What are the 4 Stages of Osteoarthritis?

Sketch a life, where every step you take is uncomfortable and painful. Where doing even the smallest basic task becomes challenging. This is the reality of millions of people struggling with osteoarthritis. But in this struggling phase, knowledge is power. 

I am here to give you an in-depth knowledge about what are the 4 stages of osteoarthritis and it’s management with prior know-how of the disease and early detection. 

Remember! osteoarthritis can be fatal. So, if you ever notice any symptoms, you must consult a healthcare advisor. You can also consider our best rheumatologist in NJ for your bone health-related query. 

Osteoarthritis: Introduction

Osteoarthritis is a slow-growing joint disorder characterized by pain, stiffness, and immobility. It not only affects the joints but also the surrounding soft tissues. Common sites include the hip, knee, and thumb joints (CMC, MP and IP) 

What are the 4 Stages of Osteoarthritis?

Osteoarthritis is a common disorder, occurring at any age. Each stage of osteoarthritis affects the joint in different ways. According to Emedicinehealth, the 4 distinct stages of osteoarthritis includes, 

4 Stages of Osteoarthritis

Stage 1: Early Osteoarthritis

Early osteoarthritis is the first stage of joint degradation. 

 In early osteoarthritis, the cartilage layer of the joints starts to break down causing stiffness, and pain. This stage causes minor deformity in bone structure. However, physical activity is not affected. 


Early osteoarthritis can show various symptoms which may include, 

  • Joint immobility 
  • Joint pain 
  • Stiffness of affected joint, even after mild activity 
  • Joint discomfort 

Joint changes

Early osteoarthritis causes minor changes in the affected joints including: 

  • Formation of outgrowth around the affected joint called bony spur/osteophytes 
  • The cartilage of joints loses its flexibility and becomes more prone to damage. 

4 Stages of Osteoarthritis

If you have been diagnosed with Ist stage of osteoarthritis, following prevention strategies may be opted to slow down the symptoms: 

  • Exercise Mild physical movements such as walking, swimming, or stretching is mandatory to maintain joint mobility. 
  • Weight Management If you are obese, losing weight can help manage the symptoms. As being overweight stresses the joints causing stiffness and pain. 
  • Pain relievers In case of joint pain non-steroidal anti-inflammatory drugs (NSAIDS) are recommended. causing a reduction in the pain and inflammation of the joints. 
  • Physio-therapy Physiotherapy sessions to restore joint movements are recommended. 
  • Lifestyle adaptations Avoid smoking, and limit the use of alcohol. A healthy balanced diet, rich in vitamins and minerals is recommended to retain joint health. 

Stage 2: Moderate Osteoarthritis

Moderate osteoarthritis is the second stage of osteoarthritis. It is a progression of the early stage of osteoarthritis where symptoms are mildly aggravated. The initiation of pain and swelling interfere with overall physical activity of a person. 


Some of the commonly noticed symptoms of moderate osteoarthritis include: 

  • Significant decrease in joint motion 
  • Increased joint pain 
  • Increased swelling of affected joints 
  • Loss of joint flexibility 

Joint Changes

If you have moderate osteoarthritis, you may experience changes in the joints which include, 

  • The protective cartilage layer of joints wears off. It leads to increased friction in the joints. 
  • The bony spurs (osteophytes) enlarge with time. 
  • Excessive production of synovial fluid, Which leads to joint inflammation. 

4 Stages of Osteoarthritis

During moderate osteoarthritis, the disease has progressed to a limit. However, you can still manage the symptoms using prevention strategies like: 

  • Physical therapy is the key factor in managing osteoarthritis symptoms. Must involve yourself in physical activities to keep your joints intact. 
  • Pain management If inflammation and pain persists for a long period, over-the-counter medications are recommended by your healthcare advisor. 
  • Supportive devices You can also use canes and braces to reduce stress on the joints while in motion. 
  • Viscosupplementation injections Hyaluronic acid injections improve the lubrication of joints and reduce friction. 
  • Lifestyle changes Adopting a healthy lifestyle including a balanced diet are recommended. Good sleep is essential and stress management practices for good joint health is recommended. 

Stage 3: Severe Osteoarthritis

Severe osteoarthritis is the third stage of osteoarthritis. It is characterized by chronic inflammation in the affected joints, which further leads to excessive pain and tenderness in the joints. It affects the physical activity to a great extent. 


The third stage of osteoarthritis gives rise to symptoms which may include: 

  • Cartilage loss In severe osteoarthritis, the cartilage layer of joints is moderately destroyed, causing joint friction and moderate immobility. 
  • Joint Instability With the loss of cartilage, the joints become weak and cannot bear the weight of the body. Hence, the risk of falls or injury increases. 
  • Impacts on daily life The pain associated with severe osteoarthritis affects a person’s quality of life. A person becomes unable to do even basic chores like walking. 

4 Stages of Osteoarthritis

Severe osteoarthritis causes excessive damage to the joints. A proper management plan to deal with this stage is hence necessary. 

  • Weight management is the most crucial step in managing osteoarthritis. Excess weight causes a burden on the joints causing reduced mobility. 
  • Physical Therapy If you can’t do the physical activity by yourself. You can hire a physiotherapist. 
  • Medications Take proper medications as prescribed by the healthcare advisor. 
  • Assistive devices Use assistive devices like braces, crutches, and canes to support your balance. It also reduces stress on joints. 
  • Surgical procedures If physical treatment is ineffective. You can go for surgical treatments such as joint replacement surgery, which reduces pain and improves joint health. 

