Degenerative arthritis is the most common form of arthritis, affecting more than 595 million people worldwide. You may also see it called osteoarthritis or simply “wear and tear” arthritis. It develops when the protective cartilage that cushions the ends of your bones gradually breaks down, eventually leading to pain, stiffness, and loss of mobility in the affected joint. Unlike inflammatory types of arthritis such as rheumatoid arthritis, degenerative arthritis is not caused by the immune system attacking healthy tissue. It results from a combination of aging, mechanical stress, and other factors that wear cartilage down over time.
What Happens Inside the Joint
Cartilage is the smooth, rubbery tissue that lets bones glide against each other during movement. In a healthy joint, cartilage absorbs shock and reduces friction. The cells that maintain cartilage, called chondrocytes, have a naturally slow metabolism and limited ability to repair themselves. That’s a key part of why degenerative arthritis is so difficult to reverse once it starts.
In the earliest stages, the cartilage surface may still look intact, but its internal structure is already changing. The molecular scaffolding that gives cartilage its strength and flexibility begins to break down. Chondrocytes try to compensate by multiplying and producing more structural material, but this repair effort is disorganized and ultimately fails. Instead, the cells begin producing substances that accelerate cartilage destruction rather than repair it. Eventually the chondrocytes die off, and the cartilage thins until it’s completely gone in some areas.
Once cartilage is lost, the bones on either side of the joint rub directly against each other. This causes pain and limits how far you can move the joint. The body responds by thickening the bone just beneath the cartilage surface (a process called sclerosis), forming small bony growths known as bone spurs around the joint edges, and sometimes developing tiny fluid-filled cysts within the bone. The surrounding muscles, tendons, and ligaments can also weaken over time, making the joint less stable.
Where It Develops Most Often
Degenerative arthritis tends to settle in the joints that bear the most weight or get the most repetitive use. The knees and hips are the most commonly affected large joints. In the spine, the discs between vertebrae narrow and bone spurs form along the edges. The hands are frequently involved too, particularly the base of the thumb and the finger joints closest to the fingertips. The big toe is another common site.
This pattern differs noticeably from rheumatoid arthritis, which tends to affect the small joints of the hands and feet symmetrically and can also damage organs beyond the joints. Degenerative arthritis stays local to the affected joint.
Symptoms and How They Progress
Joint damage from degenerative arthritis usually develops gradually over years, though in some people it can worsen quickly. Early on, you might notice stiffness when you wake up or after sitting for a long time. Pain during or after movement is one of the first signals. The joint may feel tender when you press on it, and you might sense a grating or crackling when you use it.
As the condition advances, the joint loses range of motion. You may not be able to bend your knee as far or rotate your hip the way you once could. Swelling from soft tissue inflammation can come and go. Bone spurs, which feel like hard lumps around the joint, may become noticeable. Over time, the joint can lose its normal shape entirely. Muscle weakness around the joint may develop, and in the knee this can cause a buckling sensation. In later stages, pain often becomes more persistent, and for some people it worsens at night.
Major Risk Factors
Age is the single biggest risk factor. As you get older, the cumulative effects of inflammation, muscle loss, and reduced cartilage resilience all add up. About 30% of adults aged 55 and older worldwide are living with osteoarthritis.
Carrying extra weight significantly raises your risk, particularly for knee osteoarthritis. Every additional pound puts extra mechanical stress on weight-bearing joints, and excess body fat also promotes low-grade inflammation throughout the body that can accelerate cartilage breakdown.
Previous joint injuries are a major contributor. People who have torn a ligament in the knee, for example, are substantially more likely to develop osteoarthritis in that same knee years later, even if the injury healed well. Occupations that involve heavy bending, squatting, or other repetitive joint loading also increase risk. Genetics play a role in some types of arthritis, though the hereditary link is more clearly established for inflammatory forms like rheumatoid arthritis than for degenerative arthritis.
How It’s Diagnosed
Doctors diagnose degenerative arthritis based on a combination of your symptoms, a physical exam, and imaging. X-rays are the primary tool, and physicians look for four key features: narrowing of the space between bones (indicating cartilage loss), bone spurs at the joint margins, thickening of the bone beneath the cartilage, and small cyst-like areas within the bone.
Severity is typically graded on a scale from 0 to 4. A grade 0 joint looks normal. Grade 1 shows only questionable changes. By grade 2, bone spurs are clearly visible and the joint space may be starting to narrow. Grade 3 shows definite narrowing with moderate bone spurs and some thickening of the underlying bone. Grade 4, the most severe, involves large bone spurs, significant loss of joint space, and visible deformity of the bone ends. Importantly, the severity on an X-ray doesn’t always match how much pain someone feels. Some people with advanced changes on imaging have mild symptoms, while others with modest changes have significant pain.
How Degenerative Arthritis Differs From Rheumatoid Arthritis
People often confuse these two conditions, but they have different origins and behave differently. Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks the lining of the joints. It tends to affect multiple joints symmetrically, often starts in the small joints of the hands and feet, and can involve other organ systems. It frequently causes pronounced morning stiffness lasting an hour or more.
Degenerative arthritis, by contrast, results from mechanical and biological cartilage breakdown rather than immune system malfunction. It typically affects one or a few joints asymmetrically and stays confined to those joints. Stiffness after rest tends to be briefer, usually easing within 30 minutes. Both conditions involve inflammation, but in degenerative arthritis the inflammation is a secondary consequence of cartilage damage rather than the primary driver.
Exercise and Lifestyle Approaches
Regular physical activity is one of the most effective ways to manage degenerative arthritis. It strengthens the muscles that support and protect joints, keeps joints moving through their full range of motion, reduces pain, and helps manage fatigue. The key is choosing low-impact activities that don’t pound the affected joints.
Walking, cycling (especially stationary or recumbent bikes), swimming, and water aerobics are all joint-friendly options. Aim for about 150 minutes of moderate aerobic exercise per week. Strengthening exercises using resistance bands, light weights, or body weight should be done at least two days a week. Strong muscles around a deteriorating joint act like a brace, absorbing forces that would otherwise go straight to the cartilage and bone. Range-of-motion exercises, where you gently move the joint through its full arc of movement, help combat stiffness. Practices like yoga and tai chi improve balance, lower fall risk, and encourage relaxation, which can help with pain management.
Weight management matters enormously for people with knee or hip involvement. Losing even a modest amount of weight can meaningfully reduce joint stress and slow progression.
When Joint Replacement Becomes an Option
Joint replacement surgery is considered only after conservative approaches have been given a thorough trial and haven’t provided adequate relief. The decision is based on a combination of how much pain you’re experiencing, how limited your daily function has become, and what the imaging shows. Both the European League Against Rheumatism and the U.S. National Institutes of Health consider joint replacement appropriate when a patient has continuous pain that medications can’t adequately control, or when functional limitations are substantial, alongside clear evidence of joint damage on X-rays.
A crucial detail: visible arthritis on an X-ray alone is not enough to warrant surgery. If your joint looks severely arthritic on imaging but you’re managing well day to day, replacement isn’t recommended. The decision hinges on your quality of life. How much the pain and stiffness interfere with work, sleep, walking, and the activities that matter to you is what ultimately tips the balance.