What Is Mild Osteoarthritis?

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Mild osteoarthritis, or stage 2 osteoarthritis, is the first stage of osteoarthritis where significant changes to the joints become evident on X-ray. The space between joints begins to narrow due to the breakdown of cartilage and the formation of osteophytes, or bone spurs, that form in response to increased pressure and friction within joints, is evident. Joint pain and stiffness are commonly felt in the affected joints with evidence of mild osteoarthritis on X-rays.

x-ray showing mild osteoarthritis of finger joints

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Mild Osteoarthritis Symptoms

The World Health Organization (WHO) adopted the Kellgren-Lawrence classification as the standardized criteria for diagnosing osteoarthritis. The Kellgren-Lawrence classification is the most widely used clinical tool for diagnosing osteoarthritis via radiographic imaging and categorizes osteoarthritis into the following stages:

  • Stage 1 (Minor): Minimal or no joint space narrowing with possible osteophyte formation
  • Stage 2 (Mild): Possible joint space narrowing with definite osteophyte formation
  • Stage 3 (Moderate): Definite joint space narrowing, moderate osteophyte formation, mild sclerosis, and possible deformation of bone ends
  • Stage 4 (Severe): Severe joint space narrowing, large osteophyte formation, marked sclerosis, definite deformation of bone ends

Stage 2 osteoarthritis is the first stage of osteoarthritis where a person begins to experience joint pain and stiffness, especially upon waking in the morning, although the stiffness often lasts less than 30 minutes as joints begin to loosen up as they start moving. Symptoms of mild osteoarthritis are different from those of the minor and moderate stages since these other stages are associated with either significantly more or less joint damage that affects overall level of physical functioning differently.

Minor osteoarthritis, or stage 1 osteoarthritis, is the very beginning of the development of osteoarthritis and is associated with little to no pain. Many people are unaware that they have stage 1 arthritic changes to a joint unless they have X-rays of a joint taken for some other reason, such as diagnostic imaging to check for bone fractures. If there are any symptoms of minor osteoarthritis present, they typically only include minor discomfort within joints that does not interfere with or limit your ability to perform daily activities.

Moderate osteoarthritis, or stage 3 osteoarthritis, is a more significant progression of cartilage degradation from mild osteoarthritis that results in increased joint pain and stiffness. Pain and stiffness increase after periods of rest, such as prolonged sitting, but also worsen with activity, especially in the hips and knees with weight-bearing positions and movements, such as standing, walking, squatting, and going up and down stairs.

The Kellgren-Lawrence classification is used to diagnose osteoarthritis in the joints of the body that are most commonly affected by arthritis, including:

  • Carpometacarpal joint (CMC) of the thumb
  • Cervical spine (neck)
  • Distal interphalangeal joints (DIP) of the fingers
  • Hips
  • Knees
  • Lumbar spine (lower back)
  • Metacarpophalangeal joints (MCP) of the hands
  • Wrist

Causes

Mild osteoarthritis often develops from age-related wear and tear in joints that occurs over time. Anyone who repetitively overuses their joints, including athletes, military personnel, and those with physically demanding jobs, may also be at an increased risk for developing osteoarthritis.

Risk factors that increase the likelihood of mild osteoarthritis or progressing symptoms include:

  • Older age
  • Genetics
  • Obesity
  • History of trauma or joint injury
  • Low levels of physical activity

Diagnosis 

Mild osteoarthritis, or stage 2 osteoarthritis, is distinguished from the other stages of osteoarthritis by the extent of joint damage observed through X-ray. In this stage, observable joint damage becomes evident as joint spaces begin to narrow from cartilage degradation. Cartilage lines the ends of bones between joints and provides protective cushioning and shock absorption. As cartilage begins to break down and wear away, the space within joints decreases. This causes increased friction between bones, which can also lead to the development of abnormal bony outgrowths called bone spurs.

Minor osteoarthritis, or stage 1 osteoarthritis, exhibits very little evidence of joint destruction. In this stage, there is usually no narrowing of the joint space due to relatively intact cartilage, although small bone spurs may be in the beginning stages of development. Moderate osteoarthritis, or stage 3 osteoarthritis, on the other hand, is characterized by significant changes to the integrity of the affected joints. In this stage, joint space is significantly narrowed due to cartilage breakdown. Larger bone spurs are prominent, and bone deformation and sclerosis, or abnormal thickening of the ends of bones, start to occur as joint damage progresses.

Severe osteoarthritis, or stage 4 osteoarthritis, is the highest level of progression of osteoarthritis with severe joint space narrowing, large osteophyte formation, and significant bone deformation and sclerosis. Joint degradation is severe and surgical management, including joint replacement, called arthroplasty, or joint fusion, called arthrodesis, is often indicated to manage severity of symptoms.

Treatment

A variety of different treatment methods exist to manage symptoms of mild osteoarthritis. Based on clinical research, the American College of Rheumatology strongly recommends the following interventions for managing symptoms:

  • Exercise and physical therapy to improve joint mobility, range of motion, and strength of surrounding muscles for joint support
  • Weight loss to decrease pressure and strain on arthritic joints, especially weight-bearing joints like the hips and knee
  • Self-management principles to modify activity to lessen strain on painful joints

Besides lifestyle changes, your doctor may also recommend medications and devices to help you cope with osteoarthritis symptoms:

  • Knee and thumb braces to support painful joints to lessen discomfort with everyday activities
  • Oral non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief
  • Topical NSAIDs to decrease pain signals, especially from osteoarthritis of the hands and knees
  • Cortisone injections within joints to decrease inflammation

Prognosis

Osteoarthritis is a progressive condition that can slowly get worse over time if left untreated. While there is currently no cure for osteoarthritis, treatment can help manage symptoms and slow progression and joint degeneration.

If detected and effectively managed early on in the disease process, you can prevent mild osteoarthritis from progressing further to moderate or severe osteoarthritis through lifestyle changes. These include regular exercise to decrease pain and stiffness and strengthen surrounding muscles to support arthritic joints, and joint protection strategies to rest inflamed joints and prevent repetitive overuse which can increase joint wear and tear.

A Word From Verywell

Strengthening the muscles around surrounding arthritic joints is essential for decreasing strain on your joints and preventing mild osteoarthritis from progressing to more severe forms of the disease. It is important that you seek medical attention if you have been experiencing joint pain, stiffness, or swelling for more than three months to be diagnosed and manage your symptoms early. With appropriate symptom management and progression prevention, mild osteoarthritis can effectively be treated to allow you to perform all your daily tasks and activities without significant limitations.

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