Osteoarthritis After 50: Symptoms, Diagnosis & How to Manage It

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Originally published August 14, 2017. Reviewed & Updated August 28, 2026.
By Helen Chow, ND, Dip Herb, UK-qualified Naturopath & Herbalist, Food Therapist

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If your knees feel stiff when you first stand up, your fingers seem less flexible than they used to be, or your hips begin aching after a long walk, it can be tempting to dismiss it as simply “getting older”.

But joint pain deserves a little more attention than that.

One possible cause is osteoarthritis (OA) — the most common type of arthritis in the UK.

Osteoarthritis becomes more common with age, particularly after 45, but it is not simply an inevitable consequence of getting older.

And it is certainly not a signal that you should stop moving.

In fact, one of the most important things we now know about osteoarthritis is that the right kind of movement and strengthening exercise form a central part of its management.

So what exactly is osteoarthritis, how can you recognise it, and what can you do if it starts interfering with your life?

Let’s look at it properly.
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What Is Osteoarthritis?

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Osteoarthritis is a condition affecting the whole joint.

It was once commonly described as straightforward “wear and tear”, as though your joints were simply mechanical parts gradually wearing out.

That description is now considered much too simplistic.

Arthritis UK explains that osteoarthritis involves an active process within living joint tissues. Cartilage can become thinner and rougher, changes may occur in the bone beneath it, and the tissues surrounding the joint can also be affected.

Your body continually attempts to maintain and repair your joints. Osteoarthritis develops when that process stops working as effectively as it should.

The joints most commonly affected include the:

knees
hips
small joints of the hands
spine
big toes

The NHS overview of osteoarthritis explains that symptoms vary enormously. Some people have relatively mild, intermittent symptoms, while others develop persistent pain and significant restrictions in everyday activities.

That means an osteoarthritis diagnosis does not automatically tell you how disabled, painful or limited you will become.
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What Does Osteoarthritis Feel Like?

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The two classic symptoms are:
Joint pain and Joint stiffness

But osteoarthritis can present in several ways.

You may notice:

pain during or after using a joint
stiffness after sitting or resting
morning stiffness
reduced range of movement
tenderness
occasional swelling
weakness around the joint
a grating, cracking or crunching sensation called crepitus
difficulty with activities such as stairs, walking or opening jars

Crepitus by itself does not necessarily mean that your joint is badly damaged. Noisy joints can occur without significant disease.

A more useful question is:
What is the joint preventing you from doing?

Pain, stiffness and loss of function matter more than simply hearing a click or crack.

If you are unsure whether the discomfort you are experiencing looks like osteoarthritis or something else, first read Joint Pain After 50: What’s Normal, What’s Not & When to Get Help.

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How Is Osteoarthritis Diagnosed?

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This may surprise many people:
You do not necessarily need an X-ray or MRI scan to diagnose typical osteoarthritis.

Current NICE osteoarthritis guidance NG226 says osteoarthritis can usually be diagnosed clinically in people who:

are aged 45 or over
have activity-related joint pain
have no morning joint stiffness, or stiffness lasting no longer than 30 minutes

Imaging is not routinely necessary unless there are unusual features or another diagnosis needs to be considered.

This matters because changes visible on an X-ray and the amount of pain a person experiences do not always match neatly.

Someone can have considerable structural change with relatively little pain, while another person may experience substantial symptoms despite comparatively modest changes on imaging.

Treatment should therefore be based heavily on your symptoms and what you can actually do, not simply what an X-ray looks like.
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Osteoarthritis or Another Type of Joint Problem?

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Not every painful joint after 50 is osteoarthritis.

This distinction is extremely important.

For example, prolonged morning stiffness ~ particularly lasting considerably longer than 30 minutes ~ may point towards an inflammatory condition such as rheumatoid arthritis rather than typical osteoarthritis.

Seek medical assessment if you have symptoms such as:

a joint that becomes hot and markedly swollen
rapidly worsening symptoms
significant unexplained swelling
prolonged morning stiffness
severe sudden joint pain
fever or feeling generally unwell with a painful joint
pain after a significant injury
an inability to put weight through a joint
unexplained progressive deformity

The NHS joint-pain guidance recommends urgent assessment particularly when a painful joint is hot and swollen and you also feel unwell or feverish.

Do not automatically label persistent joint pain “arthritis” and attempt to treat it yourself.

