (OA), also called "wear and tear" arthritis or degenerative joint disease, is a common joint disease affecting over 32.5 million US adults. The joints affected with OA are painful—sometimes swollen and sometimes stiff. 

Most people above 60 years have some degree of OA, which is a top cause of disability in older people. However, OA also affects people in their 20s and 30s.

OA occurs in the knees, spine, hips, hand joints, and big toes. In your entire lifetime, you have a 46% chance of OA of the knee and a 25% chance of OA of the hip.

OA is a chronic disease that develops gradually and worsens over time. There is no cure for the disease, but some treatments can slow its progression.

Every joint has a firm material known as the cartilage that cushions the ends of the bone. This helps in reducing friction between the bones in a joint.

Due to aging or a joint injury, the cartilage is more likely to wear and tear. Further deterioration of the cartilage can make the bones rub against each other, giving rise to painful joint movements.

Osteoarthritis (OA) can occur at any age. However, certain things that put you at risk of getting it include the following:

• Older age
• Family history of OA
• Obesity
• Trauma to the joint
• Repeated overuse of the joints over the years
• Joint deformity (Maybe by birth or that has developed over the years)
• Being a woman (More likely to develop OA than men, especially after menopause)
• Weak bones (Osteoporosis)

Osteoarthritis (OA) symptoms can vary greatly among patients. These include:

• Joint pain (While bending and even at rest over time)
• Joint stiffness
• Swelling at the joint
• Crepitus (Cracking noise) with joint movement
• Loss of joint flexibility

The four stages of osteoarthritis (OA) have been graded on the basis of X-ray findings. Higher grades indicate more severe signs of OA and the need for surgery.

• Grade 0 is the stage when the joint is healthy—there are no signs on X-ray.
• Grade 1: Doubtful narrowing of the joint space with possible bone spurs (tiny pointed bony growth)
• Grade 2: Definite bone spurs with possible reduced joint space
• Grade 3: Definite moderate joint space narrowing (at least 50%)
  • Multiple bone spurs present
  • Possible deformity of the bone contour
• Grade 4: Most severe stage of OA
  • Large bone spurs
  • Dramatic reduction in the joint space
  • Definite deformity of the bone contour

The symptoms experienced at each stage may vary from individual to individual. Some people have few symptoms despite the deterioration of their joints. Others experience pain and stiffness that hamper their routine chores.

Delay in the treatment will progress the OA increasing the severity of the symptoms. Hence, it is vital to consult your doctor when you experience frequent joint pain or stiffness.