Is Arthritis Really to Blame?

When someone has joint pain, they often say, “It’s just arthritis.”

But what really is arthritis?

The most common type is called osteoarthritis. Osteoarthritis happens when the tissues inside a joint change over time. The cartilage, which helps cushion the joint, can wear down. The joint may also become stiff or swollen (1, 4).

Many people think that if an X-ray shows arthritis, then the arthritis must be causing the pain.

But that is not always true.

Studies have shown that many people have arthritis on imaging and feel no pain at all. One large review found that signs of osteoarthritis on MRI were very common in people who had no symptoms (2).

Another research review found that imaging changes do not always match how a person feels. Some people have a lot of arthritis on imaging and little pain, while others have pain with only small changes on imaging (3, 4).

So what does this mean?

It means we should not only look at pictures of the body. We also need to look at how the body moves and functions.

At our office, we often find that the real problem is not where the pain is felt.

For example, someone may have pain on the outside of the hip. Many times, this is related to irritation of the hip tendons and muscles. But the reason the hip hurts may actually come from poor balance or weakness at the ankle. If the ankle is unstable, the hip muscles may need to work too hard. Over time, that extra stress can lead to pain.

An X-ray cannot show that kind of movement problem.

That is why a full functional exam is so important. We want to find out why the body is under stress, not just what an image looks like.

If you are in pain, we would love to help you.

Please call us at 717-766-5406 to see how we can help you.

References

  1. National Institute of Arthritis and Musculoskeletal and Skin Diseases. (n.d.). Osteoarthritis. U.S. Department of Health and Human Services, National Institutes of Health. Retrieved May 23, 2026, from NIAMS Osteoarthritis Overview

  2. Culvenor, A. G., Øiestad, B. E., Hart, H. F., Stefanik, J. J., Guermazi, A., & Crossley, K. M. (2019). Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(20), 1268–1278. https://doi.org/10.1136/bjsports-2018-099257

  3. Felson, D. T. (2011). Imaging abnormalities that correlate with joint pain. British Journal of Sports Medicine, 45(4), 289–291. https://doi.org/10.1136/bjsm.2010.081554

  4. Roemer, F. W., Demehri, S., Omoumi, P., Link, T. M., Kijowski, R., Saarakkala, S., Crema, M. D., Hayashi, D., & Guermazi, A. (2022). State of the art: Imaging of osteoarthritis—Revisited 2022. Osteoarthritis and Cartilage, 30(7), 913–934. https://doi.org/10.1016/j.joca.2022.02.898