Osteoarthritis: Symptoms, Causes, and Related Conditions
What is Osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis worldwide. It is a chronic joint condition characterised by changes in cartilage, bone, synovium, and surrounding tissues. Traditionally thought of as a “wear and tear” problem, OA is now understood as a whole-joint disease involving inflammation, mechanical stress, and altered joint biology.
OA most often affects the knees, hips, hands, and spine, but it can occur in any synovial joint. It develops slowly and may cause pain, stiffness, and reduced function over time.
Physiological Processes and Current Theories
Cartilage degeneration: Articular cartilage loses its smooth structure, reducing shock absorption.
Bone remodelling: Subchondral bone thickens, and osteophytes (bony growths) form.
Synovial inflammation: Low-grade synovitis contributes to pain and progression.
Muscle weakness and altered biomechanics: Surrounding muscles weaken, leading to further stress on joints.
Central sensitisation: In some people, pain becomes disproportionate to the structural changes visible on imaging.
Systemic factors: Obesity, metabolic syndrome, and inflammatory processes contribute to onset and severity.
OA is not just “cartilage wearing out.” It is an interaction of mechanical loading, joint biology, and nervous system sensitisation.
Common Symptoms
Joint pain, often activity-related at first and later more persistent
Morning stiffness or stiffness after rest (usually under 30 minutes)
Reduced range of motion
Swelling or bony enlargement of joints
Joint crepitus (crackling sensation with movement)
Less Common Symptoms
Joint instability or “giving way”
Muscle weakness around affected joints
Night pain disrupting sleep (in more advanced cases)
Comorbidities and Associated Conditions
People with OA often have overlapping conditions, including:
Obesity and metabolic syndrome, which increase systemic inflammation
Cardiovascular disease, partly due to reduced mobility
Depression and anxiety, related to pain and loss of independence
Other musculoskeletal conditions, such as low back pain or tendinopathies
Diagnosis in 2025
OA is diagnosed clinically, supported by imaging when necessary. Diagnosis is based on:
Symptoms of joint pain and stiffness
Physical findings of crepitus, restricted movement, or bony changes
X-ray evidence of joint space narrowing, osteophytes, or bone sclerosis
Importantly, imaging findings do not always match symptoms. Many people have X-ray changes without pain, while others experience significant pain with only mild radiographic evidence. This mismatch highlights the role of pain sensitisation and whole-body factors.
Current State of Knowledge
In 2025, osteoarthritis is recognised as a multifactorial condition, not an inevitable result of ageing. Current research highlights:
Exercise and weight management as first-line treatments, supported by high-level evidence
The role of low-grade inflammation in progression
Pain neuroscience concepts, showing that central sensitisation plays a role in symptom severity
Lifestyle interventions — sleep, diet, and stress regulation — as important contributors to outcomes
The value of non-surgical management for most patients, with joint replacement reserved for severe cases
If you are living with osteoarthritis in Cork and want to learn about effective, evidence-based treatment options, read more about osteoarthritis treatment and rehabilitation here.
Osteoarthritis Treatment and Rehabilitation in Cork
International Standards of Care
Osteoarthritis (OA) is a chronic joint condition, but international guidelines (NICE 2022, OARSI 2023, EULAR 2023) are clear: exercise therapy is the single most effective non-surgical treatment. Medication and injections may reduce symptoms in the short term, but long-term results come from staying active and building capacity.
The pillars of evidence-based OA management are:
Structured exercise and physiotherapy
Education and pacing strategies
Lifestyle measures, such as weight management and sleep regulation
Pain relief when needed
Joint replacement as a last resort
Medical Management
Doctors may prescribe:
NSAIDs or analgesics to help control flare-ups
Topical anti-inflammatories for hand and knee OA
Steroid injections for temporary relief in acute phases
Surgery in severe cases where conservative care fails
These measures can help, but they do not change the course of the disease. Exercise therapy does.
Exercise and Physiotherapy: The Gold Standard
Research consistently shows that graded exercise reduces pain, improves mobility, and enhances quality of life in osteoarthritis. Exercise therapy is as effective as medication in the short term and superior in the long term, without side effects.
Why it works:
Muscle strength supports joints and reduces load.
Mobility exercises maintain range and prevent stiffness.
Cartilage health improves through synovial fluid circulation during movement.
Nervous system desensitisation: exercise changes how pain signals are processed.
Confidence and independence: movement reduces fear and restores trust in the body.
The key is how it’s done. Going too hard can flare symptoms. Doing too little accelerates stiffness and decline. That’s why graded exercise with pacing is essential.
A specialised physiotherapist can help you:
Find the right entry point for exercise, tailored to your pain and mobility
Progress gradually with strength, mobility, and balance training
Incorporate low-impact aerobic work like cycling or walking to support joint and cardiovascular health
Use pacing strategies so activity is sustainable without flare-ups
Stay consistent — which is where the real gains come from
Therapists trained in OA rehabilitation achieve excellent results. Patients often report they move more freely, have less pain, and feel younger in their bodies simply by learning how to exercise the right way.
Somatic and Mind–Body Approaches
While exercise is central, nervous system regulation also matters. Many people with OA develop protective, stiff ways of moving that worsen pain. Somatic and mind–body approaches help undo these patterns.
Yoga therapy improves strength, flexibility, and balance in a low-impact way.
Feldenkrais and somatic work restore smoother movement, reducing unnecessary joint strain.
Breathwork and guided relaxation reduce background tension and pain sensitivity.
Mindfulness practices improve body awareness and reduce fear of movement.
These methods complement exercise therapy, making it easier to stay active and mobile.
Lifestyle and Psychological Support
Education: Understanding that exercise is safe and beneficial changes behaviour.
Nutrition and weight management: Reducing load on joints slows progression.
Sleep regulation: Better sleep improves energy and pain tolerance.
CBT or ACT: Psychological strategies help maintain motivation and reduce distress.
Rehabilitation at Neurokinetica
At Neurokinetica, we see osteoarthritis every day. It is not just about cartilage or X-rays. It is about the knee that makes stairs a daily challenge, the hip that stiffens after sitting, or the fear that mobility will keep slipping away.
We place exercise therapy at the centre of treatment because the evidence is overwhelming — the more you move (safely and progressively), the better you function. Our programmes are designed to:
Build joint stability and muscle strength around affected joints
Restore mobility with graded exercise and pacing
Teach you how to move with confidence, so exercise becomes sustainable, not overwhelming
Integrate yoga-based therapy and somatic practices to keep the nervous system calm and movement fluid
Give you practical strategies so you can continue progressing independently
Our patients often tell us they expected to “wear out” their joints, but instead discovered that movement gave them back their freedom.
Our goal is not short-term pain relief. It is to help you stay mobile, strong, and independent for as long as possible with osteoarthritis.
If you are searching for osteoarthritis treatment in Cork, and want an expert-led programme focused on exercise, pacing, and long-term mobility, book a session to get an assessment and to learn more about our rehabilitation programmes.