Is Osteoarthritis Onset of Symptoms Always Gradual?

The onset of osteoarthritis symptoms is typically described as being gradual. Symptoms usually develop or worsen over time rather than suddenly. But is this always the case?

Arthritic hands
Cristina Pedrazzini / Science Photo Library / Getty Images

Typical Onset of Symptoms

The typical osteoarthritis patient is middle-aged and has symptoms that develop over time. Hips and knees are the most common sites for osteoarthritis to develop. The symptoms of osteoarthritis can include:

  • Joint pain: The joint affected by osteoarthritis hurts. This can be experienced when you are using the joint, when you are standing or moving and putting weight on the joint, or even when you are at rest.
  • Joint stiffness: You feel like it is more difficult to move the joint, and it seems not to want to move fast.
  • Joint tenderness: When you press on the joint it hurts.
  • Limited range-of-motion: You can't bend the joint as much as you used to be able to do. You may not be able to completely straighten it or be able to flex it as far as you used to.
  • Crepitus: The joint makes crackling, grinding noise with movement, or you can feel it grinding inside when you move.
  • Joint effusion: There is swelling around the joint as extra fluid moves into the soft tissues.
  • Local inflammation: it is red and warm around the joint, especially compared to the opposite joint that isn't affected.
  • Bony enlargements and osteophyte formation: You develop bumps around the joint.

Gradual or Sudden Onset

While osteoarthritis symptoms usually develop gradually, it is possible for symptoms to appear suddenly, which is also called acutely. For example, symptoms of erosive osteoarthritis and inflammatory osteoarthritis can appear suddenly—with pain, tenderness, and swelling present. In addition, osteoarthritis symptoms can develop more rapidly in a joint that was previously injured.

You may not have been having pain or swelling of a joint, but after you spend a longer than usual time at a physical activity or sport stressing the joint, you may have a sudden development of symptoms.

For example, you have only rarely been having some knee pain in a knee that previously had surgery. But the day after going on a long hike or running a half marathon you experience swelling, stiffness, crackling, lock-up and pain in that knee. You go to a doctor to rule out an acute injury but after medical examination and X-ray, it is diagnosed as knee osteoarthritis.

The physical activity didn't cause you to develop osteoarthritis overnight, it had been developing gradually with milder symptoms. But the activity triggered a worsening of the symptoms so you noticed them and sought medical help.

Osteoarthritis Onset Typically Begins With Joint Pain

Gradual osteoarthritis onset usually begins with one or a few joints. The earliest and primary symptom of osteoarthritis is ​joint pain often described as a deep ache rather than sharp pain. It's important to recognize early symptoms of osteoarthritis—whether the onset of those symptoms is sudden or gradual.

Was this page helpful?
5 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.
  1. Osteoarthritis (OA). Centers for Disease Control and Prevention. January 2019.

  2. Osteoarthritis. National Institute of Health. May 2017.

  3. Limited range of motion. US National Library of Medicine. August 2018.

  4. Ferrazzo KL, Osório LB, Ferrazzo VA. CT Images of a Severe TMJ Osteoarthritis and Differential Diagnosis with Other Joint Disorders. Case Rep Dent. 2013;2013:242685.  doi:10.1155/2013/242685

  5. Post-traumatic arthritis. Cleveland Clinic. October 2014.

Additional Reading
  • Primer of the Rheumatic Diseases. Edition 13. Published by the Arthritis Foundation.