Understanding Osteoarthritis and Non-Invasive Treatment Options

Osteoarthritis (OA) is more than just a nuisance for the elderly; it's a prevalent joint disorder that significantly diminishes the quality of life for millions globally. The Cleveland Clinic found that more than 80% of adults older than 55 affected by this condition—though only about 60% exhibit noticeable symptom. This makes the impact of OA is both widespread and variable1. Notably, osteoarthritis has not spared celebrities like Kathleen Turner, Shaquille O’Neal, and Camryn Manheim, underscoring its indiscriminate nature and significant impact across diverse populations2. Shaq, the famous 7'1" center of the Los Angelous Lakers, was diagnosed with osteoarthritis in his big toe in the early 2000s. His diagnosis caused him to miss the first 12 games during the 2002-2003 games due to surgery. For this reason, awareness of OA is rising in the United States.

Knee osteoarthritis, in particular, stands out due to its common occurrence. This discussion aims to be your one-stop-shop for everything you need to know about osteoarthritis and effective non-invasive treatments, all conveniently gathered in one place.

Understanding Osteoarthritis

What is osteoarthritis? Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of the bones wears down over time. Osteoarthritis is described by the Mayo Clinic as "the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of the bones wears down over time."3

OA Is Degnerative

At its core, osteoarthritis involves the breakdown of cartilage, the cushioning material at the joint's ends that allows for smooth and pain-free movement. As this cartilage deteriorates, the bones no longer have the protection they need and begin to rub against each other. This friction can lead to pain which many sufferers describe as a persistent, grating ache, often likened to the sensation of bone scraping on bone. This degenerative disease not only affects the elderly but can also occur in younger individuals due to joint injuries or obesity.

OA Deteriorates Cartilage 

Characterized by the gradual deterioration of cartilage, osteoarthritis involves the breakdown of this tough, slippery tissue that typically ensures smooth joint motion. As the cartilage wears away, the bones begin to rub against each other. This bone-on-bone friction can cause varying degrees of pain. Many people describe the pain from osteoarthritis as a sharp ache or a burning sensation that worsens during activity and subsides at rest.

This condition is inherently degenerative, meaning it progressively worsens over time. The loss of cartilage leads to reduced motion in the affected joints, making it challenging to carry out everyday activities. The term "reduced motion" refers to a decrease in the range of movement the joint can achieve, which often leads to stiffness and difficulty in performing movements that were once routine.

By understanding that osteoarthritis is a condition that gradually strips away joint functionality, leading to significant discomfort and mobility issues, we can better appreciate the importance of effective management strategies for those affected.

Causes of Osteoarthritis in the Knee

The knee is particularly susceptible to osteoarthritis for a variety of reasons. As the National Institute of Arthritis and Skin Disease highlights, factors that may make it more likely to develop the disease include aging, being overweight or obese, history of injury or surgery to a joint, overuse from repetitive movements, incorrectly formed joints, and a family history of osteoarthritis4. This diversity in causative factors illustrates the complex nature of knee osteoarthritis. Marcy Bolster, M.D., a rheumatologist at Massachusetts General Hospital, underscores that one of the primary predisposing factors for osteoarthritis include overuse or repetitive motion of joints, prior injury, joint abnormalities, and genetics. She notes that the lifetime risk of developing knee osteoarthritis is nearly 50%, and for hip osteoarthritis, about 25%5. These statistics reflect the widespread impact of osteoarthritis and the importance of addressing its root causes. Allow us to unpack some of the primary causes of OA.

Obesity And OA

Osteoarthritis caused by obesity differs from that caused by aging in several ways. Obesity leads to osteoarthritis primarily through increased mechanical stress on the knee joints. The additional weight adds pressure, accelerating the wear of cartilage. Conversely, aging-related osteoarthritis is more about the natural degradation of joint integrity and the diminishing ability of cartilage to repair itself over time. The biochemical changes in cartilage as one ages contribute to its breakdown, irrespective of weight.

Understanding Age-Related Wear and Tear

Age-related wear and tear on joints is a gradual but inevitable process. As we age, the water content of the cartilage increases, and the protein makeup of cartilage degenerates. Repeated use of the joints over the years irritates and inflames the cartilage, causing joint pain and swelling. This wear and tear reduce the cartilage's effectiveness in acting as a shock absorber, leading to the bones rubbing against each other and ultimately contributing to the symptoms of osteoarthritis.

