Complications Associated With Osteoarthritis

Sleep Disruption, Depression, Anxiety, Disability, and More

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Osteoarthritis (OA) is a form of arthritis that eventually results in joint damage. OA is a degenerative condition, which means it gets worse with age. Without proper treatment, OA can lead to complications—some of which can be serious and life-altering.

OA is the most common form of arthritis. It is sometimes called wear-and-tear arthritis because it causes the cushion between bones—called cartilage—to break down, eventually causing pain, stiffness, and reduced mobility (the ability to move around freely and easily). OA can affect any joint, but it most often affects the hands, knees, hips, neck, and low back. OA can happen to anyone regardless of age or gender, but it mostly affects older adults.

Here is what you need to know about complications associated with OA and how effective treatment can reduce your risk.

Doctor explaining x-ray report to patient
Luis Alvarez / Getty Images

Common Complications

For most people living with OA, chronic joint pain is the most common symptom of the disease. and living with it can be exhausting and debilitating. In fact, according to the Centers for Disease Control and Prevention, 15 million American adults report severe joint pain from living with arthritis.

In addition to causing severe pain, there other ways in which OA can complicate your life.

Sleep Disruption

Painful, tender joints can affect your ability to get a good night’s sleep. Additionally, stiffness and limited range of motion make it harder to get comfortable in bed and actually fall asleep. According to a 2015 report in the journal Arthritis Care & Care Research, up to 77% of people who have knee OA report having sleep problems. Sleep problems in OA may also lead to depressed mood and disability.

Not getting enough sleep could mean more pain because sleep issues and arthritis pain feed off each other. Not only is OA keeping you up, but the low-quality sleep you are getting is causing you to experience more pain.

Reduced Productivity

Research shows OA has a significant impact on a person’s productivity on the job. OA can also force a person to miss more work than their co-workers because of chronic joint pain.

OA also affects you in your personal life by making it hard for you to do everyday tasks, such as:

  • Getting dressed
  • Cleaning your home
  • Cooking
  • Being active
  • Participating in social activities

The good news is OA function can improve with treatment. If treatments aren’t helping or you are still having trouble with simple day-to-day tasks, talk to your healthcare provider to determine whether you need additional or modified treatments.

Anxiety and Depression

Anxiety and depression associated with osteoarthritis can take away your ability to enjoy life.

Depression: When OA pain gets worse, it can make a person feel like nothing in life matters or that life is meaningless. These feelings can lead to depression, and you may experience persistent sadness, feelings of worthlessness, helplessness and hopelessness, and/or physical symptoms, such as fatigue, headaches, muscle pain, and worsening joint and bone pain.

Anxiety: Anxiety disorders cause an overwhelming sense that something could go wrong at any time. Living with a condition like OA leaves you feeling uncertain. That uncertainty causes worry over anything from finances to personal relationships. Some people even experience panic attacks where they feel actual physical symptoms, including a pounding heart and a sense they are going to die. Being limited by OA, a person with anxiety may worry that participating in activities may exacerbate pain or cause them to become injured.

A CDC study reported in 2018 found that adults with arthritis have high rates of depression in comparison to people without the condition. Almost everyone living with chronic pain experiences mood changes, and 22.5% of people with arthritis are living with depression, while another 12.1% experience anxiety, according to the CDC. 

Pain is not the only reason people with OA experience depression and/or anxiety. Arthritis-related limitations and other additional health conditions, such as diabetes or heart disease, also make it harder to cope and contribute to a worsened emotional state. Additionally, depression can worsen OA pain, and anxiety can negatively affect the ways in which you cope and perceive pain.

While the causes of depression and anxiety in people with OA differ from person to person, the connection is real and can result in worse outcomes. It is, therefore, important you work with your healthcare provider to manage OA, but also treat depression and anxiety, so that you can continue to live a full, happy, and active life.


The CDC reports that 8 million working-age adults are limited in their ability to work due to arthritis. OA can lead to a disability that limits a person’s normal movements and activities both on the job and in their personal lives.

The level of disability is determined by an inability to easily or comfortably complete specific tasks. For example, OA can limit the ability to:

  • Climb stairs
  • Walk long distances or perform high-impact physical activity
  • Stand or sit for long periods
  • Grasp small objects in their hands
  • Hold the arms up
  • Lift 10 pounds or more

Your healthcare provider is in the best position to diagnose a specific work disability or functional limitation.

Weight Gain                          

Joint pain, swelling, and stiffness can reduce your ability and desire to be active. These symptoms can stop you from participating in social activities you used to enjoy. They may also limit your ability to walk or exercise, and lack of activity can also lead to weight gain. Extra weight will make OA symptoms worse and increase the risk for other, more serious health conditions, including diabetes, high blood pressure, and heart disease.

Being overweight when you have OA may reduce mobility and initiate a series of events, including “reduced activity, further weight gain, and decreased muscle strength,” which over time leads to joint problems and worsening OA symptoms, according to a review of research.

If you are overweight, talk to your healthcare provider about the ways in which you can get to a healthy weight and reduce OA symptoms and pain.

Serious Complications

In addition to common complications, there are also complications associated with OA that can be serious and life-altering. Fortunately, you can reduce your risk for many of these by working with your healthcare provider and managing OA through healthy lifestyle habits and medications.

Falls and Fractures

OA can lead to a greater risk of falls and fractures. In fact, people with OA experience more falls and fractures than people without the condition. One study reported in 2016 finds the risk for falls increases for people who have significant OA symptoms in their lower limb joints. Further, having OA in a knee or hip is a significant risk factor for falls.