Stage 4: End-Stage Osteoarthritis

The final stage of osteoarthritis is end-stage osteoarthritis. It causes severe chronic inflammation and irreversible damage to the joints, which leads to permanent loss of physical activity. 


End-stage osteoarthritis deteriorates joints completely and shows severe symptoms which may include, 

  • Complete cartilage loss End-stage osteoarthritis destroys the cartilage layer of joints. It greatly reduces the lubrication of joints and increases friction. 
  • Permanent immobility The complete loss of cartilage significantly affects joints movements and causes permanent immobility. 
  • Joint deformities In end stage Osteoarthritis, joint deformity occurs due to excessive damage and structural changes, affecting joint alignment in most cases.  
  • Chronic pain Continuous pain is the permanent companion of end-stage osteoarthritis. However, certain medications are available to temporarily reduce the pain. 
  • Dependency on others The final stage of osteoarthritis makes a person dependent on others. A person needs assistance for small tasks like walking or even bathing. 
  • Bone spurs The formation of outgrowth around joints contributes to pain and joint impairment. 

4 Stages of Osteoarthritis

End-stage osteoarthritis causes irreversible damage to the joints, manageable by medications and surgical procedures. 

  • Medications Abrasive pain-relieving medications such as opioids are prescribed to individuals with end-stage osteoarthritis. However, most consult proper medical guidance before taking any medications. 
  • Joint injections If pain persists for a long time, doctors use intra-articular injections containing corticosteroids or hyaluronic to temporarily relieve the pain. 
  • Palliative care If you are not willing to surgical treatments, palliative care can help manage symptoms of osteoarthritis. 
  • Joint replacement When no physical treatment helps in providing relief, arthroplasty is recommended. In joint replacement surgery, the doctor replaces the damaged joint with an artificial joint made of biomaterial. Which works exactly like a normal joint. 

How are the 4 Stages of Osteoarthritis Diagnosed?

Understanding, what are the 4 stages of Osteoarthritis is crucial for the timely detection of osteoarthritis. The diagnostic techniques available to detect stages of osteoarthritis as stated by the Centers for Disease Control and Prevention include, 

  • Physical check-up: The healthcare advisor will thoroughly study your symptoms. It includes assessment of swelling in joints, or cause of low mobility. 
  • Imaging techniques: X-Ray and magnetic resonance imaging (MRI) are the most widely used techniques for the identification of osteoarthritis. Using this technique you can visualize joint damage or formation of bone spurs. 
  • Knowing the patient’s history is important in the early detection of osteoarthritis. So, the doctor can assess the symptoms. Know how they started, and their progression throughout time 

Stages of Osteoarthritis in Various Body Parts

Osteoarthritis can occur in any part of the body. According to National Institute on Aging, osteoarthritis can be seen in the hands, knees, spine, hip, and weight-bearing joints of the body. The 4 stages of osteoarthritis in different body parts are listed below. 

What are the 4 stages of osteoarthritis in the hands?

  • Stage 1: Minor damage of the joint or bone spur formation. 
  • Stage 2: Initiation of pain and stiffness of joints. 
  • Stage 3: Loss of cartilage which leads to friction between two joints. 
  • Stage 4: Severe pain, complete joint damage, and loss of hands movement occur. 

What are the 4 stages of osteoarthritis in the spine?

  • Stage 1: Minor cartilage damage. 
  • Stage 2: Change in disc space with mild pain and stiffness of spine. 
  • Stage 3: Moderate pain along with the spine compression. 
  • Stage 4: Severe pain and loss of spine function. 

What are the 4 stages of osteoarthritis knee?

  • Stage 1: Minor cartilage destruction that causes discomfort. 
  • Stage 2: Initiation of ache and tenderness around the knee joint. 
  • Stage 3: Significant cartilage loss and decreased knee flexibility. 
  • Stage 4: Strong feeling of ache, loss of cartilage, increased joint friction, and loss of knee movement. 

What are the 4 stages of osteoarthritis in the shoulder?

  • Stage 1: Mild pain with shoulder movement. 
  • Stage 2: Moderate pain and formation of bone spurs. 
  • Stage 3: Cartilage loss and reduced shoulder movement. 
  • Stage 4: Severe pain, shoulder joint destruction, and loss of shoulder movement. 

How SNS Rheumatology can Help you with Osteoarthritis?

If you want assistance related to your bone health, feel free to contact sns rheumatology. We are here for you, our specialized team of rheumatologists can guide you thoroughly about your bone health-related concern and its proper treatment. 


Knowing, what are the 4 stages of osteoarthritis is important to detect it at early stages. 

Once you get to know about one of the stages of osteoarthritis you are at. Must reach out to a healthcare advisor. So, he can do early disease management and treatment to prevent future outcomes. 

Take Action Now!

Schedule an Appointment with SNS Rheumatology.

Dr. Qaisar Usmani

Meet Dr. Qaisar Usmani, a Board Certified Rheumatologist with over 20 years of experience in the field, currently serving as Section Chief at Monmouth Medical Center and GPHA, Inc. in Pennsylvania, specializing in the treatment of various Rheumatic and Musculoskeletal diseases.

Dr. Sadia Ghafoor
Dr. Sadia Ghafoor

Meet Dr. Sadia Ghafoor, a board certified specialist in rheumatology who completed her medical training at the University of Medicine and Dentistry School of Osteopathic Medicine and her fellowship in rheumatology at the State University of New York Stony Brook campus, with additional board certification in internal medicine.

Subscribe to our Newsletter

Don’t miss our future updates!
Get Subscribed Today!

Schedule an Appointment