Osteoarthritis is often described simply as “wear and tear” of the joints. You may also hear that you should avoid moving too much, that pain necessarily means the joint is deteriorating, or that an X-ray can predict what will happen in the future.
In reality, osteoarthritis is a complex condition that can affect the entire joint and the surrounding tissues. It is particularly common in the knees, hands, hips and spine.
Here are 7 common myths about osteoarthritis and what scientific evidence actually tells us.
Myth #1: “Osteoarthritis is simply a worn-out joint”
❌ False: it is much more complex than that
The idea of “wear and tear” is easy to understand, but it is too simplistic.
Osteoarthritis involves the entire joint, including cartilage, bone and surrounding tissues. Comparing it to a mechanical part that gradually wears out does not reflect the biological complexity of the condition.
Several factors can contribute to the development of osteoarthritis, including age, certain genetic factors, previous joint injuries, some joint or metabolic conditions and, for certain joints such as the hip or knee, excess body weight.
➡️ Key takeaway: osteoarthritis is not simply “worn-out cartilage”.
Myth #2: “The worse my X-ray looks, the more pain I should have”
❌ False
Changes seen on imaging and symptoms do not always correspond directly.
EULAR recommendations highlight that abnormalities on imaging are common, particularly with increasing age, and that joint symptoms are not necessarily directly caused by the abnormalities visible on an X-ray. Clinical history and physical examination therefore remain essential.
For typical presentations, NICE guidelines also indicate that osteoarthritis can be diagnosed clinically without routinely using imaging.
➡️ An X-ray can provide useful information, but it does not measure your pain or tell the whole story.
Myth #3: “If I have osteoarthritis, I should avoid moving”
❌ False
Physical activity and appropriate exercise are among the main approaches recommended for managing osteoarthritis.
NICE recommends offering therapeutic exercise adapted to each person's needs, which may include muscle strengthening and aerobic exercise. It also notes that pain or discomfort may temporarily increase when starting an exercise programme, while regular exercise can provide longer-term benefits for pain, function and quality of life.
OARSI also recommends education and structured exercise programmes as important components of non-surgical osteoarthritis management.
➡️ The goal is generally not to stop moving, but to find an appropriate type and level of activity and progress gradually.
Myth #4: “If I have pain, it means I am damaging my joint”
❌ Not necessarily
Pain is important and should always be taken seriously. However, pain intensity is not a direct measurement of the condition of the joint structures.
The lack of a consistent relationship between abnormalities seen on imaging and symptoms is highlighted in EULAR recommendations.
NICE also points out that pain or discomfort may temporarily increase when someone starts therapeutic exercise, while emphasising the potential long-term benefits of regular and appropriate physical activity.
This does not mean that a new, severe or unusual pain should be ignored.
➡️ A temporary increase in symptoms does not automatically mean that the joint is deteriorating. Context matters.
Myth #5: “Osteoarthritis only affects older people”
❌ False
The prevalence of osteoarthritis increases with age, but it can also affect younger people, particularly following certain joint injuries or trauma.
According to the World Health Organization, osteoarthritis typically develops from the late 40s to the mid-50s, but it can also affect younger people, including athletes and people who have previously experienced a joint injury.
The WHO also highlights that several different factors can contribute to the development of osteoarthritis.
➡️ Age is therefore one factor among many, and getting older does not automatically mean developing osteoarthritis.
Myth #6: “Once I have osteoarthritis, it will inevitably get worse”
❌ Not necessarily
The progression of osteoarthritis, and particularly the progression of symptoms, can vary considerably from one person to another.
It is not possible to accurately predict a person's future pain based on a single X-ray. EULAR recommendations highlight that symptoms are not always directly related to the abnormalities observed on imaging.
This does not mean that osteoarthritis can never progress. The WHO describes osteoarthritis as a chronic condition that can progressively develop over time.
However, the clinical course, pain and functional abilities remain highly individual.
➡️ A diagnosis of osteoarthritis alone cannot accurately predict your future.
Myth #7: “There is nothing I can do except wait”
❌ False
Although there is currently no treatment that can completely eliminate osteoarthritis, there are many options available to help manage symptoms and maintain or improve physical function.
Appropriate therapeutic exercise is a central component of the NICE recommendations. Education and structured exercise programmes also play an important role in OARSI recommendations.
Depending on the situation, management may also include other interventions. Joint replacement surgery may be considered in some cases when symptoms have a significant impact on quality of life and non-surgical options have been ineffective or are not appropriate.
➡️ Having osteoarthritis does not mean that you simply have to wait for the condition to get worse.
Can osteoarthritis affect any joint?
Osteoarthritis can affect different joints. It is particularly common in:
🦵 The knees
Pain, stiffness and functional difficulties can affect walking and certain everyday activities.
🦴 The hips
Symptoms may be felt around the hip, including in the groin or thigh, depending on the individual situation.
✋ The hands
Different joints of the fingers and thumb can be affected.
🦶 The feet
Certain joints in the foot can also develop osteoarthritis.
🦴 The spine
Degenerative changes can be observed in different spinal structures. As with other areas of the body, the presence of abnormalities on imaging alone does not determine the exact cause of pain.
So, what influences osteoarthritis symptoms?
The condition of the joint is an important part of the picture, but a person cannot be reduced to their X-ray.
A comprehensive assessment takes into account symptoms, how they have changed over time, functional abilities, physical activity and the impact of pain on everyday life.
EULAR recommendations also emphasise the importance of clinical history and examination before deciding whether additional investigations are necessary.
🦴 The joint
Structural changes are one part of the overall clinical picture.
💪 Physical capacity
Strength, endurance and functional abilities can influence everyday activities.
🚶 Physical activity
Activity levels and changes in physical demands can influence symptoms.
😴 Recovery
Sleep and recovery can influence the overall experience of pain.
🧠 The experience of pain
Pain is a complex experience that cannot be explained by a single image or a single structure.
Two people with similar joint changes may therefore experience very different symptoms and limitations.
What is the role of a chiropractor?
When someone presents with joint pain, a chiropractic consultation begins with an individual assessment.
The aim is to understand, among other things:
- your symptoms and how they have changed;
- which movements or activities are difficult;
- your mobility and functional abilities;
- how the pain affects your everyday life.
Depending on the situation, care may include advice regarding movement and physical activity, appropriate techniques when relevant, and referral to another healthcare professional when necessary.
The goal is not to claim to “cure” osteoarthritis or to eliminate changes visible on an X-ray.
Instead, the aim is to support each individual according to their symptoms, physical capacity and personal goals.
🧠 Key Takeaways
Osteoarthritis is a complex condition.
An X-ray does not measure your pain and cannot, on its own, predict your future.
Having osteoarthritis does not automatically mean that you should stop moving or simply wait for inevitable deterioration.
Current recommendations place an important emphasis on education, physical activity and appropriate exercise, as part of an individualised approach to management.
Understanding osteoarthritis can therefore be just as important as understanding the changes seen on an X-ray.
Osteoarthritis is not simply “wear and tear”, and a diagnosis does not define what you will be able to do in the future.