History of Injury

A history of injury or surgery to a knee joint can significantly increase the risk of developing osteoarthritis in that joint. Injuries such as torn cartilage or ligament damage can destabilize the knee, leading to increased wear on the joint surfaces. The Osteoarthritis Action Alliance examine patients previous injuries as an indicator of OA risk6. Surgeries, even those intended to repair joints, can alter the mechanics of the knee, sometimes leading to uneven stress distribution across the joint surface, which accelerates the degenerative process.

Overuse & Repetitive Movements

Regular engagement in activities that put repetitive stress on the knee joints, such as running, squatting, and jumping, can lead to osteoarthritis. These repetitive movements cause micro-traumas to the joint tissues, which over time can lead to the breakdown of cartilage. Quincy Physical Therapy’s OA Case Study compilation insightfully states, "Major injuries and repetitive stress both seem to cause OA. A person who breaks an ankle is likely to develop OA in that same ankle. Just like any machine, a joint that is damaged and unbalanced wears out faster. People who consistently put heavy stress on the same joint, such as jackhammer operators or baseball pitchers, are more likely to develop OA in that joint."7 Individuals in occupations requiring repetitive knee use, like construction workers or athletes, are particularly prone to developing osteoarthritis. 

Incorrectly Formed Joints

Joints that are incorrectly formed, either due to congenital conditions or as the result of growth abnormalities, are more susceptible to osteoarthritis. These abnormalities can lead to improper alignment of the knee, causing uneven stress and increased wear on the cartilage. Over time, this misalignment can severely compromise the joint's ability to function normally, accelerating the onset of osteoarthritis.

Family History 

Genetics plays a significant role in the development of osteoarthritis. If osteoarthritis runs in the family, there is a higher likelihood of individuals developing the condition. This genetic predisposition can affect how cartilage is formed and maintained, potentially making some individuals more susceptible to joint degeneration than others. Dr. Mercedes Fernández-Moreno states, "It is reasonable to suggest that various genes may influence genetic susceptibility to osteoarthritis."8

Symptoms of OA

Individuals with knee osteoarthritis often experience a gradual worsening of symptoms over time. Some patients share that symptoms of OA are particularly pronounced in the early hours of the morning; others say that symptoms flare up after a long day behind at the office while sitting stationary desk.

According to the Mayo Clinic, osteoarthritis symptoms can include pain during or after joint movement, significant stiffness when waking up or after being inactive, and tenderness around the joint. Patients might also lose the ability to move the joint through its full range of motion, feel a grating sensation during joint use, develop bone spurs around the joint, or experience swelling due to soft tissue inflammation (ibid).


The early stages of OA might involve slight discomfort which can advance to persistent pain. Osteoarthritis (OA) causes pain primarily due to the deterioration of cartilage, which normally acts as a cushion between bones in a joint. As this cartilage wears away, the bones begin to rub directly against each other without the protective shock absorption, leading to inflammation and pain. Additionally, the increased friction can cause micro-tears and lesions in the surrounding tissues, further exacerbating the discomfort associated with OA.


Stiffness in joints affected by OA is often a result of the loss of cartilage and the subsequent changes in joint mechanics. As the smooth surfaces of the cartilage degrade, movement becomes less fluid, causing the joint to feel stiff, especially after periods of inactivity or upon waking. This stiffness can also be due to the thickening of the joint capsule and increased production of joint fluid, which is a natural response to inflammation but restricts easy movement.


Tenderness in osteoarthritis results from inflammation in and around the joint. As the cartilage wears down and the bones come into closer contact, the stress on the joint increases, leading to inflammation of the surrounding tissues. This inflammation sensitizes the nerve endings in the tissue, making the joint painful to touch or pressure, reflecting the body's response to injury and mechanical stress.

Loss of Flexibility

Loss of flexibility in joints afflicted with OA occurs as the range of motion decreases due to the physical and biological changes within the joint. The loss of cartilage, combined with the development of bone spurs and thickening of the joint lining, can physically restrict the movement of the joint. Furthermore, pain and muscle weakness associated with OA can lead to a reluctance to move the joint through its full range, contributing to a decrease in flexibility over time.