First find out, as far as possible, what is causing it.

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**What Actually Helps ‘Heal’ Osteoarthritis?**

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There is currently no treatment that simply makes osteoarthritis disappear.

But that does not mean there is nothing you can do.

Modern management is far more constructive than “take a painkiller and learn to live with it”.

NICE identifies three foundations:
information and support, therapeutic exercise, and weight management where appropriate.

Let’s look at those ~ and the other ~ options individually.
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1. Exercise Is a Treatment, Not an Optional Extra

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When a joint hurts, instinct often tells us to protect it by using it less. A short period of modification may sometimes be sensible. But long-term avoidance of movement can produce exactly what we do not want:
weaker muscles, increasing stiffness and declining function.

NICE recommends therapeutic exercise for everyone with osteoarthritis, individually adapted according to their needs.

That can include:

strengthening the muscles surrounding the affected joint
aerobic exercise
mobility work
balance work
gradually increasing everyday physical activity

Importantly, NICE also advises that discomfort can temporarily increase when someone begins therapeutic exercise.

That does not automatically mean the joint is being damaged. With regular, appropriately progressed exercise, pain can decrease and physical function and quality of life can improve.

For practical guidance, review How to Stay Active After 50: Strength, Balance, Mobility & Independence.

And if the knee is your main problem area, read How to Take Care of Your Knees After 50.

Strength matters particularly.

Strong muscles help support a joint. For knee osteoarthritis, for example, strengthening the muscles around the knee can improve function and make normal movement easier.

You do not have to start with heavy weights. Depending on your current condition, strengthening might begin with:

sit-to-stand exercises
resistance bands
light weights
supported squats
controlled step exercises
exercises prescribed by a physiotherapist

The important words are appropriate and progressive. Doing nothing because you are frightened of damaging the joint can eventually be more limiting than carefully rebuilding its capacity.
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2. Keep Moving Between Exercise Sessions

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Formal exercise is useful. But so is ordinary movement.

Walking to the shops, moving around the house, gardening, swimming, climbing stairs when comfortable and regularly changing position all help prevent life from becoming increasingly sedentary.

This is particularly important because pain can create a vicious circle:
pain → less movement → weaker muscles → poorer function → more difficulty moving.

Your objective is to interrupt that cycle.

You can explore additional approaches in Joint Pain Relief After 50: What Actually Helps?.

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3. Manage Your Weight ~ If Weight Is Actually an Issue for You

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This recommendation is specifically relevant to people living with overweight or obesity. It is not an instruction that everyone with osteoarthritis should become thinner.

For weight-bearing joints such as the knees and hips, excess body weight can increase mechanical loading and contribute to symptoms.

NICE advises that for people with osteoarthritis who are overweight or obese, any amount of weight loss is likely to be beneficial, while around 10% body-weight reduction is likely to produce greater benefit than 5%.

The purpose is not cosmetic. The objective is:

reduced pain
better physical function
improved quality of life
less load on painful weight-bearing joints

At Health Sifu, we will return to weight and body composition separately because after 50 the objective should never be indiscriminate weight loss at the expense of muscle.

We want less unnecessary load while protecting strength.
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4. Learn to Pace Activity ~ Without Becoming Inactive

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There is a difference between pacing yourself and avoiding life.

Suppose your knee feels good one morning: You clean the house, go shopping, garden for two hours and then take a long walk. By evening your knee is throbbing. The next day you can barely move.

This “boom and bust” pattern can make managing chronic joint symptoms much harder.

Instead, learn how much activity your joint currently tolerates and distribute demanding tasks more intelligently.

You might:

divide a large job into several smaller ones
alternate heavier and lighter activities
take short planned rests
vary your movement rather than remaining in one position
gradually expand your capacity over time

The objective is not to do less forever. It is to build a level of activity you can sustain.

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5. Heat or Cold May Help Symptoms

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Simple measures still have a place.

The NHS osteoarthritis treatment guidance notes that some people find hot or cold packs helpful for relieving symptoms.

Warmth may feel particularly soothing for stiffness.
Cold can sometimes help when a joint feels swollen or irritated.
Always protect the skin rather than applying extreme heat or ice directly.

Neither treatment reverses osteoarthritis, but symptom relief can make movement and daily activities easier.
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6. What About Taking Pain Medication?

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Medication can be useful when pain is preventing you from moving, sleeping or functioning normally. However, medication is generally intended to support function and exercise, rather than replace them.

