The stages of osteoarthritis of the knee Osteoarthritis is a common form of arthritis that often affects the knee. In the first stage, symptoms are mild, but by the fourth, a person may need urgent medical care. Stages : OA of the knee takes several years to develop, and it progresses in stages. Stage 1: Minor Small lumps of bone called osteophytes may grow in the knee area. There may be slight damage to the cartilage. There will be no apparent narrowing of the space between the bones to indicate that the cartilage is breaking down. People with stage 1 OA are unlikely to feel pain or experience discomfort. The joint will appear normal on an X-ray. Stage 2: Mild During this stage, a person may start to notice symptoms, and doctors can see some signs of wear. X-rays and other scans of the knee joints will clearly show more osteophyte growth, and the cartilage will begin to thin. The space between the bones will still appear normal, but the area where the bones and the tissues meet will start to harden. When the tissues harden, this makes the bone thicker and denser. A thin layer of bone will also develop beneath the cartilage in the joints. The person may experience stiffness or joint pain. The area around the knee joint may start to feel particularly stiff and uncomfortable after a person has been sitting for extended periods. Though there may be some minor damage, the bones are not rubbing or scraping against each other. Synovial fluid is present, and it helps to reduce friction and support the movement of the knee. Stage 3: Moderate The damage to the cartilage has progressed, the gap between the bones has narrowed, and X-rays will show cartilage loss. Pain and discomfort may occur while performing daily activities, such as running, walking, kneeling, and bending. There may be early signs of joint inflammation. As OA progresses, the cartilage will continue to thin and break down. The bones will respond by thickening and growing outward to form lumps. The tissue that lines the joint will become inflamed, and it may produce extra synovial fluid, resulting in increased swelling. This is called synovitis, and it is commonly known as water on the knee. Stage 4 - Severe This is the most advanced stage of OA, and the symptoms are very visible. The space between the bones in the joint has continued to narrow, causing the cartilage to break down further. As a result, there is stiffness in the joint, constant inflammation, and less fluid around the joint. There is more friction in the joint and more significant pain and discomfort while moving. X-rays will show bone on bone, meaning that either the cartilage has completely worn away or there is very little left. The individual will likely develop more bone lumps and experience pain that is often intense during simple activities, such as walking. In severe cases, the bones may become deformed and angulated because of asymmetric loss of cartilage. Most common and safe line of treatment at any stage is Physiotherapy. Physiotherapy heals the pain, subsides inflammation, reduced pain and stiffness and discomfort. Advanced Electrotherapy Machines can render pain relief for a very very long time. We at Dr Paiwal's Physiotherapy Clinic treating such painful knees since 2007.