Emma Glynn
Managing Executive and Senior Physiotherapist at Life Ready Physio + Pilates Camberwell

Osteoarthritis is a degenerative joint disease characterised by the gradual breakdown of cartilage and underlying bone changes (2). The primary causes driving this process are:

• Age: Ageing is the most significant risk factor for osteoarthritis. As people grow older, the natural wear and tear on joints over time contributes to the deterioration of cartilage and subsequent joint pain and stiffness (1).
• Joint trauma and overuse: Previous joint injuries, whether from sports, accidents, or occupational hazards, can predispose individuals to osteoarthritis. Repetitive stress on the joints from activities like very heavy lifting may also accelerate joint degeneration (3).
• Genetic factors: Family history plays a crucial role in osteoarthritis risk. Certain genetic traits may predispose people to abnormalities in joint structure or cartilage composition, increasing susceptibility to the disease (1).
• Weight: Excess body weight places additional strain on weight-bearing joints, such as the knees and hips. Over time, this increased stress can hasten the breakdown of cartilage and contribute to the development of osteoarthritis (1).
• Joint alignment and instability: Structural abnormalities, such as misaligned joints or ligament laxity, can disrupt normal joint mechanics and lead to uneven wear and tear on cartilage, ultimately contributing to osteoarthritis (3).

Risk Factors for Osteoarthritis:

In addition to the underlying causes, several modifiable and non-modifiable risk factors influence the likelihood of developing osteoarthritis:

• Gender: While osteoarthritis affects both men and women, women are more commonly affected, particularly after menopause. Hormonal changes may play a role in this gender disparity (1).
• Occupational hazards: Certain occupations involving repetitive movements or heavy lifting may increase the risk of osteoarthritis, particularly in joints subjected to chronic overuse (4).
• Physical activity level: Regular physical activity is essential for maintaining joint health, but high-impact activities or sports that place excessive stress on the joints may contribute to osteoarthritis development (4).
• Inflammatory conditions: Chronic inflammatory disorders, such as rheumatoid arthritis or gout, can predispose individuals to secondary osteoarthritis by promoting joint inflammation and cartilage damage (5).
• Medication Use: Long-term use of corticosteroids or certain medications may increase the risk of osteoarthritis by promoting bone loss or altering joint metabolism (6).

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REFERENCES

1. He Y, Li Z, Alexander PG, Ocasio-Nieves BD, Yocum L, Lin H, Tuan RS. Pathogenesis of Osteoarthritis: Risk Factors, Regulatory Pathways in Chondrocytes, and Experimental Models. Biology. 2020; 9(8):194. https://doi.org/10.3390/biology9080194
2. Cui, A., Li, H., Wang, D., Zhong, J., Chen, Y., & Lu, H. (2020). Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. eClinicalMedicine, 29, 100587. https://doi.org/10.1016/j.eclinm.2020.100587
3. Li, M., Nie, Y., Zeng, Y., Wu, Y., Wu, L., Liu, Y., & Shen, B. (2022, March 3). Eight-year trajectories of malalignment progression in symptomatic knee osteoarthritis. Chinese Medical Journal. https://doi.org/10.1097/CM9.0000000000002027
4. Wang, X., Perry, T.A., Arden, N., Chen, L., Parsons, C.M., Cooper, C., Gates, L. and Hunter, D.J. (2020), Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Observational Studies. Arthritis Care Res, 72: 1213-1223. https://doi.org/10.1002/acr.24333
5. Knights AJ, Redding SJ, Maerz T. Inflammation in osteoarthritis: the latest progress and ongoing challenges. Curr Opin Rheumatol. 2023 Mar 1;35(2):128-134. doi: 10.1097/BOR.0000000000000923. Epub 2022 Dec 22. PMID: 36695054; PMCID: PMC10821795.
6. Thomas A Perry, Xia Wang, Michael Nevitt, Christina Abdelshaheed, Nigel Arden, David J Hunter, Association between current medication use and progression of radiographic knee osteoarthritis: data from the osteoarthritis initiative, Rheumatology, Volume 60, Issue 10, October 2021, Pages 4624–4632, https://doi.org/10.1093/rheumatology/keab059