Current NICE guidance recommends a topical non-steroidal anti-inflammatory drug (NSAID) for knee osteoarthritis and says one can be considered for osteoarthritis in other joints.

If topical treatment is inadequate or unsuitable, an oral NSAID may sometimes be considered after taking account of gastrointestinal, kidney, liver and cardiovascular risks as well as other medication and medical conditions.

That is important after 50, when people are more likely to be taking other medicines or living with several health conditions.

Do not assume that because an anti-inflammatory medicine can be bought without prescription it is automatically suitable for you. Ask your pharmacist, GP or other appropriate healthcare professional when in doubt.
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7. What About Injections?

This is an area where recommendations have changed ~ and it is particularly relevant to the old version of this Health Sifu article.

NICE says intra-articular corticosteroid injections may sometimes be considered when other medication is unsuitable or ineffective, or when short-term pain relief could help someone participate in therapeutic exercise.

But the expected benefit is short term.

NICE advises that relief typically lasts around 2–10 weeks. Importantly, NICE recommends against intra-articular hyaluronan injections for osteoarthritis.
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8. What About Glucosamine, Acupuncture and Other Popular Treatments?

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All of us, understandably, look for alternatives when persistent joint pain interferes with life. But “natural”, popular or expensive does not automatically mean effective.

Current NICE guidance:

does not recommend glucosamine for osteoarthritis
does not recommend acupuncture or dry needling specifically for osteoarthritis
does not recommend several electrotherapy treatments, including TENS, as osteoarthritis treatments because of insufficient evidence of benefit

That does not mean every person who has ever used one of these approaches felt no benefit. It means the available evidence is not strong enough for NICE to recommend them as osteoarthritis treatments.

This is an important distinction.
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And…What About Food, Herbs and Supplements?

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Nutrition matters enormously for overall health, metabolic health, muscle and bone ~ all of which influence how well we function as we age.

But we should distinguish between: supporting health and claiming that a particular food rebuilds an osteoarthritic joint. Those are not the same thing.

A good-quality diet supplying sufficient protein and essential micronutrients supports muscle, bone and general health. Some foods and dietary patterns may also influence inflammatory processes.

But there is currently no particular food, broth or supplement that can legitimately be promised to “cure” osteoarthritis.

As an herbalist, I am very interested in what complementary approaches can genuinely contribute. But I am equally interested in separating plausible or evidence-supported help from exaggerated claims.

We will explore food, herbs and complementary approaches separately in other articles in this site.
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When Would Surgery be Considered?

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Most people with osteoarthritis do not automatically progress to joint replacement.

However, surgery can become appropriate when symptoms substantially impair your quality of life and well-conducted non-surgical management is no longer adequate.

NICE recommends considering referral for joint replacement when pain, stiffness, reduced function or progressive deformity are substantially affecting quality of life and non-surgical options have been ineffective or unsuitable.

For someone whose life has become severely restricted, a hip or knee replacement can produce a major improvement in mobility and quality of life.

Surgery is therefore neither something to rush towards nor something to regard automatically as failure.

It is one possible tool when the circumstances justify it.
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Having Osteoarthritis Does Not Mean “Stop Using the Joint”

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Perhaps this is the most important message of the entire article.

An osteoarthritis diagnosis does not mean:
“My joint is worn out, so I’d better use it as little as possible.”

That belief can gradually take away your strength, confidence and independence.

A much more constructive interpretation would be:
“This joint needs intelligent management.”

That may mean:

understanding what is causing the symptoms
strengthening the muscles supporting the joint
moving regularly
adjusting activities temporarily when symptoms flare
managing weight when relevant
using appropriate pain relief when necessary
working with a physiotherapist or clinician when needed
gradually rebuilding what your body can do

The objective is not merely to make an X-ray look different. The objective is to help you move, function and live well.

Your joints are part of the body that carries you through your life. Look after them ~ but don’t become frightened of using them.
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Health Sifu Joint Health Series

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If joint pain is beginning to affect your life, read these:

References & Further Reading

Health Sifu Medical Disclaimer

This article is for educational and informational purposes and is not intended to diagnose or treat any medical condition. Joint pain can have many causes. Seek advice from an appropriately qualified healthcare professional for diagnosis and treatment, particularly if symptoms are persistent, severe, rapidly worsening or associated with swelling, heat, fever or general illnes