What are the risk factors for osteoarthritis?

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OA is a degenerative joint disease that involves the bone, cartilage, ligaments, fat, and tissues lining the joints. It causes cartilage to break down, bones to change shape, and inflammation, leading to pain, swelling, stiffness, and a loss of mobility.

Cartilage is a tissue that covers the ends of bones, providing a cushion between the bones in a joint. Without cartilage, bones can rub against each other as the joint moves.

OA, most often, affects the hands, knees, hips, neck, and lower back.

It affects people of all ages, but it most often occurs in older adults. It can also develop as a result of injury or overuse.

A risk factor is a variable that increases the likelihood of developing a disease.

Some risk factors are modifiable, meaning people have some control over them. Other risk factors are non-modifiable and are not under a person’s control. However, the distinction between modifiable and non-modifiable risk factors is not always clear.

Below are some modifiable and non-modifiable risk factors.

Below are some non-modifiable risk factors for OA.

Age

A person’s chances of developing OA increase as they age. According to the American Association of Neurological Surgeons (AANS), 50% of people over the age of 65 show evidence of OA in at least one joint on their X-rays studies.

Gender

Gender may also affect a person’s chances of developing OA. OA is more common in males aged 50 and younger. However, in people 50 and older, it is more common in females, particularly after menopause. OA of the hands and knees is more common in females than in males.

Genetics

If someone has a family member with OA, they are more likely to develop it themselves. However, it is not inevitable. People with a family history of OA can take preventive measures to lower their risk.

Genetic research points to several genetic traits that can lead to OA, but results are inconclusive and more research is necessary.

Race

According to the CDC, some Asian populations have a lower risk of developing OA than other races.

However, a 2016 study found that only 17.9% of males of Asian heritage experienced symptoms of OA. Comparatively, 22.2% of males who identified as white and 49.4% of those who identified as Native Hawaiians or Pacific Islanders (NHPI) experienced OA symptoms.

The research suggests that obesity among NHPI males is a significant determining factor for developing OA as compared to white and Asian males.

The study found that OA prevalence seemed to increase in females based on their age.

Musculoskeletal abnormalities

When people have malalignment of their bones or joints, they may be more likely to develop OA.

Below are some modifiable risk factors for OA.

Occupational overuse

Injuring or repeatedly stressing a joint may cause OA. It is common in weight-bearing joints, such as the knees.

A 2020 review found that people whose jobs required heavy lifting had an increased risk of OA in their knees and hips. Squatting, knee bending, climbing, and kneeling may also increase the risk.

Sports

Participating in certain sports may play a role in OA. A 2022 review in Sports Medicine and Arthroscopy Review looked at data from 20,288 participants, including both former athletes and non-athletes. 74% of the athletes suffered from premature OA.

The researchers concluded that certain sports, such as soccer, ice hockey, handball, and rugby, were more likely to lead to premature hip and knee OA.

Athletes are more likely to sustain joint injuries that can accelerate OA development.

Joint injury and surgery

Injury to a bone, cartilage, or ligament may lead to OA, although it may not develop until years later.

Surgery on a joint can also damage its structures and increase a person’s likelihood of OA.

Obesity

Being overweight puts an extra strain on a person’s joints and increases their risk of developing OA. The Arthritis Foundation (AF) states that being overweight by 10 pounds adds an extra 15–50 pounds of pressure on the knees.

Being overweight not only puts pressure on joints but can also lead to inflammation. Fat cells produce proteins that can travel around the body, causing inflammation. This explains why people with OA in one joint are likely to develop it in others.

Hand OA is twice as common in people with obesity as it is in people of more moderate weight.

Weak muscles

According to the AF, having weak muscles may increase a person’s risk of OA. If a joint is unsupported by adequate skeletal muscles, it may be prone to injury and changes in alignment, which can lead to OA.

A 2019 review notes that, as people age, their muscle mass tends to decrease and reduce in quality, which may partly explain why the prevalence of OA increases with age.

There is no cure for OA. However, there are ways to help prevent OA from developing and slow the disease’s progression. The AF provides the following recommendations:

• Get at least 150 minutes of moderate to vigorous exercise weekly, including strength training, balance, cardio, and stretching.
• Achieve and maintain a moderate weight.
• Eat foods that may prevent inflammation.
• Control blood sugar, as there is an association between diabetes and OA.
• Protect the joints by avoiding repetitive motions, particularly when doing sports.
• Try to reduce stress.
• Adopt healthy habits, such as getting plenty of sleep, avoiding smoking, and drinking alcohol in moderation.

Read more about what to eat for osteoarthritis here.

Osteoarthritis is a degenerative condition that affects joint tissues and bones. The cartilage that cushions the ends of bones wears away, leading to pain, stiffness, swelling, a reduced range of motion, and joint deformity.

There are various risk factors for OA. Some are modifiable, and others are beyond people’s control. Aging is a major risk factor for OA, as cartilage and other joint structures degrade with time.

People who use repetitive motions in their job or a sport may also have an increased risk of developing OA. The condition is common in weight-bearing joints, such as the knees and hips.

People can reduce their risk of OA by staying physically active, maintaining a moderate weight, getting plenty of sleep, and eating a healthy, balanced diet.