This study of men and women found those who have at least one joint affected by OA were at 53% increased risk for a fall, those with two affected joints had a 74% increased risk, and those with three or more OA affected joints had an 85% higher risk. Additionally, those with symptomatic knee or hip OA had an even higher risk.

OA can affect joint function in the hands, wrists, knees, hips, and the spine. Symptoms in affected areas can lead to balance issues, poor gait, and decreased ability to perform daily tasks. These symptoms also make you more prone to falls and injuries from falls. Having other chronic diseases and taking certain medications (i.e. ones that cause dizziness or affect balance) can also increase your fall risk.

Tendon and Ligament Deterioration

OA causes cartilage in joints to become stiff and lose elasticity, making cartilage more susceptible to injury. Over time, the cartilage wears away in some areas, reducing the cartilage’s ability to act as a shock absorber. As the cartilage deteriorates, tendons and ligaments stretch, causing more pain.

If this process continues, bones eventually start to rub against one another. When OA becomes this severe, a person may experience joint locking (sudden inability to move a joint) or buckling—when a joint (usually a knee) gives out—increasing the risk for falls and injuries.

OA of the Spine

Spine OA may lead to neck or back pain. Pain from spinal OA is usually worse in the morning, after activity, or with sitting for too long. It comes and goes and improves with rest. While rest helps, long periods of inactivity can lead to stiffness, tenderness, and limited mobility.

Sometimes, spinal OA causes bone spurs on the spine called osteophytes. Osteophytes can pinch nerves causing pain, tingling, and/or numbness that radiates into the arms and legs. Osteophytes can also lead to a serious condition called spinal stenosis, where the nerve roots or spinal cord are pinched. Symptoms of spinal stenosis, which include pain, tingling, and numbness, come on gradually and improve with bending forward. Severe symptoms include loss of bladder control, bowel control, or sexual dysfunction.

Spinal stenosis treatment is dependent on the location of the stenosis and the severity of symptoms. Most people experience relief from medication, physical therapy, and corticosteroid injections in the area causing the impingement. Others may need a decompression procedure where part of the thickened ligament in the back of the spinal column is cut to increase spinal column space to remove the source of the impingement. Some others may need more invasive surgical treatment.

Another spine condition related to OA is degenerative disc disease. This condition is a result of aging reducing the space between the discs and causing lower back pain.

Degenerative disc disease can cause weakness, numbness, and shooting pains in the arms and legs. It tends to cause periods of low-level ongoing chronic pain and intermittent episodes of very severe pain. The condition is treatable through a combination of pain management, exercise, physical therapy, and lifestyle modifications. In rare cases, surgery may be needed to correct the problem.

Reducing Risk For OA Complications

There is no cure for OA, but treatment can reduce symptoms and improve joint function. When joint symptoms are managed, a person’s risk for falls and other serious complications of OA is reduced.

You have many options to choose from for managing symptoms of osteoarthritis, among them:

Physical therapy and exercise: Physical therapy can help maintain mobility. Exercise can reduce stiffness and help with weight management, but choose activities carefully: Opt for those that are gentle on joints, such as walking, swimming, biking, or tai chi.

Occupational Therapy: Occupational therapy can teach ways for completing everyday tasks without putting stress on painful joints.Similarly, you can make modifications in your home, such as a bench in your shower if you find it difficult to stand, or use equipment such as a cane.

Medications: There is a wide variety of over-the-counter pain medications that are strongly recommended for easing pain and inflammation of OA. These include oral nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, pain relief medications like acetaminophen, and topical creams, ointments, and medicated patches with active ingredients such as capsaicin and menthol. Your healthcare provider may prescribe stronger pain relievers if OTC options aren't effective.

Injections: Corticosteroids injected directly into a joint can help reduce pain and swelling. A similar treatment for OA, viscosupplementation, involves injecting hyaluronic acid into joints. This gel-like substance occurs naturally in the synovial fluid that surrounds joints, where it serves as a natural lubricant and shock absorber between bones.

However, the American College of Rheumatology and the Arthritis Foundation conditionally recommend against intraarticular hyaluronic acid injections for OA of the knee and first carpometacarpal (base of the thumb) and strongly recommend against this therapy for hip arthritis.Your healthcare provider will have the last word on whether viscosupplementation is appropriate for you.

Surgery: Depending on the severity of OA, your healthcare provider may recommend surgery to repair or replace part or all of a joint. If surgery is needed, joint replacement surgery is the best option, especially in older adults, because they are less likely to need a second replacement. Other procedures can remove the damaged surfaces and replace them with plastic or metal prosthetics.

Alternative therapies: Alternative therapies, such as tai chi, yoga, acupuncture, and different types of water therapy can help improve mobility, reduce stress, and improve your outlook.

A Word From Verywell

Osteoarthritis usually gets worse over time. Left untreated, it can cause profoundly serious and life-altering complications. It is also a major cause of disability in adults.

Talk to your healthcare provider if you find OA is impacting your quality of life. Treatments are available, including pain medications, lifestyle changes, and surgery to replace and repair joints severely affected by OA. Regardless of the treatment options you choose, reducing OA symptoms and pain will improve your function, reduce your risk for complications, and allow you to enjoy a better quality of life.

16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Lana Barhum
Lana Barhum has been a freelance medical writer since 2009. She shares advice on living well with chronic disease.