Aging or osteoarthritis: which is the problem?

OA is not an inevitable consequence of aging, but aging-related changes in the musculoskeletal system increase the risk of developing OA if other risk factors are also present. The joint is a functioning biomechanical unit of the neuromuscular system. Factors that contribute to the development of joint pain and loss of joint function include those associated with aging, those associated with underuse or misuse of the musculoskeletal system, and those associated directly with the development of OA. Complex interactions exist among many of these factors such as strength, balance, and proprioception, which are affected by aging, underuse, and OA. Many older adults who have joint pain and loss of function do not exhibit structural changes of OA that can be detected by standard radiography. When structural damage is present, its contribution to pain and disability is not always clear. In the absence of pharmacologic agents that can prevent the progression of structural damage in OA, management of older adults who have joint pain and loss of function should focus on improving neuromuscular function and preventing further declines.