Osteoarthritis pain and x-rays 

X-rays and pain

Professor Kim Bennell, physiotherapist 

Now we know that what you see on x-ray doesn't reflect the amount of pain that you'll have all your function. So, people can have an x-ray that looks terrible but experience little pain and vice versa. So, someone will have a lot of pain and a lot of physical dysfunction and yet their x-ray is fairly mild. So, we don't treat the x-ray we treat the person. 

Professor David Hunter, rheumatologist 

At best osteoarthritis may manifest just as a structural change on an image such as an x-ray and a person may not have any pain or limited function as a consequence of that. So, just to paraphrase that, about fifty percent of people that have  structural change on an x-ray will not have  any symptoms related to the joint that's affected.  At worst a person may present with complete pain and loss of function as a consequence of their joint disease. Specifically pain at rest, pain while their trying to sleep, that is obviously severely disabling as a consequence of that.  

Matthew Williams, physiotherapist 

We also hear a lot about people indicating they've got bone on bone severity of their arthritis on x-rays and different types of scans and therefore they must have an operation. This is another myth regardless of the severity of the osteoarthritis on scans people can still derive significant benefits in pain function and their quality of life.