Grating Sensation

The grating sensation, or crepitus, associated with OA is caused by the rough surfaces of the bones rubbing together due to the loss of smooth cartilage. This sensation can also occur when fragments of bone or cartilage become loose within the joint, creating a crunching or crackling sound during movement. The presence of these rough surfaces and loose bodies disrupts the joint's normal function, contributing to the characteristic grating noise and feeling.

Bone Spurs

Bone spurs, or osteophytes, form in osteoarthritis as a natural response of the body trying to repair itself. As the cartilage degenerates, the body attempts to stabilize the joint by increasing the bone area, which leads to the formation of these bony projections. However, these spurs can limit joint movement and cause pain by impinging on nerves or rubbing against other bones or soft tissues within the joint.


Swelling in OA is primarily due to inflammation within the joint. As the cartilage breaks down and the bone surfaces rub against each other, the body reacts by increasing the flow of fluid and immune cells to the joint, leading to swelling. This inflammatory response is meant to heal the damage but often results in an increase in joint size, warmth, and further discomfort, impeding normal joint function.

Diagnosing Knee Osteoarthritis

Diagnosing knee osteoarthritis involves multiple steps and cannot be determined through a single test. Here are a few of the primary ways that OA is diagnosed.


According to the National Institute of Arthritis and Skin Disease, "Having images taken of your joint using: X-rays, which can show loss of joint space, bone damage, bone remodeling, and bone spurs" is a crucial part of the diagnostic process." [ibid]

Detailed Medical History

Another common method of diagnosis may include providing a detailed medical history. A detailed medical history helps in understanding the onset and progression of symptoms, which are vital for diagnosing osteoarthritis. It includes discussing previous injuries, existing medical conditions, family history of osteoarthritis, and any medications that might influence joint health.

Joint Health Assessment

Joint health assessments during physical exams focus on detecting tenderness, swelling, reduced range of motion, and any sounds made during joint movement. These assessments provide direct insights into the functional status of the joints and help in identifying signs of osteoarthritis.

MRI Scans

MRI scans are utilized when a more detailed view of the joint's soft tissues is necessary, offering images that show damage to cartilage, ligaments, and tendons around the joints. These scans are particularly helpful in evaluating complex cases where bone structures do not show the full extent of the disease.

Blood Tests And Joint Fluid Samples

Blood tests and joint fluid samples are important for ruling out other conditions that mimic osteoarthritis symptoms, such as rheumatoid arthritis or gout. Analyzing these samples helps ensure that the diagnosis is accurate and that any underlying or co-existing conditions are identified. This helps exclude other causes of joint pain, such as infections or gout.

Non-Invasive Treatment Options

Weight Management

Managing knee osteoarthritis effectively often involves a combination of lifestyle changes and physical therapies. One crucial aspect is weight management through diet and exercise, which reduces stress on the knee joints. Excess body weight puts additional pressure on weight-bearing joints like the knees, accelerating the wear and tear of cartilage. Furthermore, maintaining a healthy weight can help reduce systemic inflammation, a contributor to joint pain. By keeping weight under control, individuals can decrease the severity of symptoms and slow the progression of osteoarthritis.

Physical Therapy

Physical therapy is another cornerstone of non-invasive treatment for knee osteoarthritis. It can include exercises tailored to increase range of motion and flexibility, strengthen muscles around the knee, and improve overall joint function. Specific types of therapy may involve aerobic conditioning, resistance training, and water-based exercises, which are particularly gentle on sore joints. Manual therapy techniques such as massage and joint manipulation can also be beneficial in improving joint mobility and reducing stiffness.

Use of Knee Braces and Exercise

The use of knee braces is a common practice, but it's important to balance this with active therapy. "A knee brace should not typically be used as an excuse to avoid exercise,” Dr. Behr warns. “Unless you are prescribed complete rest by a physician, there is usually a benefit to regular stretching and at least moderate exercise to help strengthen the leg muscles, which in turn helps to support the knee."9

OA Wraps

Among the non-invasive treatment options OA wraps. These specially designed wraps provide targeted compression and support to alleviate knee pain and improve mobility. They work by offloading the pressure from the affected part of the knee, redistributing it more evenly across the joint. This not only helps in reducing pain but also aids in maintaining an active lifestyle, crucial for managing osteoarthritis. OA wraps offer a sustainable and effective way to manage symptoms without the risks associated with long-term medication use.

