What Is Primary Osteoarthritis?

You may be under the assumption that all cases of arthritis are the same, however, quite the opposite is true. There are many different varieties of arthritis and each has its own specific characteristics. Osteoarthritis (OA), the most common form, can occur on its own (called primary arthritis) or as the result of another injury or disease (called secondary arthritis). The info below can help differentiate the two and clarify which version you may have. 

Middle-aged woman suffering from pain in leg at home, sitting on a yoga mat, clutching her hurt knee

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How Osteoarthritis Develops

Cartilage is a firm, but flexible tissue that covers the ends of the bones in your body. When two (or more) bones meet at a joint, the cartilage tissue helps absorb the forces that are transmitted through the area and reduce the amount of friction that occurs.

Osteoarthritis is the process by which inflammation or injury causes the body’s cartilage to wear down or thin in a particular joint. This degeneration, which usually occurs gradually over time, can alter the way your joint moves and increase the rubbing or friction in the area. In addition, the body responds to increased friction by building up excess bone in the joint which can further impede or alter your movement.

Is Osteoarthritis an Autoimmune Disease?

Some forms of arthritis, like rheumatoid or psoriatic, are considered autoimmune diseases. In these varieties, a faulty immune system response causes your body to attack its own healthy cells in many different areas and joints. Osteoarthritis is not an autoimmune disease.

Primary vs. Secondary Osteoarthritis

As mentioned above, even osteoarthritis itself has several different variations:

  • Primary osteoarthritis refers to degenerative changes to the cartilage and joint that occur without a known cause. These arthritic changes are idiopathic, meaning they arise spontaneously and cannot be directly attributed to another issue or condition.
  • Secondary osteoarthritis occurs when a previous injury or pre-existing condition causes arthritis in a joint. For example, repetitive injuries or those that occur while playing sports can cause secondary osteoarthritis to develop in the affected joint later in life. Certain inflammatory diseases, like rheumatoid arthritis or gout, can also result in secondary osteoarthritic change.

Symptoms of Primary Osteoarthritis

Primary osteoarthritis causes several different symptoms that can impact your function and affect your ability to perform your daily activities. Most frequently, this condition causes joint pain with activity and at the end of the day after more strenuous tasks.

People with OA also frequently experience:

  • Stiffness in their affected joints, particularly in the morning when they get out of bed. This stiffness usually decreases after the arthritic area is “warmed up” with movement.
  • Limited range of motion at the arthritic joint may be limited and can be accompanied by creaking or popping noises.
  • Swelling around the area that fluctuates based on your activity.
  • Muscle weakness as arthritis progresses.
  • Instability or “giving-way” may also occur if the joints of the leg are affected.

Where Does Osteoarthritis Typically Occur?

While these osteoarthritis symptoms can be present at nearly any joint in the body, some are more frequently impacted than others. Primary osteoarthritis is most commonly seen in the:

  • Fingers and thumbs
  • Spine
  • Hips
  • Knees
  • Big toes


Almost anyone can be afflicted by osteoarthritis. That said, there are several things that can make it more likely to develop including:

  • Females, particularly those who are postmenopausal
  • Individuals in their middle ages
  • Those with a family history of osteoarthritis
  • People who regularly perform repetitive tasks at work

Those who participate in higher impact sporting activities may also be susceptible, though the research on this is still not definitive.

Risk Factors

Several risk factors can also elevate your chances of getting osteoarthritis. This include:

  • People who are obese
  • Individuals with elevated cholesterol levels
  • Those with diabetes

Each of these conditions can increase the body’s inflammatory response and impact the force absorption of the cartilage in your joints.


Several different tools can be used to diagnose osteoarthritis. Most commonly, an X-ray is used to confirm the condition’s presence. Using this type of imaging, a healthcare provider can detect:

  • Decreased space between the bones of a joint (an indicator of cartilage deterioration)
  • New boney growth (also known as osteophytes or bone spurs)
  • The hardening of the boney layer just under the cartilage (called subchondral sclerosis), which is seen in advanced OA case

In other instances, an MRI may also be useful. Because this form of imaging allows the joint to be seen in much higher definition, early osteoarthritic changes may be more easily viewed, and changes to the cartilage can be better tracked over time.


Osteoarthritis is a disease that is managed, rather than cured. Treatment methods include:

  • Regular aerobic activity and strengthening exercises: This can reduce your symptoms by promoting joint health and lending support to the affected areas of your body. Staying active can also help you lower your body weight and reduce the stress placed on your arthritic joints.
  • Physical therapy: This can help improve your overall strength and flexibility and guide your return to exercise.
  • Hot/cold packs: Hot packs can be used to improve joint stiffness and cold packs can help with the soreness you may be feeling.
  • Medication: Your healthcare provider may also suggest taking over-the-counter (OTC) or prescription pain medication. In some cases, a pain-relieving steroid injection can also be administered to alleviate the pain.

Unfortunately, conservative treatment is not always enough and in some cases surgery is necessary. This option is usually reserved for advanced cases of osteoarthritis that significantly limit your function and cause high amounts of pain. In this situation, the surgeon usually performs a joint replacement operation where the arthritic surfaces of the joint are replaced with prosthetic pieces.


The best way to keep osteoarthritis from limiting the activities you love is to stop it from happening in the first place. Some risk factors, such as age, family history, and gender, cannot be changed. The key to preventing osteoarthritis is to address the risk factors that can be modified.

One of the biggest means of prevention is maintaining a healthy body weight. Every extra pound you carry is an extra pound of stress on your joints with each step you take. Working with your healthcare provider or a nutritionist to reach a healthy body weight can help avoid osteoarthritis from developing.

In addition, it is also important to keep your cholesterol in a healthy range and to monitor your blood sugars to avoid diabetes. Staying on top of these important lab values can help you prevent excess inflammation in the body and maintain healthy cartilage.


Staying active is the key to coping with osteoarthritis. Not only can regular exercise help alleviate the pain associated with OA, but it can also help mobilize your stiff joints. A well-rounded exercise program should include:

  • Strengthening exercises
  • Stretches
  • Cardio activities (like walking, biking, or using the elliptical)

Pool exercises can also be quite useful as they tend to decrease the stress that is placed on your arthritic joints. Finally, balance exercises or yoga can be incorporated into your routine to build strength in your leg and ankle muscles. Ideally, each variety of exercise should combine to equal at least 150 minutes of activity per week.

A Word From Verywell

Osteoarthritis can be frustrating to deal with, however, there are usually many different treatment options that can help alleviate your symptoms. If you suspect you may have OA, it is important to speak to your healthcare provider. After a thorough evaluation, your healthcare provider can help you design a treatment plan that is tailored to your individual situation. The quicker you address the problem, the faster you can return to doing the things you love! 

3 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. Cleveland Clinic. Osteoarthritis.

  2. Arthritis Foundation. Osteoarthritis.

  3. Glyn-Jones S, Palmer AJ, Agricola R, et al. Osteoarthritis. Lancet. 2015;386(9991):376-387. doi:10.1016/S0140-6736(14)60802-3

By Tim Petrie, DPT, OCS
Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade.