What Causes Osteoarthritis? Understanding Key Risk Factors and Prevention Strategies

Osteoarthritis (OA) isn't just "wear and tear" — it's a complex, progressive joint disorder influenced by multiple interconnected biological, mechanical, and lifestyle factors. While aging plays a role, OA is not an inevitable part of getting older. Identifying and managing modifiable risk factors early can significantly slow disease progression, improve joint function, and enhance long-term quality of life.

Excess Body Weight: One of the Most Significant Modifiable Risks

Carrying extra weight dramatically increases your risk of developing osteoarthritis — especially in weight-bearing joints like the knees, hips, and spine. Research shows that individuals with obesity are up to four times more likely to develop knee OA compared to those at a healthy weight. This risk is even higher among women, partly due to differences in joint alignment, muscle distribution, and hormonal influences on cartilage metabolism.

Beyond simple mechanical stress, excess adipose tissue acts as an active endocrine organ — releasing pro-inflammatory cytokines like interleukin-6 (IL-6) and leptin. These molecules contribute directly to cartilage breakdown and synovial inflammation, accelerating joint degeneration from within. That's why weight management isn't just about reducing pressure on joints — it's about calming systemic inflammation.

Age-Related Joint Changes: More Than Just Time Passing

While osteoarthritis prevalence rises sharply after age 45, aging itself doesn't cause OA — rather, it reduces the joint's natural resilience. Over decades, chondrocytes (the cells responsible for maintaining cartilage) become less efficient at repairing micro-damage. Collagen structure weakens, proteoglycan content declines, and synovial fluid production diminishes — all compromising shock absorption and lubrication.

Importantly, many older adults maintain healthy, pain-free joints well into their 70s and 80s. This underscores that chronological age is only one piece of the puzzle — genetics, lifelong activity patterns, nutrition, and metabolic health play equally vital roles.

Joint Overuse, Injury, and Repetitive Stress

Sports Injuries and Post-Traumatic OA

A prior joint injury — such as an ACL tear, meniscus rupture, or recurrent ankle sprain — increases the likelihood of developing OA in that joint by 3–6 times within 10–15 years. Even seemingly minor injuries can disrupt joint biomechanics, alter load distribution, and trigger low-grade, persistent inflammation that silently degrades cartilage over time.

Occupational and Lifestyle Strain

Jobs or hobbies involving frequent kneeling, squatting, heavy lifting, or prolonged standing place cumulative stress on specific joints. For example, construction workers face elevated hip and knee OA risk; dancers and runners may experience earlier onset in ankles or feet. The key isn't avoiding movement — it's optimizing movement quality, incorporating strength training, and allowing adequate recovery to prevent repetitive microtrauma.

Understanding these root causes empowers proactive care. Whether through personalized exercise programs, nutritional support for joint health, or early intervention after injury, evidence-based strategies exist to protect your joints — starting today.