The Aspen OA Wrap (Our Favorite!)

The Aspen OA Wrap emerges as a notable solution. This innovative brace is designed to alleviate pain and improve mobility, offering a practical alternative to medication and more invasive procedures.

Breathable Material

The Aspen OA Wrap is designed with a breathable material that enhances comfort by allowing air circulation. This feature is particularly valuable in warm climates, where it helps to prevent excessive sweating and discomfort, ensuring the brace remains comfortable even during extended wear.

Adjustable Range of Motion

The brace includes adjustable stops that can be set to customize the range of motion based on the individual's treatment phase. This feature allows for a tailored approach to mobility that progresses with the patient's recovery, helping to protect the knee while fostering healing.

Numbered Hook and Loop Tabs

Equipped with numbered hook and loop tabs, the Aspen OA Wrap simplifies the process of putting on and taking off the brace. This design eliminates the confusion and hassle often associated with adjusting unnumbered braces, ensuring a quick, correct fit every time.

Two-Point Hinge System

The two-point hinge system allows for dual hinge adjustments, promoting even pressure distribution and enhancing comfort. This mechanism is particularly beneficial for people with osteoarthritis, as it reduces stress on the affected joint while supporting natural movement patterns.

An Inspiring Story Of Hope In The Midst of OA

The personal story of Ruth Mann vividly highlights the impact of these symptoms. A viola player for prestigious orchestras such as the RTÉ Concert Orchestra and the BBC Northern Ireland Orchestra, Ruth's career was deeply affected by osteoarthritis in her neck and hips. Her condition escalated to severe pain and immobility, leading to the use of a wheelchair and eventually forcing her retirement at the age of 53. Despite these challenges, Ruth has found new pursuits and passions, like yoga and gardening, which help manage her condition and improve her quality of life.

As we navigate through the complexities of osteoarthritis, it becomes clear that while the condition is indeed degenerative, hope and quality of life can be sustained through informed choices and appropriate interventions. Awareness, early diagnosis, and personalized treatment plans play crucial roles in managing the disease effectively, ensuring that individuals can continue to lead fulfilling lives despite the challenges posed by OA. Ultimately, the journey with osteoarthritis is deeply personal, but with the right support and resources, it can be managed in a way that minimizes pain and maximizes mobility and independence.



    [1] https://my.clevelandclinic.org/health/diseases/5599-osteoarthritis

    [2] https://doctorarthritis.org/blogs/about-arthritis/celebrities-who-have-rheumatoid-arthritis

    [3] https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925

    [4] https://www.niams.nih.gov/health-topics/osteoarthritis/diagnosis-treatment-and-steps-to-take Last reviewed September 2023

    [5] Marcy Bolster, M.D. Rheumatologist and Director of the Rheumatology Fellowship Training Program at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School https://www.youtube.com/watch?v=Rgtl97yO5ec

    [6] https://oaaction.unc.edu/oa-module/case-studies/

    [7] https://quincypt.com/arthritis/

    [8] Fernández-Moreno M, Rego I, Carreira-Garcia V, Blanco FJ. Genetics in osteoarthritis. Curr Genomics. 2008 Dec;9(8):542-7. doi: 10.2174/138920208786847953. PMID: 19516961; PMCID: PMC2694558.

    [9] https://www.piedmont.org/living-real-change/when-are-knee-braces-helpful#:~:text=Knee%20braces%20for%20pain%20relief&text=%E2%80%9CThere%20is%20no%20medical%20research,relief%20is%20an%20unloader%20brace. 

    [10] https://www.advamed.org/patient-stories/barbara-ford-osteoarthritis-knee-pain/#:~:text=Barbara%20Ford,replacement%2C%20Barbara's%20chronic%20pain%20persisted.

    [11] https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/non-surgical-osteoarthritis-treatments-arthritis-f

    [12] https://www.ossur.com/en-ca/bracing-and-supports/motion-lab-clinics/patient-success-stories