The starting point of every osteoarthritis is a damage of the cartilage, the so-called “cartilage damage” (chondropathy). This damage is often restricted to a small area and usually superficial. Shortly afterwards first density changes of the bone can be found in the XRays.

In this case these are always affected bone areas that are lying directly beneath the affected cartilage (sclerosis). These additional changes in the bones are a key sign of the early stages of osteoarthritis. Without these changes in the bones it is only a “cartilage damage” and not a “osteoarthritis”. Osteoarthritis is therefore always a cartilage damage with changes in the bones.


Stage I: Chondromalacia

Stage II: Superficial cartilage damage

Stage III: Deeper cartilage damage

Stage IV: Cartilage loss, osteophyte formation (bony extensions)


  • Gonarthrosis: knee arthritis 
  • Coxarthrosis: hip arthritis
  • Omarthritis: shoulder arthritis
  • Rhizarthritis: thumb arthritis
  • Heberden’s node: arthritis in the finger’s end joint
  • Bouchard arthritis: arthritis in the finger’s middle joint

Treatments of arthritis

  • conservative therapy: physical therapy and
    manual therapy treatment
  • surgical treatment: surgery with joint replacement
  • medicamental therapy: nonsteroidal antirheumatica
    to ease the pain
  • prevetion: condrosulf, green-lipped mussel extract

Manualtherapeutic interventions deal with the preservation and improvement of joint mobility and physiotherapy exercises that help to strenghten and coordinate perarticularly muscles (the ones surrounding the joint). Strong muscles relieve the degenerative (changed) joint, even if a radiological progession (increased abrasion) is verifiable. Physiotherapy is especially in the arthritis stages I and II an important support.